Our Summary

This research paper looks at the occurrence of avascular necrosis, a condition where bone tissue dies due to a lack of blood supply, following knee arthroscopy, a minimally invasive surgical procedure for diagnosing and treating knee problems. The researchers studied patients who had undergone knee arthroscopy for meniscal tears (a common knee injury) between January 2015 and March 2024. They excluded patients who showed signs of bone swelling on MRI scans carried out 4-6 weeks after the onset of preoperative symptoms.

Out of 974 surgeries, 8 patients met the criteria for the study. This group was predominantly male, with an average age of 57. The majority had undergone treatment for tears in the medial meniscus (a cartilage in the knee), while one had a tear in the lateral meniscus. In each of these cases, osteonecrosis developed after the procedure.

The researchers found that older patients with worsening symptoms following knee arthroscopy, particularly those with degenerative meniscus tears and partial meniscectomy (a procedure where part of the meniscus is removed), may be at risk of osteonecrosis. It was also observed that those with a higher body mass index (BMI), and a delayed diagnosis, were more likely to experience severe disease progression and require surgery.

The aim of the study was to gain a clearer understanding of the causes and likely outcomes of osteonecrosis following knee arthroscopy, by analyzing individual cases and reviewing existing literature on the subject.

FAQs

  1. What is the connection between knee arthroscopy and the development of avascular necrosis or osteonecrosis?
  2. Who are at a higher risk of developing osteonecrosis following a knee arthroscopy according to the study?
  3. What was the primary aim of this research study on knee arthroscopy and avascular necrosis?

Doctor’s Tip

A doctor might advise a patient undergoing knee arthroscopy to maintain a healthy weight and to promptly address any worsening symptoms post-surgery, as these factors may increase the risk of developing avascular necrosis. It is important for patients to follow post-operative care instructions closely and to communicate any concerns or changes in their condition to their healthcare provider.

Suitable For

Patients who are typically recommended arthroscopy are those who have knee problems such as meniscal tears, ligament injuries, cartilage damage, and joint inflammation. Arthroscopy is often recommended when non-invasive treatments like physical therapy and medication have not been effective in alleviating symptoms. Additionally, patients who have persistent knee pain, swelling, stiffness, and limited range of motion may also be candidates for arthroscopy. It is important for patients to consult with their healthcare provider to determine if arthroscopy is the right treatment option for their specific condition.

Timeline

Before knee arthroscopy:

  • Patient experiences knee pain, swelling, and limited range of motion
  • Patient undergoes diagnostic tests such as X-rays and MRI to identify the cause of the symptoms
  • Orthopedic surgeon recommends knee arthroscopy as a minimally invasive procedure to diagnose and treat the knee problem
  • Patient undergoes preoperative evaluations and preparations for the surgery

After knee arthroscopy:

  • Patient undergoes knee arthroscopy procedure to repair or remove damaged tissue in the knee joint
  • Patient experiences postoperative pain, swelling, and stiffness in the knee
  • Patient undergoes rehabilitation and physical therapy to regain strength and range of motion in the knee
  • Patient follows up with the orthopedic surgeon for monitoring and evaluation of the surgical outcome
  • In rare cases, patient may develop complications such as avascular necrosis, which may require further treatment and surgery

What to Ask Your Doctor

Some questions a patient should ask their doctor about arthroscopy include:

  1. What is the purpose of the arthroscopy procedure?
  2. What are the potential risks and complications associated with arthroscopy?
  3. How long will the recovery process take after arthroscopy?
  4. Will I need physical therapy or rehabilitation following the procedure?
  5. Are there any alternative treatments to arthroscopy that I should consider?
  6. How many arthroscopy procedures have you performed, and what is your success rate?
  7. How will you ensure that the procedure is performed safely and effectively?
  8. What is the likelihood of developing complications such as avascular necrosis after arthroscopy?
  9. What steps will be taken to monitor and manage any potential complications during and after the procedure?
  10. How can I minimize the risk of developing avascular necrosis or other complications following arthroscopy?

Reference

Authors: Ntagiopoulos P, Kalinterakis G, Pozzi P, Fligkos D, Themistocleous G, Themistokleous S, Dimou T, Compagnoni R, Ferrua P, Simone Randelli P. Journal: Orthop Surg. 2025 May;17(5):1378-1388. doi: 10.1111/os.70020. Epub 2025 Mar 17. PMID: 40098290