SPONTANEOUS OSTEONECROSIS OF THE FEMORAL CONDYLE - CAUSAL TREATMENT BY EARLY CORE DECOMPRESSION

In 16 patients with an average age of 64.6 +/- 9.8 years and sudden on set of severe knee pain, the initial stage of Ahlback disease (spontan eous osteonecrosis of a femoral condyle) was verified by magnetic reso nance imaging (MRI) and subsequent histology. The first radiological s ign of osteonecrosis (flattening of the affected femoral condyle) was present in only one case. All patients were treated surgically by extr a-articular drilling into the affected femoral condyle to achieve core decompression. The knee pain disappeared immediately after surgery in all patients. Successful healing was confirmed by normalization of th e bone marrow signal on MRI (on average, 35.8 months follow-up). Core decompression by extra-articular drilling into the femoral condyle can be recommended as an effective treatment in initial osteonecrosis of the knee (still radiologically invisible). However, if radiologically a flattening of the affected femoral condyle becomes apparent, progres sion of this disease cannot be avoided.