{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:32:03Z","timestamp":1783654323041,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2012,4,26]],"date-time":"2012-04-26T00:00:00Z","timestamp":1335398400000},"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":[[2013,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Spontaneous osteonecrosis of the knee (SONK\/Morbus Ahlback) mainly affects the medial condyle of elderly women. It is assumed that localized vascular insufficiency leads to necrosis of the subchondral bone with subsequent disruption of the nutrition supply to the cartilage above. The aetiology remains unclear in detail. Operative treatment procedures compete against non\u2010operative strategies, whereas the outcome is unpredictable in many cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A consecutive case series of five patients suffering from SONK was analysed. All patients underwent a clinical examination, magnetic resonance imaging (MRI) and dual\u2010energy X\u2010ray absorptiometry scan, as well as laboratory analyses and visual analogue scale (VAS) evaluation. Our treatment regime is based on high\u2010dose vitamin D administered orally and intravenous application of 3\u00a0mg ibandronate two times within 8 weeks. Another 8 weeks later, all patients were followed up including a follow\u2010up MRI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Within 4 weeks, all patients were free of symptoms. The MRI follow\u2010up showed remission of the bone marrow oedema in every case studied. VAS decreased significantly from 7.4 \u00b1 1.0 pre\u2010interventional to 0.8 \u00b1 1.0 post\u2010interventional. No allergic reactions or other side effects were documented.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We showed that our treatment regime not only eliminated the pathological findings in the MRI of all cases studied, but also decreased the pain level and functional limitations within a short\u2010time period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-012-2017-3","type":"journal-article","created":{"date-parts":[[2012,4,25]],"date-time":"2012-04-25T03:11:50Z","timestamp":1335323510000},"page":"340-345","source":"Crossref","is-referenced-by-count":39,"title":["Spontaneous osteonecrosis of the knee (SONK)"],"prefix":"10.1002","volume":"21","author":[{"given":"S.","family":"Breer","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Osteology and Biomechanics University Medical Center Hamburg\u2010Eppendorf Lottestra\u00dfe 59 22529 Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Oheim","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Osteology and Biomechanics University Medical Center Hamburg\u2010Eppendorf Lottestra\u00dfe 59 22529 Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Krause","sequence":"additional","affiliation":[{"name":"<!--<label>1<\/label>--> Department of Osteology and Biomechanics University Medical Center Hamburg\u2010Eppendorf Lottestra\u00dfe 59 22529 Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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