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Case Reports   |    
Stage-IV Medial Femoral Condyle Osteochondritis Dissecans Treated with Unicompartmental Arthroplasty and Trabecular Metal AugmentationA Case Report
Evan M. Schwechter, MD1; Ran Schwarzkopf, MD, MSc1; Wolfgang Fitz, MD1
1 Department of Orthopedic Surgery, Brigham and Women’s Hospital, 75 Francis Street, Boston, MA 02115 E-mail address for E.M. Schwechter: eschwec@gmail.com
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Investigation performed at the Department of Orthopedic Surgery, Brigham and Women’s Hospital, Boston, Massachusetts



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Apr 10;3(2):e32 1-4. doi: 10.2106/JBJS.CC.L.00190
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Extract

First described by Ahlbäck et al. in 1968, spontaneous osteonecrosis of the knee (SPONK) occurs most commonly in elderly females with a sudden onset, but without a known precipitating event1. SPONK is described as a distinct entity, bearing no relation to the more common causes of osteonecrosis around the knee, including corticosteroid use, alcohol abuse, coagulopathy, and trauma. Its etiology is unknown but may be attributed to a local microcirculatory vascular disturbance or to subclinical microfractures that weaken the subchondral bone and eventually cause osteoarticular collapse2. Clinical onset of SPONK is often abrupt, characterized by medial condylar tenderness, synovitis, effusion, and pain. Localized intense radiotracer uptake on a three-phase bone scan is suggestive of an osteonecrotic lesion3.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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