Total knee arthroplasty for steroid-induced osteonecrosis

There have been only a few reports that evaluate the outcome of total knee arthroplasty in patients with steroid-induced osteonecrosis of the knee. We retrospectively reviewed 31 total knee arthroplasties in 24 patients with confirmed steroid induced osteonecrosis of the knee. The average follow-up was 64 months. Of surviving knees, 92% had significant improvement in knee scores. Five knees (16%) required a revision procedure. Reasons for revisio n were aseptic loosening in 3 knees and sepsis in 2 knees. Complications no t requiring revision occurred in 6 of 31 knees (19%). Survivorship of total knee arthroplasty to revision in patients with steroid-induced avascular n ecrosis of the knee was 84% at 5 years. Although there was a slightly highe r complication rate, this may, in part, be due to the severity of the patie nts' underlying disease processes. Total knee arthroplasty can be a success ful procedure for chronically ill patients with steroid-induced osteonecros is.