外科ジャーナル

Spontaneous Osteonecrosis of the Medial Femoral Condyle: Case Report

Abstract

Ovidiu Alexa, Dan Cionca, Samir Albetar and Bogdan Veliceasa

Spontaneous osteonecrosis of the knee presents with acute onset of severe pain in elderly patients, usually females, without a history of trauma. Originally described as idiopathic osteonecrosis, the exact etiology is still debated. Evidence suggests that an acute fracture occurs as a result of chronic stress or minor trauma to a weakened subchondral bone plate. We report one case of spontaneous osteonecrosis of medial femoral condyle in a 71-year-old female with no evidence of trauma involving a 4 cm weight bearing surface. According to Koshino this case can be classified as stage II. Various types of treatment have been reported, including conservative treatment with physical exercise and nonsteroidal anti-inflammatory drugs, arthroscopy alone, arthroscopy and drilling, valgus high tibial osteotomy, and total knee arthroplasty. Total knee arthroplasty was considered the appropriate management strategy in this case.