[Nonoperative treatment for the management of osteonecrosis and bone marrow oedema of the foot and ankle].

Abstract

Background: Today, there are several nonoperative treatment measures available for the management of osteonecrosis and bone marrow oedema of the foot and ankle.

Treatment: These include immobilisation, the use of anti-inflammatory drugs (NSAIDs), physical therapy, orthotics and extracorporeal shockwave therapy (ESWT). Furthermore, off-label use of either bisphosphonates, denosumab or prostacyclins have proven to be effective treatment options. Notably, in many cases, symptoms resolve after several months without any specific treatment. As patients often present with insufficient vitamin D levels, the measurement and correction of vitamin D status is recommended.