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Outcomes of Joint Replacement in Spontaneous Osteonecrosis of The Knee

Outcomes of Joint Replacement in Spontaneous Osteonecrosis of The Knee. Husam Darwish Arthroplasty Rounds April 17 th 2007. JBJS Am 2006;88-A Systematic Review 148 pt TKR average age 68 and mean F/U 4 years 64 pt UKR average age 69 and mean F/U 5 years

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Outcomes of Joint Replacement in Spontaneous Osteonecrosis of The Knee

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  1. Outcomes of Joint Replacement in Spontaneous Osteonecrosis of The Knee Husam Darwish Arthroplasty Rounds April 17th 2007

  2. JBJS Am 2006;88-A • Systematic Review • 148 pt TKR average age 68 and mean F/U 4 years • 64 pt UKR average age 69 and mean F/U 5 years • Inclusion: SONK and secondary osteonecrosis treated with knee Arthroplasty • Exclusion: revision knee arthroplasty

  3. Outcome Measures • KSS, HSS and revision rates • Good Outcome no revision AND no radiographic loosening AND good or excellent clinical outcomes • Poor outcome revision OR loosening OR score < 60

  4. Results

  5. Oxford medial unicompartmental arthroplasty for focal spontaneous osteonecrosis of the knee • JBJS Br. 2006 • Retrospective Cohort study • Aim: assessed the outcome of medial unicompartmental knee arthroplasty using the Oxford prosthesis for end-stage SONK • 29 knees (SONK) matched to 28 knees (OA) • F/U 5 years (1-13)

  6. RESULTS: • There were no implant failures in either group • The mean Oxford Knee Score in the group with SONK was 38, and it was 40 in the group with OA CONCLUSION: • Use of the Oxford Medial UKA for spontaneous focal osteonecrosis of the knee is reliable in the short to medium term, and gives results similar to those obtained when it is used for patients with primary osteoarthrosis.

  7. Conclusion • TKR for SONK is comparable to TKR for OA • Results of TKR are superior to UKR • HOWEVER, 1- Bias due to poor indications for UKR 2- Under-powered studies

  8. Thank You!

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