Diagnostics and treatment of subchondral insufficiency fracture of the knee Exchange of experience
Abstract
Subchondral insufficiency fracture of the knee (SIFK) is a new nosologic entity that has replaced the diagnosis of spontaneous osteonecrosis of the knee (SONK). Primary avascular necrosis of the femoral condyles is a differential diagnosis with subchondral fracture of bone insufficiency of the knee joint, which requires a different approach to treatment. This article reviews the principles of diagnosis and results of conservative treatment of subchondral bone insufficiency fracture of the knee (SIFK).
References
1. Ahlback S., Bauer G. C., Bohne W. H. Spontaneous osteonecrosis of the knee. Arthritis Rheum 1968: (11): 705 -33.
2. Yamamoto T., Bullough P. G. Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture. J. Bone Joint Surg. Am. 2000; (82): 858 66.
3. Kidwai A. S., Hemphill S. D., Griffiths H. J. Radiologic case study. Spontaneous osteonecrosis of the knee reclassified as insufficiency fracture. Orthopedics 2005; 28 (3): 236, 333 6.
4. Hussain Z. B., Chahla J., Mandelbaum B. R. et al. 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.
5. Hatanaka H., Yamamoto T., Motomura G. et al. Histopathologic findings of spontaneous osteonecrosis of the knee at an early stage: a case report. Skeletal Radiol. 2016; 45: 713 6.
6. Tanaka Y., Mima H., Yonetani Y. et al. 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.
7. Takeda M., Higuchi H., Kimura M. et al. Spontaneous osteonecrosis of the knee. J. Bone J. Surg Br. 2008; 90: 324 -9.
8. MacDessi S. J., Brophy R. H., Bullough P. G. et al. Subchondral fracture following arthroscopic knee surgery a series of eight cases. J. Bone Joint Surg. Am. 2008; 90: 1007-12.
9. Jose J., Pasquotti G., Smith M. K. et al. Subchondral insufficiency fractures of the knee: review of imaging findings. Acta Radiol. 2015; 56: 714 -9.
10. Sayyid S., Younan Y., Sharma G. et al. Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome. Skeletal Radiol 2019; 48:1961-74.
11. Barras L. A., Pareek A., Parkes C. W. et al. Post-arthroscopic subchondral insufficiency fractures of the knee yield high rate ofconversion to arthroplasty. Arthroscopy. 2021; 37(8): 2545 53.
12. Husain R., Nesbitt J., Tank D. et al. Spontaneous osteonecrosis of the knee (SONK): The role of MR imaging in predicting clinical outcome. J. Orthop. 2020, 22, 606 -11.
13. Pape D., Seil R., Fritsch E. et al. Prevalence of spontaneous osteonecrosis of the medial femoral condyle in elderly patients. Knee Surg. Sport. Traumatol. Arthrosc. 2002; 10, 233 40.
14. Plett S. K., Hackney L. A., Heilmeier U. et al. Femoral condyle insufficiency fractures: associated clinical and morphological findings and impact on outcome. Skelet Radiol. 2015; 44: 1785 94.
15. Wilmot A. S., Ruutiainen A. T., Bakhru P. T. et al. 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: 2096 -103.
16. Lansdown D. A., Shaw J., Allen C. R. et al. Osteonecrosis of the knee after anterior cruciate ligament reconstruction: a report of 5 cases. Orthop. J. Sports Med. 2015; 3 (3): 2325967115576120.
17. Pareek A., Parkes C. W., Bernard C. etal. Spontaneous osteonecrosis/subchondral insufficiency fractures of the knee: high rates of conversion to surgical treatment and arthroplasty. J. Bone Joint Surg. Am. 2020; 102: 821-9.
18. Nelson F. R., Craig J., Francois H. et al. Subchondral insufficiency fractures and spontaneous osteonecrosis of the knee may not be related to osteoporosis. Arch. Osteoporos. 2014: 9: 194.
19. Farrell T.P., Deely D. M., Zoga A. C., McClure K. E. Lateral femoral condyle insufficiency fractures: imaging findings, demographics, and analysis of outcomes Skeletal Radiol. 2021; 50 (1): 189 99.
20. Reddy A. S., Frederick R. W. Evaluation of the intraosseous and extraosseous blood supply to the distal femoral condyles. Am. J. Sports Med. 1998; 26 (3): 415 -9.
21. Harada Y., Wevers H. W., Cooke T. D. Distribution of bone strength in the proximal tibia. J. Arthroplast. 1988; 3: 167-75 .
22. Ochi J., Nozaki T., Nimura A. et al. Subchondral insufficiency fracture of the knee: review of current concepts and radiological differential diagnoses. Jpn. J. Radiol. 2022; 40: 443 57.
23. Ramnath R. R., Kattapuram S. MR appearance of SONK-like subchondral abnormalities in the adult knee: SONK redefined. Skelet Radiol. 2004; 33: 575 -81.
24. Madry H., van Dijk C. N., Mueller-Gerbl M. The basic science of the subchondral bone. Knee Surg. Sports Traumatol. Arthrosc. 2010; 18: 419 33.
25. Vidoni A., Shah R., Mak D. et al. Metaphyseal burst sign: A secondary sign on MRI of subchondral insufficiency fracture of the knee. J. Med. Imaging Radiat. Oncol. 2018; 62 (6): 764 -8.
26. Gorbachova T., Melenevsky Y., Cohen M., Cerniglia B.W. Osteochondral lesions of the knee: differentiating the most common entities at MRI. Radiographics. 2018; 38: 1478 95.
27. Broida S. E., Wong P. K. W., Umpierrez E. et al. 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.
28. Meier C., Kraenzlin C., Friederich N. F. et al. Effect of Ibandronate on Spontaneous Osteonecrosis of the Knee: A Randomized, Double-Blind, Placebo-Controlled Trial. Osteoporos. Int. 2014; 25: 359 66.
29. Marcheggiani Muccioli G. M., Grassi A., Setti S. et al. Conservative treatment of spontaneous osteonecrosis of the knee in the early stage: Pulsed electromagnetic fields therapy. Eur. J. Radiol. 2013; 82: 530 -7.
Review
For citations:
Koshman G.A. Diagnostics and treatment of subchondral insufficiency fracture of the knee Exchange of experience. Healthcare. 2023;(12):36-41. (In Russ.)