Lateral Unicompartmental knee arthroplasty for a secondary osteonecrosis of the lateral femoral condyle. A case report

• Published in: BMC musculoskeletal disorders 2020-08, Vol.21 (1), p.585-585, Article 585
• Main Authors: Yang, Tao, Xue, Huaming, Ma, Tong, Wen, Tao, Xue, Long, Guan, Mengyin, Tu, Yihui
• Format: Article
• Language: English
• Subjects: Ambulation aids; Anesthesia; Anesthetics; Arthritis; Arthroplasty (knee); Arthroplasty, Replacement, Knee - adverse effects; Cartilage; Case Report; Case reports; Case studies; Corticosteroids; Epiphyses; Female; Femur; Femur - surgery; General anesthesia; Humans; Idiopathic thrombocytopenic purpura; Joint replacement surgery; Joint surgery; Knee; Knee Joint - diagnostic imaging; Knee Joint - surgery; Knee Prosthesis; Knee replacement arthroplasty; Lateral unicompartmental knee arthroplasty; Magnetic resonance imaging; Middle Aged; Musculoskeletal diseases; Osteoarthritis; Osteoarthritis, Knee - surgery; Osteonecrosis; Osteonecrosis - diagnostic imaging; Osteonecrosis - surgery; Pain; Patients; Prostheses; Prostheses and implants; Purpura; Range of motion; Retrospective Studies; Saphenous nerve; Secondary osteonecrosis of the knee; Surgical methods; Thrombocytopenic purpura; Treatment Outcome; Walking
• ISSN: 1471-2474; 1471-2474
• DOI: 10.1186/s12891-020-03585-8

Secondary osteonecrosis of the knee is a rare event. There are few reports regarding management of this condition. The aim of the present study is to report treatment outcomes for secondary osteonecrosis of the lateral condyle treated with unicompartmental knee arthroplasty (UKA). A 54-year-old woman with idiopathic thrombocytopenic purpura, who received low-dosage corticosteroids, complained of knee pain for 5 years and difficulty walking in the last 5 months. Fixed-bearing lateral UKA was performed under general anesthesia combined with midthigh saphenous nerve block. The patient could walk without ambulation aid shortly after the operation and achieved satisfactory knee joint function at the 6-week follow-up. The knee society score (KSS) increased from 68 to 91. The follow-up period was up to 1 year. There was no pain, loosening, or fracture of the prosthesis at the latest follow-up. This case study demonstrates successful management of secondary osteonecrosis of the lateral femoral condyle is possible with a fixed bearing lateral UKA. Early diagnosis, rigorous indication, and appropriate surgical techniques were critical to maximizing prosthesis stability in lateral UKA.