자발성 슬관절 골괴사증의 임상적 고찰

Spontaneous osteonecrosis of the knee was first described in 1986 by Ahlback et al, as a painful radiolucent lesion associated with a focally active bone scan involving the medial femord. Condyle, but without any of such well knowo. Predisposing factors as oral steroids, lupus erythematosus, hyperlipidemia, alcohol, or Caissons disease. The etiology of the lesion is still unknown and this entity is believed to be an important but uaderestimated cause of osteoarthritis of the knee. The clinical course and the prognosis of the disease depemrk on the radiqgraphic size, the area, and the stage of the lesion. Bone sean allows aed early diagnosis, and MRI is useful in the evaluation of separated asteonecrosis of the knee an4 the determination of the prognosis, Prognoiia is unfavorable if tho lesion is larger than five square centimeters and if its width is more than 40 % of that of the condyle. Arthroscopy not only allows an effective method of evaluating the articular lesion, but a1so provides an effective treatment. When varus deformity is present, the arthroscopic treatment can be associated with a high tibial osteotomy. During the period of 4 years from February, 1989 to July, 1993, spontaneous osteoneeroais was diagnosed in 15 knees in 13 patients. Of the 6 knees followed up after coaservative treatment, 83 % were satisfactory. Of the 6 knees treated by arthroscopic debridement, 83 % were satisfactory, and of the 3 knees treated by osteotomy, all were satisfactory.