Rahmi Can AKGÜN, Nevzat Reha TANDOĞAN, Aytekin KARAMAN, TOLGA AKKAYA, Ahmet Fevzi ÖZGÜR, İsmail Cengiz TUNCAY

Artroskopik menisküs ve kıkırdak cerrahisinden sonra osteonekroz gelişimi: Beş olgu sunumu

Artroskopik cerrahiden sonra gelişen osteonekroz, menisektomi, kıkırdak cerrahisi ve termal enerji kullanımıyla ilişkilendirilmiştir. Bu yazıda beş olgudan oluşan bir hasta grubu sunuldu; bunların dördünde zaman aralığı olarak artroskopi sonrası nekroz ölçütleri (artroskopi öncesi manyetik rezonans görüntüler yakınmaların başlamasından en az dört hafta sonra elde edilmişti) vardı. Dört olgu konservatif olarak takip edilirken, birine artroskopik debridman ve mikrokırık girişimi uygulandı. Travma olmaksızın yakınmalarda ani artış ortaya çıkan dejeneratif artritli dizlerde ve artroskopik menisküs veya kıkırdak cerrahisinden sonra yakınmalarında artış görülen olgularda osteonekroz tanısı akla gelmelidir. En uygun tedavinin ne olduğu konusundaki tartışmalar devam etmektedir.

Anahtar Kelimeler:

Osteonekroz, Artroskopi, Tanı, ayırıcı, Diz eklemi, Manyetik rezonans görüntüleme, Menisküs, tibial, Ameliyat sonrası komplikasyonlar

Development of osteonecrosis after arthroscopic meniscal and chondral knee surgery: A report of five cases

The development of osteonecrosis after arthroscopic surgery has been associated with meniscectomy, chondral surgery, and the use of thermal energy. This paper presents five cases, four of which fulfilled the temporal criteria for postarthroscopy necrosis, i.e. presurgical magnetic resonance imaging was obtained at least four weeks after the onset of symptoms). Four cases were treated conservatively while one underwent arthroscopic debridement and microfracturing. The diagnosis of osteonecrosis should be kept in mind in osteoarthritic patients whose knee symptoms manifest a sudden increase without trauma, and in cases with worsening knee symptoms after arthroscopic surgery. The optimal treatment strategy in these patients is still debatable.

Keywords:

Osteonecrosis, Arthroscopy, Diagnosis, Differential, Knee Joint, Magnetic Resonance Imaging, Menisci, Tibial, Postoperative Complications,

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