{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T21:33:01Z","timestamp":1783805581888,"version":"3.55.0"},"reference-count":24,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"3","license":[{"start":{"date-parts":[[2008,3,1]],"date-time":"2008-03-01T00:00:00Z","timestamp":1204329600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery. British volume"],"published-print":{"date-parts":[[2008,3]]},"abstract":"<jats:p> We prospectively examined the physical and imaging findings, including MRI, of 23 patients with spontaneous osteonecrosis of the knee after obtaining informed consent to acquire tissue specimens at surgery. There were four men and 19 women, with a mean age of 67.5 years (58 to 77). Plain radiographs were designated as stages 1, 2, 3 or 4 according to the classification of Koshino. Five knees were classified as stage 1, five as stage 2, seven as stage 3 and six as stage 4. The histological specimens were stained with haematoxylin and eosin and tetrachrome. <\/jats:p><jats:p> In the early stages of the condition, a subchondral fracture was noted in the absence of any features of osteonecrosis, whereas in advanced stages, osteonecrotic lesions were confined to the area distal to the site of the fracture which showed impaired healing. In such cases, formation of cartilage and fibrous tissue, occurred indicating delayed or nonunion. These findings strongly suggest that the histopathology at each stage of spontaneous osteonecrosis is characterised by different types of repair reaction for subchondral fractures. <\/jats:p>","DOI":"10.1302\/0301-620x.90b3.18629","type":"journal-article","created":{"date-parts":[[2008,3,1]],"date-time":"2008-03-01T22:24:34Z","timestamp":1204410274000},"page":"324-329","source":"Crossref","is-referenced-by-count":44,"title":["Spontaneous osteonecrosis of the knee"],"prefix":"10.1302","volume":"90-B","author":[{"given":"M.","family":"Takeda","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Kimura","sequence":"additional","affiliation":[{"name":"Gunma Sports Medicine Research Centre Zenshukai Hospital, 1381 Ninomiya, Maebashi, Gunma 379-2117, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Gunma Sports Medicine Research Centre Zenshukai Hospital, 1381 Ninomiya, Maebashi, Gunma 379-2117, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Terauchi","sequence":"additional","affiliation":[{"name":"Gunma Chuo General Hospital, 1-7-13 Kounmachi, Maebashi, Gunma 371-0025, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Takagishi","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"R1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780110602"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.65B5.6643563"},{"key":"R3","doi-asserted-by":"crossref","unstructured":"Koshino T. 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