{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T09:07:54Z","timestamp":1770887274036,"version":"3.50.1"},"reference-count":29,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2019,12,19]],"date-time":"2019-12-19T00:00:00Z","timestamp":1576713600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Resumo<\/jats:title><jats:p>\n          Objetivo\u2003Determinar o efeito do tratamento combinado de \u00e1cido zoledr\u00f4nico e alendronato no edema \u00f3sseo e na dor no joelho em casos de osteonecrose espont\u00e2nea do joelho. A experi\u00eancia dos autores com este tratamento \u00e9 relatada.<\/jats:p><jats:p>\n          M\u00e9todos\u2003S\u00e9rie de casos retrospectiva, incluindo 11 pacientes com osteonecrose espont\u00e2nea do joelho confirmada por resson\u00e2ncia magn\u00e9tica. Os pacientes foram tratados com uma dose intravenosa \u00fanica de 5\u2009mg de \u00e1cido zoledr\u00f4nico combinada com 35\u2009mg de alendronato oral, 2 vezes por semana, por 16 semanas. Os escores da escala visual anal\u00f3gica foram aferidos antes do come\u00e7o do tratamento, em 8 semanas e em 16 semanas de acompanhamento. O tamanho do edema da medula \u00f3ssea adjacente \u00e0 les\u00e3o foi medido em imagens de resson\u00e2ncia magn\u00e9tica coronal ponderadas em T2 no in\u00edcio do tratamento e em 16 semanas.<\/jats:p><jats:p>\n          Resultados\u2003O escore m\u00e9dio da escala visual anal\u00f3gica em 0 semanas foi de 7,72, contra 0,81 em 16 semanas de tratamento, uma diferen\u00e7a estatisticamente significativa (p\u2009=\u20090,03). O envolvimento m\u00e9dio da medula \u00f3ssea em 0 semanas foi de 80%, e foi reduzido para 11,81% em 16 semanas de tratamento, uma diferen\u00e7a tamb\u00e9m estatisticamente significativa (p\u2009=\u20090,03).<\/jats:p><jats:p>\n          Conclus\u00e3o\u2003Os dados mostram que a terapia combinada proporciona al\u00edvio da dor inicial e redu\u00e7\u00e3o do edema \u00f3sseo, sendo segura, e\ufb01caz e bem tolerada em uma enfermidade dolorosa como a osteonecrose espont\u00e2nea do joelho.<\/jats:p>","DOI":"10.1016\/j.rboe.2017.12.008","type":"journal-article","created":{"date-parts":[[2018,2,9]],"date-time":"2018-02-09T06:46:47Z","timestamp":1518158807000},"page":"543-550","source":"Crossref","is-referenced-by-count":7,"title":["Efeito do \u00e1cido zoledr\u00f4nico e do alendronato no edema \u00f3sseo e dor na osteonecrose espont\u00e2nea do joelho: Um novo paradigma no manejo"],"prefix":"10.1055","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3146-2019","authenticated-orcid":false,"given":"Sanjay","family":"Agarwala","sequence":"additional","affiliation":[{"name":"Hinduja Hospital and Medical Research Centre, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lokesh","family":"Sharoff","sequence":"additional","affiliation":[{"name":"Hinduja Hospital and Medical Research Centre, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naeem","family":"Jagani","sequence":"additional","affiliation":[{"name":"Hinduja Hospital and Medical Research Centre, Mumbai, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2019,12,19]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1002\/art.1780110602","article-title":"Spontaneous osteonecrosis of the knee","volume":"11","author":"S Ahlb\u00e4ck","year":"1968","journal-title":"Arthritis Rheum"},{"issue":"04","key":"ref2","doi-asserted-by":"crossref","first-page":"410","DOI":"10.3109\/17453674.2013.810521","article-title":"The natural course of spontaneous osteonecrosis of the knee (SPONK): a 1- to 27-year follow-up of 40 patients","volume":"84","author":"J Jur\u00e9us","year":"2013","journal-title":"Acta Orthop"},{"issue":"12","key":"ref3","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1007\/s00167-010-1106-4","article-title":"Possible beneficial effect of bisphosphonates in osteonecrosis of the knee","volume":"18","author":"M E Kraenzlin","year":"2010","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"issue":"06","key":"ref4","doi-asserted-by":"crossref","first-page":"858","DOI":"10.2106\/00004623-200006000-00013","article-title":"Spontaneous osteonecrosis of the knee: the result of subchondral insufficiency fracture","volume":"82","author":"T Yamamoto","year":"2000","journal-title":"J Bone Joint Surg Am"},{"issue":"04","key":"ref5","doi-asserted-by":"crossref","first-page":"279","DOI":"10.4055\/cios.2011.3.4.279","article-title":"Medial unicompartmental knee arthroplasty in patients with spontaneous osteonecrosis of the knee","volume":"3","author":"W S Choy","year":"2011","journal-title":"Clin Orthop Surg"},{"key":"ref6","first-page":"38","article-title":"Characterization and pathological characteristics of spontaneous osteonecrosis of the knee","volume":"29","author":"S C Mears","year":"2009","journal-title":"Iowa Orthop J"},{"issue":"05","key":"ref7","doi-asserted-by":"crossref","first-page":"588","DOI":"10.1302\/0301-620X.65B5.6643563","article-title":"Idiopathic osteonecrosis of the knee. 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