{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T12:48:55Z","timestamp":1775738935172,"version":"3.50.1"},"reference-count":66,"publisher":"Open Medical Publishing","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Knee osteonecrosis is a debilitating progressive degenerative disease characterized by subchondral bone ischemia. It can lead to localized necrosis, tissue death, and progressive joint destruction. For this reason, it is essential to diagnose and treat this disease early to avoid subchondral collapse, chondral damage, and end-stage osteoarthritis, where the only solution is total knee arthroplasty.<\/jats:p> <jats:p>Three types of knee osteonecrosis have been documented in the literature: spontaneous or primitive, secondary, and post arthroscopy. Spontaneous osteonecrosis is the most common type studied in the literature. Secondary osteonecrosis of the knee is a rare disease and, unlike the spontaneous one, involves patients younger than 50 years. It presents a particular set of pathological, clinical, imaging, and progression features. The management of secondary osteonecrosis is determined by the stage of the disorder, the clinical manifestation, the size and location of the lesions, whether the involvement is unilateral or bilateral, the patient\u2019s age, level of activity, general health, and life expectancy. This review aims to present the recent evidence on treatment options for secondary osteonecrosis of the knee, including conservative treatment, joint preserving surgery, and knee replacement.<\/jats:p>","DOI":"10.52965\/001c.33639","type":"journal-article","created":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T16:26:34Z","timestamp":1650903994000},"source":"Crossref","is-referenced-by-count":9,"title":["Treatment options for secondary osteonecrosis of the knee"],"prefix":"10.52965","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3353-1759","authenticated-orcid":false,"given":"Hassan","family":"Zmerly","sequence":"first","affiliation":[{"name":"San Pier Damiano Hospital, GVM, Faenza (RA), Italy; Villa Erbosa Hospital, Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manuela","family":"Moscato","sequence":"additional","affiliation":[{"name":"San Pier Damiano Hospital, Faenza, Italy","department":["Orthopaedics"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3972-5968","authenticated-orcid":false,"given":"Ibrahim","family":"Akkawi","sequence":"additional","affiliation":[{"name":"Villa Erbosa Hospital, Bologna, Italy","department":["Orthopaedics"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Riccardo","family":"Galletti","sequence":"additional","affiliation":[{"name":"San Pier Damiano Hospital, Faenza (RA), Italy","department":["Orthopaedics"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Di Gregori","sequence":"additional","affiliation":[{"name":"San Pier Damiano Hospiatl, GVM care and research, Faenza (RA), Italy","department":["Medical direction"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"30777","published-online":{"date-parts":[[2022,4,25]]},"reference":[{"issue":"1","key":"ref1","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1177\/1947603517749920","article-title":"Thrombophilia-Associated Factors in Patients with Spontaneous Osteonecrosis of the Knee","volume":"10","author":"Niv Marom","year":"2019","journal-title":"Cartilage","ISSN":"https:\/\/id.crossref.org\/issn\/1947-6035","issn-type":"print"},{"issue":"6","key":"ref2","doi-asserted-by":"publisher","first-page":"719","DOI":"10.1007\/s00296-009-1269-9","article-title":"Osteonecrosis secondary to antiphospholipid syndrome: a case report, review of the literature, and treatment strategy","volume":"30","author":"Waqar Haque","year":"2010","journal-title":"Rheumatology International","ISSN":"https:\/\/id.crossref.org\/issn\/0172-8172","issn-type":"print"},{"key":"ref3","first-page":"234","article-title":"Multifocal osteonecrosis predominantly affecting the knees secondary to chronic alcohol ingestion: a case report and review","volume":"Apr;72(2):234-6. 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