Osteonecrosis bilateral de rodilla tratada con descompresión y concentrado de aspirado de médula ósea

Abstract

Described by Ahlbäck in 1968, osteonecrosis of the knee is a pathology with great potential for morbidity. It is divided into three large groups: primary/spontaneous, postoperative, and secondary/atraumatic. The latter might be directly related to prolonged consumption of steroids. Its treatment is a challenge for the orthopedist. It will depend on the disease stage and articular collapse, always trying to preserve the native articular surface. Within the different therapeutic options, biological therapies are a potentially valuable tool as a complement to surgical treatment, showing encouraging clinical results. 

We present the case of a female patient with bilateral osteonecrosis of the knee, secondary to chronic consumption of steroids, treated with bilateral arthroscopy associated with decompressive subchondral perforations and subchondral application of bone marrow concentrate (BMC), with a satisfactory evolution of symptoms after thirty months of follow-up in the right knee. However, the left knee showed a torpid evolution of symptoms after twenty-four months of follow-up, so she is on a joint replacement plan.