{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T00:23:09Z","timestamp":1761092589094,"version":"build-2065373602"},"reference-count":101,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:00:00Z","timestamp":1761004800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"2022 Zhejiang Provincial High-Level Health Talent Medical Rookie","award":["1S22317"],"award-info":[{"award-number":["1S22317"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82074469"],"award-info":[{"award-number":["82074469"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Zhejiang Administration of Traditional Chinese Medicine","award":["2023ZF019"],"award-info":[{"award-number":["2023ZF019"]}]},{"name":"2024 Zhejiang Chinese Medical University Cultivation Plan for Top Innovative Talents of Postgraduates","award":["721100G00747"],"award-info":[{"award-number":["721100G00747"]}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Subchondral Insufficiency Fracture of the Knee (SIFK) is a disease with unclear pathogenesis and rapid progression, it is prone to developing end-stage osteoarthritis. Due to the lack of a definitive treatment strategy for SIFK in the clinic, knee replacement is often the preferred measure. However, in recent years, as the disease has become better understood, more and more effective treatments have been proposed, but there is a lack of summarization. Therefore, this article summarizes its pathogenesis and therapeutic advances.<\/jats:p>","DOI":"10.3389\/fsurg.2025.1640316","type":"journal-article","created":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T06:18:28Z","timestamp":1761027508000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Subchondral insufficiency fracture of the knee: progress in the pathogenesis and treatment"],"prefix":"10.3389","volume":"12","author":[{"given":"Ziyue","family":"Wang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiale","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bangjian","family":"He","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Pei","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1002\/art.1780110602","article-title":"Spontaneous osteonecrosis of the knee","volume":"11","author":"Ahlb\u00e4ck","year":"1968","journal-title":"Arthritis Rheum"},{"key":"B2","doi-asserted-by":"publisher","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":"Yamamoto","year":"2000","journal-title":"J Bone Joint Surg Am"},{"key":"B3","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1007\/s00256-016-2328-4","article-title":"Histopathologic findings of spontaneous osteonecrosis of the knee at an early stage: a case report","volume":"45","author":"Hatanaka","year":"2016","journal-title":"Skeletal Radiol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"100922","DOI":"10.1016\/j.jisako.2025.100922","article-title":"Deepening the subchondral insufficiency fracture and osteonecrosis of the knee dilemma: time for a new classification: current concepts","volume":"14","author":"Za","year":"2025","journal-title":"J ISAKOS"},{"key":"B5","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1249\/JSR.0000000000000271","article-title":"Spontaneous osteonecrosis of the knee","volume":"15","author":"Zaremski","year":"2016","journal-title":"Curr Sports Med Rep"},{"key":"B6","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1007\/s00167-002-0285-z","article-title":"Prevalence of spontaneous osteonecrosis of the medial femoral condyle in elderly patients","volume":"10","author":"Pape","year":"2002","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B7","first-page":"113","article-title":"Research progress on the mechanism of spontaneous osteonecrosis of knee joint","volume":"13","author":"Maorong","year":"2021","journal-title":"Chin J Clini Res"},{"key":"B8","doi-asserted-by":"publisher","first-page":"164","DOI":"10.1016\/j.knee.2021.06.003","article-title":"Medial meniscus extrusion as a predictor for a poor prognosis in patients with spontaneous osteonecrosis of the knee","volume":"31","author":"Hashimoto","year":"2021","journal-title":"Knee"},{"key":"B9","doi-asserted-by":"publisher","first-page":"2049","DOI":"10.1007\/s00198-021-05900-y","article-title":"The clinician's guide to prevention and treatment of osteoporosis","volume":"33","author":"LeBoff","year":"2022","journal-title":"Osteoporos Int"},{"key":"B10","doi-asserted-by":"publisher","first-page":"88","DOI":"10.1016\/j.cytogfr.2020.02.003","article-title":"The relationship between bone marrow adipose tissue and bone metabolism in postmenopausal osteoporosis","volume":"52","author":"Li","year":"2020","journal-title":"Cytokine Growth Factor Rev"},{"key":"B11","doi-asserted-by":"publisher","first-page":"249","DOI":"10.3109\/17453674.2012.684139","article-title":"Low bone mineral density is associated with the onset of spontaneous osteonecrosis of the knee","volume":"83","author":"Akamatsu","year":"2012","journal-title":"Acta Orthop"},{"key":"B12","doi-asserted-by":"publisher","first-page":"532","DOI":"10.2174\/1874325001610010532","article-title":"Spontaneous osteonecrosis of the knee: a retrospective analysis by using MRI and DEXA","volume":"10","author":"Horikawa","year":"2016","journal-title":"Open Orthop J"},{"key":"B13","doi-asserted-by":"publisher","first-page":"569","DOI":"10.1177\/1753193410364484","article-title":"The arterial anatomy of the medial femoral condyle and its clinical implications","volume":"35","author":"Yamamoto","year":"2010","journal-title":"J Hand Surg Eur"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1024e","DOI":"10.1097\/PRS.0000000000002182","article-title":"Anatomy of the vascularized lateral femoral condyle flap","volume":"137","author":"Parvizi","year":"","journal-title":"Plast Reconstr Surg"},{"key":"B15","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1177\/03635465980260031201","article-title":"Evaluation of the intraosseous and extraosseous blood supply to the distal femoral condyles","volume":"26","author":"Reddy","year":"1998","journal-title":"Am J Sports Med"},{"key":"B16","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1055\/s-2000-10135","article-title":"Die arterielle versorgung der femurkondylen [arterial supply of the femoral condyles]","volume":"138","author":"Lankes","year":"2000","journal-title":"Z Orthop Ihre Grenzgeb"},{"key":"B17","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1007\/s12178-023-09840-4","article-title":"Meniscal extrusion: diagnosis, etiology, and treatment options","volume":"16","author":"Langhans","year":"2023","journal-title":"Curr Rev Musculoskelet Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"74881","DOI":"10.52965\/001c.74881","article-title":"Meniscal extrusion: risk factors and diagnostic tools to predict early osteoarthritis","volume":"15","author":"Papalia","year":"2023","journal-title":"Orthop Rev (Pavia)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"2104","DOI":"10.1111\/1756-185X.13074","article-title":"Association between medial meniscus extrusion and spontaneous osteonecrosis of the knee","volume":"21","author":"Yasuda","year":"2018","journal-title":"Int J Rheum Dis"},{"key":"B20","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1016\/j.jos.2019.02.001","article-title":"Medial meniscal extrusion and spontaneous osteonecrosis of the knee","volume":"24","author":"Oda","year":"2019","journal-title":"J Orthop Sci"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1922","DOI":"10.2106\/JBJS.G.00748","article-title":"Biomechanical consequences of a tear of the posterior root of the medial meniscus. Similar to total meniscectomy","volume":"90","author":"Allaire","year":"2008","journal-title":"J Bone Joint Surg Am"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2289","DOI":"10.1007\/s00167-022-07285-9","article-title":"Medial meniscus posterior root tears and partial meniscectomy significantly increase stress in the knee joint during dynamic gait","volume":"31","author":"Yang","year":"2023","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B23","doi-asserted-by":"publisher","first-page":"390","DOI":"10.1016\/j.knee.2016.12.004","article-title":"The role of medial meniscus posterior root tear and proximal tibial morphology in the development of spontaneous osteonecrosis and osteoarthritis of the knee","volume":"24","author":"Yamagami","year":"2017","journal-title":"Knee"},{"key":"B24","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1177\/0363546517743734","article-title":"The role of meniscal tears in spontaneous osteonecrosis of the knee: a systematic review of suspected etiology and a call to revisit nomenclature","volume":"47","author":"Hussain","year":"2019","journal-title":"Am J Sports Med"},{"key":"B25","doi-asserted-by":"publisher","first-page":"2282","DOI":"10.1007\/s00167-018-4885-7","article-title":"Medial meniscus extrusion increases with age and BMI and is depending on different loading conditions","volume":"26","author":"Achtnich","year":"2018","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B26","doi-asserted-by":"publisher","first-page":"3311","DOI":"10.1007\/s00167-018-5341-4","article-title":"No dynamic extrusion of the medial meniscus in ultrasound examination in patients with confirmed root tear lesion","volume":"27","author":"Karpinski","year":"2019","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B27","doi-asserted-by":"publisher","first-page":"269","DOI":"10.1007\/s12306-023-00783-0","article-title":"Time to reconsider post arthroscopic osteonecrosis of the knee: a systematic review","volume":"107","author":"Za","year":"2023","journal-title":"Musculoskelet Surg"},{"key":"B28","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.knee.2025.05.025","article-title":"Histopathological examination of post-arthroscopy osteonecrosis of the knee: a scoping review","volume":"56","author":"Za","year":"2025","journal-title":"Knee"},{"key":"B29","doi-asserted-by":"publisher","first-page":"1418","DOI":"10.2106\/00004623-199509000-00018","article-title":"Osteonecrosis of the femoral condyle after arthroscopic reconstruction of a cruciate ligament. Report of two cases","volume":"77","author":"Athanasian","year":"1995","journal-title":"J Bone Joint Surg Am"},{"key":"B30","doi-asserted-by":"publisher","first-page":"69","DOI":"10.2106\/JBJS.F.00533","article-title":"Osteonecrosis of the knee after laser or radiofrequency-assisted arthroscopy: treatment with minimally invasive knee arthroplasty","volume":"88","author":"Bonutti","year":"2006","journal-title":"J Bone Joint Surg Am"},{"key":"B31","doi-asserted-by":"publisher","first-page":"246","DOI":"10.1007\/s00167-013-2450-y","article-title":"Postarthroscopy osteonecrosis of the knee","volume":"23","author":"T\u00fcrker","year":"2015","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B32","doi-asserted-by":"publisher","first-page":"238","DOI":"10.1053\/jars.2002.29938","article-title":"Juxta-articular bone marrow signal changes on magnetic resonance imaging following arthroscopic meniscectomy","volume":"18","author":"Kobayashi","year":"2002","journal-title":"Arthroscopy"},{"key":"B33","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.ijscr.2019.10.049","article-title":"Subchondral fracture caused by unevenly stiffened meniscus after radiofrequency-assisted arthroscopic knee meniscectomy: a case report and review of the literature","volume":"65","author":"Fukui","year":"2019","journal-title":"Int J Surg Case Rep"},{"key":"B34","doi-asserted-by":"publisher","first-page":"1556","DOI":"10.3390\/microorganisms10081556","article-title":"Coronavirus disease 2019-associated coagulopathy","volume":"10","author":"Seo","year":"2022","journal-title":"Microorganisms"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1007\/s00296-021-04882-8","article-title":"Postdischarge rheumatic and musculoskeletal symptoms following hospitalization for COVID-19: prospective follow-up by phone interviews","volume":"41","author":"Karaarslan","year":"2021","journal-title":"Rheumatol Int"},{"key":"B36","doi-asserted-by":"publisher","first-page":"31","DOI":"10.21037\/aoj-23-67","article-title":"Knee osteonecrosis after SARS-CoV-2 infection: a systematic case-based review","volume":"9","author":"Za","year":"2024","journal-title":"Ann Jt"},{"key":"B37","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1007\/s00296-023-05332-3","article-title":"Osteonecrosis amid the COVID-19 pandemic","volume":"43","author":"Baimukhamedov","year":"2023","journal-title":"Rheumatol Int"},{"key":"B38","doi-asserted-by":"publisher","first-page":"105","DOI":"10.13107\/jocr.2024.v14.i08.4664","article-title":"Spontaneous osteonecrosis of knee: a complication of COVID-19 or an iatrogenic side effect of steroid use?","volume":"14","author":"Ahmad","year":"2024","journal-title":"J Orthop Case Rep"},{"key":"B39","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s12306-024-00854-w","article-title":"Osteonecrosis as a manifestation of long-COVID syndrome: a systematic review","volume":"109","author":"Za","year":"2025","journal-title":"Musculoskelet Surg"},{"key":"B40","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.17219\/acem\/153004","article-title":"Transient spontaneous osteonecrosis of the knee (SONK) shortly after SARS-CoV-2 infection: a report of 2 cases","volume":"31","author":"Malinowski","year":"2022","journal-title":"Adv Clin Exp Med"},{"key":"B41","first-page":"320","article-title":"The diagnosis and management of spontaneous and post-arthroscopy osteonecrosis of the knee","volume":"69","author":"Strauss","year":"2011","journal-title":"Bull NYU Hosp Jt Dis"},{"key":"B42","doi-asserted-by":"publisher","first-page":"6","DOI":"10.3978\/j.issn.2305-5839.2014.11.13","article-title":"Osteonecrosis of the knee: review","volume":"3","author":"Karim","year":"2015","journal-title":"Ann Transl Med"},{"key":"B43","doi-asserted-by":"publisher","first-page":"482","DOI":"10.5435\/00124635-201108000-00004","article-title":"Osteonecrosis of the knee and related conditions","volume":"19","author":"Mont","year":"2011","journal-title":"J Am Acad Orthop Surg"},{"key":"B44","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1097\/00003086-198211000-00019","article-title":"The treatment of osteonecrosis of the medial femoral condyle","author":"Lotke","year":"1982","journal-title":"Clin Orthop Relat Res"},{"key":"B45","doi-asserted-by":"publisher","first-page":"481","DOI":"10.1097\/00002281-199106000-00023","article-title":"Osteonecrosis","volume":"3","author":"Zizic","year":"1991","journal-title":"Curr Opin Rheumatol"},{"key":"B46","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1016\/j.knee.2016.04.005","article-title":"The importance of early diagnosis in spontaneous osteonecrosis of the knee\u2014a case series with six year follow-up","volume":"23","author":"Jordan","year":"2016","journal-title":"Knee"},{"key":"B47","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1097\/00003086-198708000-00021","article-title":"Clinical evaluation of the treatment of osteoarthritic knees using a newly designed wedged insole","author":"Sasaki","year":"1987","journal-title":"Clin Orthop Relat Res"},{"key":"B48","doi-asserted-by":"publisher","first-page":"847","DOI":"10.1002\/acr.21606","article-title":"Patterns of compartment involvement in tibiofemoral osteoarthritis in men and women and in whites and African Americans","volume":"64","author":"Wise","year":"2012","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"B49","doi-asserted-by":"publisher","first-page":"139","DOI":"10.1186\/s13018-016-0472-0","article-title":"A non-invasive, home-based biomechanical therapy for patients with spontaneous osteonecrosis of the knee","volume":"11","author":"Atoun","year":"2016","journal-title":"J Orthop Surg Res"},{"key":"B50","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s40945-019-0068-1","article-title":"The optimal degree of lateral wedge insoles for reducing knee joint load: a systematic review and meta-analysis","volume":"9","author":"Ferreira","year":"2019","journal-title":"Arch Physiother"},{"key":"B51","doi-asserted-by":"publisher","first-page":"11239","DOI":"10.3390\/ijms241411239","article-title":"Pulsed electromagnetic fields (PEMF)-physiological response and its potential in trauma treatment","volume":"24","author":"Flatscher","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B52","doi-asserted-by":"publisher","first-page":"1333566","DOI":"10.3389\/fbioe.2024.1333566","article-title":"Signalling pathways underlying pulsed electromagnetic fields in bone repair","volume":"12","author":"Wang","year":"2024","journal-title":"Front Bioeng Biotechnol"},{"key":"B53","doi-asserted-by":"publisher","first-page":"827","DOI":"10.23812\/20-706-L","article-title":"Beyond pre-analytical and analytical concerns in the study of synovial fluid proteome: description of an optimized gel-based protocol","volume":"35","author":"Bizzoca","year":"2021","journal-title":"J Biol Regul Homeost Agents"},{"key":"B54","doi-asserted-by":"publisher","first-page":"10090","DOI":"10.3390\/ijms241210090","article-title":"Targeting adenosine signalling in knee chondropathy: the combined action of polydeoxyribonucleotide and pulsed electromagnetic fields: a current concept review","volume":"24","author":"Moretti","year":"2023","journal-title":"Int J Mol Sci"},{"key":"B55","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1016\/j.ejrad.2012.11.011","article-title":"Conservative treatment of spontaneous osteonecrosis of the knee in the early stage: pulsed electromagnetic fields therapy","volume":"82","author":"Marcheggiani Muccioli","year":"2013","journal-title":"Eur J Radiol"},{"key":"B56","doi-asserted-by":"publisher","first-page":"1368982","DOI":"10.3389\/fragi.2024.1368982","article-title":"Hyperbaric oxygen therapy: future prospects in regenerative therapy and anti-aging","volume":"5","author":"Gupta","year":"2024","journal-title":"Front Aging"},{"key":"B57","doi-asserted-by":"publisher","first-page":"10656","DOI":"10.1007\/s12035-024-04227-z","article-title":"Unraveling the intricacies of OPG\/RANKL\/RANK biology and its implications in neurological disorders-A comprehensive literature review","volume":"61","author":"Freeman","year":"2024","journal-title":"Mol Neurobiol"},{"key":"B58","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1210\/endrev\/bnac031","article-title":"Bone turnover markers: basic biology to clinical applications","volume":"44","author":"Schini","year":"2023","journal-title":"Endocr Rev"},{"key":"B59","doi-asserted-by":"publisher","first-page":"759","DOI":"10.1177\/11207000211003285","article-title":"Combination of hyperbaric oxygen and core decompression therapies improve outcomes in the treatment of hip osteonecrosis","volume":"32","author":"Bozkurt","year":"2022","journal-title":"Hip Int"},{"key":"B60","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1080\/14756366.2018.1485149","article-title":"Hyperbaric oxygen therapy ameliorates osteonecrosis in patients by modulating inflammation and oxidative stress","volume":"33","author":"Bosco","year":"2018","journal-title":"J Enzyme Inhib Med Chem"},{"key":"B61","doi-asserted-by":"publisher","first-page":"62","DOI":"10.1007\/s11916-016-0591-7","article-title":"NSAIDs in the treatment of postoperative pain","volume":"20","author":"Gupta","year":"2016","journal-title":"Curr Pain Headache Rep"},{"key":"B62","doi-asserted-by":"publisher","first-page":"114147","DOI":"10.1016\/j.bcp.2020.114147","article-title":"Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: a current perspective","volume":"180","author":"Bindu","year":"2020","journal-title":"Biochem Pharmacol"},{"key":"B63","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.knee.2006.10.012","article-title":"Early MRI diagnosis and non-surgical management of spontaneous osteonecrosis of the knee","volume":"14","author":"Yates","year":"2007","journal-title":"Knee"},{"key":"B64","doi-asserted-by":"publisher","first-page":"4158","DOI":"10.1016\/j.radcr.2024.06.069","article-title":"Subchondral insufficiency fracture of the medial femoral condyle treated conservatively with early non-weightbearing","volume":"19","author":"Maris","year":"2024","journal-title":"Radiol Case Rep"},{"key":"B65","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.18553\/jmcp.2013.19.s9.1","article-title":"NSAIDs for musculoskeletal pain management:current perspectives and novel strategies to improve safety","volume":"19","author":"Atchison","year":"2013","journal-title":"J Manag Care Pharm"},{"key":"B66","doi-asserted-by":"publisher","first-page":"182","DOI":"10.7326\/M22-0684","article-title":"Effectiveness and safety of treatments to prevent fractures in people with low bone mass or primary osteoporosis: a living systematic review and network meta-analysis for the American college of physicians","volume":"176","author":"Ayers","year":"2023","journal-title":"Ann Intern Med"},{"key":"B67","doi-asserted-by":"publisher","first-page":"e23123","DOI":"10.1097\/MD.0000000000023123","article-title":"Bisphosphonate for spontaneous osteonecrosis of the knee: a protocol for systematic review and meta-analysis of randomized controlled trials","volume":"99","author":"Shen","year":"2020","journal-title":"Medicine (Baltimore)"},{"key":"B68","doi-asserted-by":"publisher","first-page":"300","DOI":"10.23736\/S0026-4806.18.05688-4","article-title":"Clodronate in the management of different musculoskeletal conditions","volume":"109","author":"Frediani","year":"2018","journal-title":"Minerva Med"},{"key":"B69","first-page":"1477","article-title":"Intravenous clodronate in the treatment of reflex sympathetic dystrophy syndrome. A randomized, double blind, placebo controlled study","volume":"27","author":"Varenna","year":"2000","journal-title":"J Rheumatol"},{"key":"B70","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s40261-013-0062-4","article-title":"Improved efficacy of intramuscular weekly administration of clodronate 200\u2005mg (100\u2005mg twice weekly) compared with 100\u2005mg (once weekly) for increasing bone mineral density in postmenopausal osteoporosis","volume":"33","author":"Frediani","year":"2013","journal-title":"Clin Drug Investig"},{"key":"B71","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1007\/s40268-020-00294-4","article-title":"Intramuscular clodronate in long-term treatment of symptomatic knee osteoarthritis: a randomized controlled study","volume":"20","author":"Frediani","year":"2020","journal-title":"Drugs R D"},{"key":"B72","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.1093\/rheumatology\/kev123","article-title":"Intravenous neridronate in the treatment of acute painful knee osteoarthritis: a randomized controlled study","volume":"54","author":"Varenna","year":"2015","journal-title":"Rheumatology (Oxford)"},{"key":"B73","doi-asserted-by":"publisher","first-page":"9802827","DOI":"10.1155\/2019\/9802827","article-title":"Monthly intramuscular neridronate for the treatment of postmenopausal osteoporosis: results of a 6-year prospective Italian study","volume":"2019","author":"Guiducci","year":"2019","journal-title":"Int J Endocrinol"},{"key":"B74","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1007\/s00223-008-9179-5","article-title":"Intramuscular neridronate in postmenopausal women with low bone mineral density","volume":"83","author":"Adami","year":"2008","journal-title":"Calcif Tissue Int"},{"key":"B75","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1080\/14740338.2018.1424828","article-title":"The role of Iloprost on bone edema and osteonecrosis: safety and clinical results","volume":"17","author":"Pountos","year":"2018","journal-title":"Expert Opin Drug Saf"},{"key":"B76","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1007\/s00132-022-04300-2","article-title":"Medikament\u00f6se therapie von osteonekrosen [drug treatment of osteonecrosis]","volume":"51","author":"Roth","year":"2022","journal-title":"Orthopadie (Heidelb)"},{"key":"B77","doi-asserted-by":"publisher","first-page":"6150","DOI":"10.4081\/or.2016.6150","article-title":"Long-term clinical results after iloprost treatment for bone marrow edema and avascular necrosis","volume":"8","author":"Cla\u00dfen","year":"2016","journal-title":"Orthop Rev (Pavia)"},{"key":"B78","doi-asserted-by":"publisher","first-page":"R120","DOI":"10.1186\/ar2526","article-title":"Rationale for prostaglandin I2 in bone marrow oedema\u2013from theory to application","volume":"10","author":"J\u00e4ger","year":"2008","journal-title":"Arthritis Res Ther"},{"key":"B79","doi-asserted-by":"publisher","first-page":"7794","DOI":"10.3390\/ijms21207794","article-title":"Platelet-rich plasma: new performance understandings and therapeutic considerations in 2020","volume":"21","author":"Everts","year":"2020","journal-title":"Int J Mol Sci"},{"key":"B80","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1080\/09537104.2020.1810221","article-title":"Platelet-rich plasma promotes bone formation, restrains adipogenesis and accelerates vascularization to relieve steroids-induced osteonecrosis of the femoral head","volume":"32","author":"Xu","year":"2021","journal-title":"Platelets"},{"key":"B81","doi-asserted-by":"publisher","first-page":"e0304096","DOI":"10.1371\/journal.pone.0304096","article-title":"Clinical evaluation of platelet-rich plasma therapy for osteonecrosis of the femoral head: a systematic review and meta-analysis","volume":"19","author":"Guo","year":"2024","journal-title":"PLoS One"},{"key":"B82","first-page":"525","article-title":"Research progress of gene therapy in the treatment of non-traumatic osteonecrosis of femoral head","volume":"25","author":"Zhou","year":"2012","journal-title":"Zhongguo Gu Shang"},{"key":"B83","doi-asserted-by":"publisher","first-page":"503","DOI":"10.1186\/s13287-021-02572-7","article-title":"The effect of genetically modified platelet-derived growth factor-BB over-expressing mesenchymal stromal cells during core decompression for steroid-associated osteonecrosis of the femoral head in rabbits","volume":"12","author":"Guzman","year":"2021","journal-title":"Stem Cell Res Ther"},{"key":"B84","doi-asserted-by":"publisher","first-page":"834","DOI":"10.1016\/j.arthro.2005.04.106","article-title":"Arthroscopic microfracture treatment for osteonecrosis of the knee","volume":"21","author":"Akgun","year":"2005","journal-title":"Arthroscopy"},{"key":"B85","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1016\/j.csm.2019.08.009","article-title":"Injury of the meniscus root","volume":"39","author":"Kennedy","year":"2020","journal-title":"Clin Sports Med"},{"key":"B86","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1007\/s00402-009-0872-2","article-title":"Joint-preserving surgical treatment of spontaneous osteonecrosis of the knee","volume":"130","author":"Duany","year":"2010","journal-title":"Arch Orthop Trauma Surg"},{"key":"B87","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1007\/s00167-008-0558-2","article-title":"Artificial bone grafting [calcium hydroxyapatite ceramic with an interconnected porous structure (IP-CHA)] and core decompression for spontaneous osteonecrosis of the femoral condyle in the knee","volume":"16","author":"Deie","year":"2008","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B88","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.arthro.2017.08.244","article-title":"Mosaic osteochondral autograft transplantation versus bone marrow stimulation technique as a concomitant procedure with opening-wedge high tibial osteotomy for spontaneous osteonecrosis of the medial femoral condyle","volume":"34","author":"Kumagai","year":"2018","journal-title":"Arthroscopy"},{"key":"B89","doi-asserted-by":"publisher","first-page":"2325967117730540","DOI":"10.1177\/2325967117730540","article-title":"Fresh osteochondral allograft transplantation for spontaneous osteonecrosis of the knee: a case series","volume":"5","author":"T\u00edrico","year":"2017","journal-title":"Orthop J Sports Med"},{"key":"B90","doi-asserted-by":"publisher","first-page":"234","DOI":"10.1007\/s00402-025-05857-1","article-title":"Biomechanical and biocompatibility study of carbon fibre\/kevlar high tibial osteotomy elastic composite plate","volume":"145","author":"Xu","year":"2025","journal-title":"Arch Orthop Trauma Surg"},{"key":"B91","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1007\/s00167-008-0698-4","article-title":"Clinical results and radiographical evaluation of opening wedge high tibial osteotomy for spontaneous osteonecrosis of the knee","volume":"17","author":"Takeuchi","year":"2009","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B92","doi-asserted-by":"publisher","first-page":"19476035221118171","DOI":"10.1177\/19476035221118171","article-title":"Biological effects of high tibial osteotomy on spontaneous osteonecrosis of the knee","volume":"13","author":"Kumagai","year":"2022","journal-title":"Cartilage"},{"key":"B93","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1186\/s13018-020-01894-1","article-title":"Effects of proximal fibular osteotomy on stress changes in mild knee osteoarthritis with varus deformity: a finite element analysis","volume":"15","author":"Pan","year":"2020","journal-title":"J Orthop Surg Res"},{"key":"B94","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1016\/j.cpm.2018.06.001","article-title":"Subchondroplasty: treatment of bone marrow lesions in the lower extremity","volume":"35","author":"Pelucacci","year":"2018","journal-title":"Clin Podiatr Med Surg"},{"key":"B95","doi-asserted-by":"publisher","first-page":"e287","DOI":"10.3928\/01477447-20230310-03","article-title":"Subchondroplasty for osteonecrosis of the knee","volume":"46","author":"Fitzpatrick","year":"2023","journal-title":"Orthopedics"},{"key":"B96","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1615\/JLongTermEffMedImplants.2023049584","article-title":"Complications following intraosseous injections of calcium phosphate bone cement in subchondroplasty","volume":"34","author":"Zachariadis","year":"2024","journal-title":"J Long Term Eff Med Implants"},{"key":"B97","doi-asserted-by":"publisher","first-page":"821","DOI":"10.2106\/JBJS.19.00381","article-title":"Spontaneous osteonecrosis\/subchondral insufficiency fractures of the knee: high rates of conversion to surgical treatment and arthroplasty","volume":"102","author":"Pareek","year":"2020","journal-title":"J Bone Joint Surg Am"},{"key":"B98","first-page":"1907","article-title":"Stepwise treatment strategy for spontaneous osteonecrosis of the medial femoral condyle of the knee joint","volume":"28","author":"Pan","year":"2024","journal-title":"Chin J Tissue Eng Res"},{"key":"B99","doi-asserted-by":"publisher","first-page":"73916","DOI":"10.52965\/001c.73916","article-title":"Unicompartmental knee arthroplasty (UKA) for primary spontaneous osteonecrosis of the knee (SONK): a systematic review","volume":"15","author":"Saccone","year":"2023","journal-title":"Orthop Rev (Pavia)"},{"key":"B100","doi-asserted-by":"publisher","first-page":"3254","DOI":"10.1007\/s00167-020-06132-z","article-title":"Total and unicondylar knee arthroplasty are equivalent treatment options in end-stage spontaneous osteonecrosis of the knee, and the size of the lesion has no influence on the results","volume":"29","author":"Flury","year":"2021","journal-title":"Knee Surg Sports Traumatol Arthrosc"},{"key":"B101","doi-asserted-by":"publisher","first-page":"3352","DOI":"10.1016\/j.arth.2017.05.050","article-title":"Midterm-adjusted survival comparing the best performing unicompartmental and total knee arthroplasties in a registry","volume":"32","author":"Bini","year":"2017","journal-title":"J Arthroplasty"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1640316\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T06:18:32Z","timestamp":1761027512000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2025.1640316\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,21]]},"references-count":101,"alternative-id":["10.3389\/fsurg.2025.1640316"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2025.1640316","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,21]]},"article-number":"1640316"}}