{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:16:25Z","timestamp":1790403385759,"version":"4.1.0"},"reference-count":43,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T00:00:00Z","timestamp":1669334400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Osteonecrosis is a terrible condition that can cause advanced arthritis in a number of joints, including the knee. The three types of osteonecrosis that can affect the knee are secondary, post-arthroscopic, and spontaneous osteonecrosis of the knee (SPONK). Regardless of osteonecrosis classification, treatment for this condition seeks to prevent further development or postpone the onset of knee end-stage arthritis. Joint arthroplasty is the best course of action whenever there is significant joint surface collapse or there are signs of degenerative arthritis. The non-operative options for treatment at the moment include observation, nonsteroidal anti-inflammatory medications (NSAIDs), protective weight bearing, and analgesia if needed. Depending on the severity and type of the condition, operational procedures may include unilateral knee arthroplasty (UKA), total knee arthroplasty (TKA), or joint preservation surgery. Joint preservation techniques, such as arthroscopy, core decompression, osteochondral autograft, and bone grafting, are frequently used in precollapse and some postcollapse lesions, when the articular cartilage is typically unaffected and only the underlying subchondral bone is affected. In contrast, operations that try to save the joint following significant subchondral collapse are rarely successful and joint replacement is required to ease discomfort. This article\u2019s goal is to summarise the most recent research on evaluations, clinical examinations, imaging and various therapeutic strategies for osteonecrosis of the knee, including lesion surveillance, medicines, joint preservation methods, and total joint arthroplasty.<\/jats:p>","DOI":"10.3390\/jcm11236943","type":"journal-article","created":{"date-parts":[[2022,11,25]],"date-time":"2022-11-25T03:34:24Z","timestamp":1669347264000},"page":"6943","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Spontaneous Osteonecrosis of the Knee: State of the Art"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3350-2157","authenticated-orcid":false,"given":"Daniel Veloz","family":"Serrano","sequence":"first","affiliation":[{"name":"Hospital Britanico of Buenos Aires, Buenos Aires C1280 AEB, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samundeeswari","family":"Saseendar","sequence":"additional","affiliation":[{"name":"Apollo Hospital Muscat, Muscat 131, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saseendar","family":"Shanmugasundaram","sequence":"additional","affiliation":[{"name":"Apollo Hospital Muscat, Muscat 131, Oman"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohan","family":"Bidwai","sequence":"additional","affiliation":[{"name":"Senior Clinical Fellow, York Teaching Hospital NHS Foundation Trust, York YO31 8HE, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"G\u00f3mez","sequence":"additional","affiliation":[{"name":"Hospital Britanico of Buenos Aires, Buenos Aires C1280 AEB, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1216-792X","authenticated-orcid":false,"given":"Riccardo","family":"D\u2019Ambrosi","sequence":"additional","affiliation":[{"name":"IRCCS Istituto Ortopedico Galeazzi, 20161 Milan, Italy"},{"name":"Dipartimento di Scienze Biomediche per la Salute, Universit\u00e0 degli Studi di Milano, 20133 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1007\/s00264-020-04536-7","article-title":"Spontaneous osteonecrosis of the knee: What do we know thus far? 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