Zachary S Aman, Nicholas N. DePhillipo, D. R. Lind, T. Dekker, R. LaPrade
{"title":"双膦酸盐和前列腺素治疗膝关节软骨下不全骨折的作用:基于证据的观点","authors":"Zachary S Aman, Nicholas N. DePhillipo, D. R. Lind, T. Dekker, R. LaPrade","doi":"10.60118/001c.34672","DOIUrl":null,"url":null,"abstract":"Subchondral Insufficiency Fractures of the Knee (SIFK) can result in accelerated cartilage degeneration and poor outcomes. The presence of SIFK is difficult to manage and can cause persistent knee swelling, pain, and prolonged disability. Pharmacologic agents to suppress extensive bone remodeling, improve blood supply, and reduce pain have been suggested as treatment for these lesions. Nonoperative management with prostaglandins and bisphosphonates has emerged as a potentially efficacious intervention for symptom reduction and resolution of knee bone marrow edema. However, previous reports of potential serious adverse effects including atypical femoral fractures of the proximal femur raise concerns for clinical safety. This evidence-based opinion article demonstrates the potential clinical efficacy of various pharmacologic therapies, including prostaglandins and bisphosphonates, for the treatment of SIFK. The overall rate of reporting adverse effects in the literature is high (47.3%), while significant clinical improvements have been identified in 66% to 100% of the patient population. This collective information may help guide physicians during prescription drug therapy for the treatment of SIFK.","PeriodicalId":298624,"journal":{"name":"Journal of Orthopaedic Experience & Innovation","volume":"6 1","pages":"0"},"PeriodicalIF":0.0000,"publicationDate":"2022-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Role of Bisphosphonates and Prostaglandins for the Treatment of Subchondral Insufficiency Fractures of the Knee: An Evidenced-Based Opinion\",\"authors\":\"Zachary S Aman, Nicholas N. DePhillipo, D. R. Lind, T. Dekker, R. LaPrade\",\"doi\":\"10.60118/001c.34672\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Subchondral Insufficiency Fractures of the Knee (SIFK) can result in accelerated cartilage degeneration and poor outcomes. The presence of SIFK is difficult to manage and can cause persistent knee swelling, pain, and prolonged disability. Pharmacologic agents to suppress extensive bone remodeling, improve blood supply, and reduce pain have been suggested as treatment for these lesions. Nonoperative management with prostaglandins and bisphosphonates has emerged as a potentially efficacious intervention for symptom reduction and resolution of knee bone marrow edema. However, previous reports of potential serious adverse effects including atypical femoral fractures of the proximal femur raise concerns for clinical safety. This evidence-based opinion article demonstrates the potential clinical efficacy of various pharmacologic therapies, including prostaglandins and bisphosphonates, for the treatment of SIFK. The overall rate of reporting adverse effects in the literature is high (47.3%), while significant clinical improvements have been identified in 66% to 100% of the patient population. This collective information may help guide physicians during prescription drug therapy for the treatment of SIFK.\",\"PeriodicalId\":298624,\"journal\":{\"name\":\"Journal of Orthopaedic Experience & Innovation\",\"volume\":\"6 1\",\"pages\":\"0\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-09-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Orthopaedic Experience & Innovation\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.60118/001c.34672\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Orthopaedic Experience & Innovation","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.60118/001c.34672","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
The Role of Bisphosphonates and Prostaglandins for the Treatment of Subchondral Insufficiency Fractures of the Knee: An Evidenced-Based Opinion
Subchondral Insufficiency Fractures of the Knee (SIFK) can result in accelerated cartilage degeneration and poor outcomes. The presence of SIFK is difficult to manage and can cause persistent knee swelling, pain, and prolonged disability. Pharmacologic agents to suppress extensive bone remodeling, improve blood supply, and reduce pain have been suggested as treatment for these lesions. Nonoperative management with prostaglandins and bisphosphonates has emerged as a potentially efficacious intervention for symptom reduction and resolution of knee bone marrow edema. However, previous reports of potential serious adverse effects including atypical femoral fractures of the proximal femur raise concerns for clinical safety. This evidence-based opinion article demonstrates the potential clinical efficacy of various pharmacologic therapies, including prostaglandins and bisphosphonates, for the treatment of SIFK. The overall rate of reporting adverse effects in the literature is high (47.3%), while significant clinical improvements have been identified in 66% to 100% of the patient population. This collective information may help guide physicians during prescription drug therapy for the treatment of SIFK.