Total knee arthroplasty for corticosteroid associated avascular necrosis of the knee

Michael A. Mont, Thomas H. Myers, Kenneth A. Krackow, David S. Hungerford

Research output: Contribution to journalArticle

Abstract

Despite their age, patients younger than 50 years who have collapse of their femoral condyles caused by steroid associated avascular necrosis have few options except total knee arthroplasty. There have been no specific reports of the results of total knee replacements for this disease. Between 1980 and 1993, 31 porous coated anatomic total knee replacements were performed in 21 patients younger than 50 years of age with avascular necrosis of the femoral condyles and tibial plateaus. There were 17 women and 4 men, with an average age of 36 years (range, 22-48 years). Seventeen of 21 patients had systemic lupus erythematosus, and all patients had a history of corticosteroid use. Patients underwent a complete clinical and radiographic evaluation at final followup that averaged 8.2 years (range, 2-16 years). Overall, there were 17 good and excellent results (55%). Eleven knees were revised for aseptic loosening (37%), and 3 additional knees (10%) ultimately were revised for deep sepsis. All 6 knees in patients with no diagnosis of systemic lupus erythematosus had excellent clinical results. There were only 11 of 25 successful outcomes (44%) in the patients with systemic lupus erythematosus. There were no differences in results when patients were stratified by degree of steroid use, cemented versus cementless fixation, or activity level.

Original languageEnglish (US)
Pages (from-to)124-130
Number of pages7
JournalClinical Orthopaedics and Related Research
Issue number338
StatePublished - 1997

Fingerprint

Knee Replacement Arthroplasties
Knee
Adrenal Cortex Hormones
Necrosis
Systemic Lupus Erythematosus
Thigh
Steroids
Bone and Bones
Sepsis

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

Cite this

Mont, M. A., Myers, T. H., Krackow, K. A., & Hungerford, D. S. (1997). Total knee arthroplasty for corticosteroid associated avascular necrosis of the knee. Clinical Orthopaedics and Related Research, (338), 124-130.

Total knee arthroplasty for corticosteroid associated avascular necrosis of the knee. / Mont, Michael A.; Myers, Thomas H.; Krackow, Kenneth A.; Hungerford, David S.

In: Clinical Orthopaedics and Related Research, No. 338, 1997, p. 124-130.

Research output: Contribution to journalArticle

Mont, Michael A. ; Myers, Thomas H. ; Krackow, Kenneth A. ; Hungerford, David S. / Total knee arthroplasty for corticosteroid associated avascular necrosis of the knee. In: Clinical Orthopaedics and Related Research. 1997 ; No. 338. pp. 124-130.
@article{e99e6af09b334fff8d80f0c779f64b99,
title = "Total knee arthroplasty for corticosteroid associated avascular necrosis of the knee",
abstract = "Despite their age, patients younger than 50 years who have collapse of their femoral condyles caused by steroid associated avascular necrosis have few options except total knee arthroplasty. There have been no specific reports of the results of total knee replacements for this disease. Between 1980 and 1993, 31 porous coated anatomic total knee replacements were performed in 21 patients younger than 50 years of age with avascular necrosis of the femoral condyles and tibial plateaus. There were 17 women and 4 men, with an average age of 36 years (range, 22-48 years). Seventeen of 21 patients had systemic lupus erythematosus, and all patients had a history of corticosteroid use. Patients underwent a complete clinical and radiographic evaluation at final followup that averaged 8.2 years (range, 2-16 years). Overall, there were 17 good and excellent results (55{\%}). Eleven knees were revised for aseptic loosening (37{\%}), and 3 additional knees (10{\%}) ultimately were revised for deep sepsis. All 6 knees in patients with no diagnosis of systemic lupus erythematosus had excellent clinical results. There were only 11 of 25 successful outcomes (44{\%}) in the patients with systemic lupus erythematosus. There were no differences in results when patients were stratified by degree of steroid use, cemented versus cementless fixation, or activity level.",
author = "Mont, {Michael A.} and Myers, {Thomas H.} and Krackow, {Kenneth A.} and Hungerford, {David S.}",
year = "1997",
language = "English (US)",
pages = "124--130",
journal = "Clinical Orthopaedics and Related Research",
issn = "0009-921X",
publisher = "Springer New York",
number = "338",

}

TY - JOUR

T1 - Total knee arthroplasty for corticosteroid associated avascular necrosis of the knee

AU - Mont, Michael A.

AU - Myers, Thomas H.

AU - Krackow, Kenneth A.

AU - Hungerford, David S.

PY - 1997

Y1 - 1997

N2 - Despite their age, patients younger than 50 years who have collapse of their femoral condyles caused by steroid associated avascular necrosis have few options except total knee arthroplasty. There have been no specific reports of the results of total knee replacements for this disease. Between 1980 and 1993, 31 porous coated anatomic total knee replacements were performed in 21 patients younger than 50 years of age with avascular necrosis of the femoral condyles and tibial plateaus. There were 17 women and 4 men, with an average age of 36 years (range, 22-48 years). Seventeen of 21 patients had systemic lupus erythematosus, and all patients had a history of corticosteroid use. Patients underwent a complete clinical and radiographic evaluation at final followup that averaged 8.2 years (range, 2-16 years). Overall, there were 17 good and excellent results (55%). Eleven knees were revised for aseptic loosening (37%), and 3 additional knees (10%) ultimately were revised for deep sepsis. All 6 knees in patients with no diagnosis of systemic lupus erythematosus had excellent clinical results. There were only 11 of 25 successful outcomes (44%) in the patients with systemic lupus erythematosus. There were no differences in results when patients were stratified by degree of steroid use, cemented versus cementless fixation, or activity level.

AB - Despite their age, patients younger than 50 years who have collapse of their femoral condyles caused by steroid associated avascular necrosis have few options except total knee arthroplasty. There have been no specific reports of the results of total knee replacements for this disease. Between 1980 and 1993, 31 porous coated anatomic total knee replacements were performed in 21 patients younger than 50 years of age with avascular necrosis of the femoral condyles and tibial plateaus. There were 17 women and 4 men, with an average age of 36 years (range, 22-48 years). Seventeen of 21 patients had systemic lupus erythematosus, and all patients had a history of corticosteroid use. Patients underwent a complete clinical and radiographic evaluation at final followup that averaged 8.2 years (range, 2-16 years). Overall, there were 17 good and excellent results (55%). Eleven knees were revised for aseptic loosening (37%), and 3 additional knees (10%) ultimately were revised for deep sepsis. All 6 knees in patients with no diagnosis of systemic lupus erythematosus had excellent clinical results. There were only 11 of 25 successful outcomes (44%) in the patients with systemic lupus erythematosus. There were no differences in results when patients were stratified by degree of steroid use, cemented versus cementless fixation, or activity level.

UR - http://www.scopus.com/inward/record.url?scp=0030973564&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030973564&partnerID=8YFLogxK

M3 - Article

SP - 124

EP - 130

JO - Clinical Orthopaedics and Related Research

JF - Clinical Orthopaedics and Related Research

SN - 0009-921X

IS - 338

ER -