{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T04:38:56Z","timestamp":1791952736924,"version":"4.3.4"},"reference-count":52,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2010,4,8]],"date-time":"2010-04-08T00:00:00Z","timestamp":1270684800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Osteonecrosis (ON) in the knee occurs as a localized inflammatory disease in relation to spontaneous or non\u2010traumatic ON. Conservative treatment possibilities are limited, and prognosis appears to be poor; in most cases, ON results in knee arthroplasty. Bisphosphonates are suggested to prevent bone resorption and collapse of necrotic bone. In this observational, prospective study we investigated the effect of bisphosphonate treatment in patients with spontaneous or arthroscopy\u2010induced ON of the knee. Twenty\u2010eight patients with osteonecrotic lesions and bone marrow oedema in the knee were included. In 22 patients (80%), ON was identified after arthroscopic surgery of the knee; six patients were diagnosed with spontaneous ON. Patients were initially given pamidronate 120\u00a0mg i.v. divided in 3\u20134 perfusions over 2 weeks, followed by oral bisphosphonate treatment with alendronate 70\u00a0mg weekly for 4\u20136\u00a0months. Bisphosphonate treatment resulted in a rapid pain relief, VAS decreasing from 8.2 \u00b1 1.2 at baseline to 5.02 \u00b1 0.6 after 4\u20136 weeks (<jats:italic>p<\/jats:italic> &lt; 0.001). After 6\u00a0months, the VAS decreased by 80% (<jats:italic>p<\/jats:italic> &lt; 0.001). At the 6\u2010month follow\u2010up, symptoms had resolved completely in 15 patients out of 28; in 6 patients, minimal symptoms (VAS 1\u20132) remained. In two patients, treatment effect was unsatisfactory, and surgical intervention was needed (arthroplasty). Bone marrow oedema on MRI resolved completely in 18 patients out of 28 with substantial reduction in the remaining. Furthermore, osteonecrotic area resolved completely or demarcation with sclerotic changes of the necrotic area could be observed. Bisphosphonate treatment in patients with osteonecrosis of the knee was associated with a rapid improvement in pain score and radiological consolidation of the area of osteonecrosis. Further randomized, controlled trials are warranted to confirm the potential beneficial role of bisphosphonates in the treatment of osteonecrosis of the knee. Level of evidence: observational study, level IV.<\/jats:p>","DOI":"10.1007\/s00167-010-1106-4","type":"journal-article","created":{"date-parts":[[2010,4,7]],"date-time":"2010-04-07T12:53:36Z","timestamp":1270644816000},"page":"1638-1644","source":"Crossref","is-referenced-by-count":54,"title":["Possible beneficial effect of bisphosphonates in osteonecrosis of the knee"],"prefix":"10.1002","volume":"18","author":[{"given":"Marius E.","family":"Kraenzlin","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Division of Endocrinology, Diabetes and Clinical Nutrition University Hospital 4031 Basel Switzerland"},{"name":"<!--<label>3<\/label>--> Endocrine Practice and Laboratory Missionsstrasse 24 4055 Basel Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Graf","sequence":"additional","affiliation":[{"name":"<!--<label>2<\/label>--> Department of Orthopedic Surgery Bruderholz Spital 4101 Bruderholz 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