Diagnosis and treatment of subchondral bone insufficiency fracture of the knee joint: case series

Authors

  • Koshman Gennadiy Department of Traumatology, Orthopedics and Military Surgery of the educational Institution, Grodno State Medical University, Grodno, Belarus
  • Eshwar Ravindrakumar Faculty of Foreign Students, Grodno State Medical University, Grodno, Belarus
  • Dasun I. A. Jayasooriya Patabadege Faculty of Foreign Students, Grodno State Medical University, Grodno, Belarus
  • Prithvi Akaash Dineshkumar Faculty of Foreign Students, Grodno State Medical University, Grodno, Belarus
  • Mariyam Mihasha Faculty of Foreign Students, Grodno State Medical University, Grodno, Belarus

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20242398

Keywords:

SIFK, Spontaneous osteonecrosis of the knee joint, Stress fracture, Osteoporosis, Osteopenia, Osteoarthritis

Abstract

Subchondral insufficiency fracture of the knee (SIFK) is a stress fracture that happens under the cartilage usually due to repetitive stress to the bone which is already weakened by non-cancerous diseases which impacts the bone strength and fragility. SIFK is a new nosologic entity that has replaced the diagnosis of spontaneous osteonecrosis of the knee. Primary avascular necrosis of the femoral condyles is a differential diagnosis of subchondral fracture of bone insufficiency of the knee joint, which requires a different approach to treatment. The aim of our study was to evaluate the effectiveness of conservative treatment of subchondral bone insufficiency fracture of the knee joint (SIFK).

References

Ahlbäck S, Bauer GC, Bohne WH. Spontaneous osteonecrosis of the knee. Arthritis Rheum. 1968;11(6):705-33.

Yamamoto T, Bullough PG. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. J Bone Joint Surg Am 2000;82(6):858-66.

Kidwai AS, Hemphill SD, Griffiths HJ. Radiologic case study. Spontaneous osteonecrosis of the knee reclassified as insufficiency fracture. Orthopedics. 2005;28(3):236.

Hussain ZB, Chahla J, Mandelbaum BR, Gomoll AH, LaPrade RF. The role of meniscal tears in spontaneous osteonecrosis of the knee: a systematic review of suspected etiology and a call to revisit nomenclature. Am J Sports Med. 2019;47(2):501-7.

Hatanaka H, Yamamoto T, Motomura G, Sonoda K, Iwamoto Y. Histopathologic findings of spontaneous osteonecrosis of the knee at an early stage: a case report. Skeletal Radiol. 2016;45:713-6.

Tanaka Y, Mima H, Yonetani Y, Shiozaki Y, Nakamura N, Horibe S. Histological evaluation of spontaneous osteonecrosis of the medial femoral condyle and short-term clinical results of osteochondral autografting: a case series. Knee. 2009;16(2):130-5.

Takeda M, Higuchi H, Kimura M, Kobayashi Y, Terauchi M, Takagishi K. Spontaneous osteonecrosis of the knee. J Bone J Surg Br. 2008;90(3):324-9.

Mac Dessi SJ, Brophy RH, Bullough PG, Windsor RE, Sculco TP. Subchondral fracture following arthroscopic knee surgery a series of eight cases. J Bone Joint Surg Am. 2008;90(5):1007-12.

Jose J, Pasquotti G, Smith MK, Akhil G, Bryson PL, Lee DK. Subchondral insufficiency fractures of the knee: review of imaging findings. Acta Radiol. 2015;56(6):714-9.

Sayyid S, Younan Y, Sharma G, Adam S, William M, Adam Z, et al. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. Skeletal Radiol. 2019;48(12):1961-74.

Barras LA, Pareek A, Parkes CW, Bryant MS, Christopher LC, Daniel BFS, et al. Post-arthroscopic subchondral insufficiency fractures of the knee yield high rate of conversion to arthroplasty. Arthroscopy. 2021;37(8):2545-53.

Plett SK, Hackney LA, Heilmeier U, Lorenzo N, Aihong Y, Chiyuan AZ, et al. Femoral condyle insufficiency fractures: associated clinical and morphological findings and impact on outcome. Skelet Radiol. 2015;44(12):1785-94.

Wilmot AS, Ruutiainen AT, Bakhru PT, Schweitzer ME, Shabshin N. Subchondral insufficiency fracture of the knee: a recognizable associated soft tissue edema pattern and a similar distribution among men and women. Eur J Radiol. 2016;85(11):2096-103.

Lansdown DA, Shaw J, Allen CR, Ma BC. Osteonecrosis of the knee after anterior cruciate ligament reconstruction: a report of 5 cases. Orthop. J Sports Med. 2015;3(3):2325967115576120.

Pareek A, Parkes CW, Bernard C, Christopher LC, Daniel BFS, Michael JS, et al. Spontaneous osteonecrosis/subchondral insufficiency fractures of the knee: high rates of conversion to surgical treatment and arthroplasty. J Bone Joint Surg. Am. 2020;102(9):821-9.

Nelson FR, Craig J, Francois H, Ogochukwu A, Patricia OW, Brandon K. Subchondral insufficiency fractures and spontaneous osteonecrosis of the knee may not be related to osteoporosis. Arch Osteoporos. 2014;9:194.

Ochi J, Nozaki T, Nimura A, Takehiko Y, Nobuto K. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Jpn J Radiol. 2022;40(5):443-57.

Ramnath RR, Kattapuram S. MR appearance of SONK-like subchondral abnormalities in the adult knee: SONK redefined. Skelet Radiol. 2004;33(10):575-81.

Broida SE, Wong PKW, Umpierrez E, Aparna K, Nickolas BR, Felix MG. Alternate treatment approach to subchondral insufficiency fracture of the knee utilizing genicular nerve cooled radiofrequency ablation and adjunctive bisphosphonate supplementation: A case report. Radiol Case Rep. 2020;15(6):691-6.

Broida SE, Wong PK, Umpierrez E, Kakarala A, Reimer NB, Gonzalez FM. Alternate treatment approach to subchondral insufficiency fracture of the knee utilizing genicular nerve cooled radiofrequency ablation and adjunctive bisphosphonate supplementation: A case report. Radiol Case Rep. 2020;15(6):691-6.

Muccioli MGM, Grassi A, Setti S, Filardo G, Zambelli L, Bonanzinga T, et al. Conservative treatment of spontaneous osteonecrosis of the knee in the early stage: Pulsed electromagnetic fields therapy. Eur J Radiol. 2013;82(3):530-7.

Downloads

Published

2024-08-28

Issue

Vol. 10 No. 5 (2024): September-October 2024

Section

Case Series