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Association of Spontaneous Osteonecrosis of the Knee with Ipsilateral Meniscus and Posterior Root Tear: Systematic Review and Meta-analysis

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Abstract

Objective

The relationship between spontaneous osteonecrosis of the knee (SONK) and ipsilateral meniscus tear remains to be established, and the possible causes are clarified and summarized.

Methods

We conducted a search in Pubmed, Web of Science, Embase, and the Cochrane Library to include all English articles published from the establishment of the database until April 2023. The odds ratio (OR) and 95% confidence interval (CI) were calculated to evaluate the relationship between SONK and ipsilateral meniscus lesions.

Results

A total of 405 patients were included in eight articles, including 157 males and 248 females, with an average age of 63.94 years and an average BMI of 26.36 kg/m2. In patients with medial SONK, the prevalence of ipsilateral meniscus tear was 0.8982, 95% CI (0.7389, 0.9648), and the prevalence of ipsilateral posterior root tear was 0.6198, 95% CI (0.5169, 0.7118). The prevalence of ipsilateral meniscus tears in patients with lateral SONK was 0.2188, 95% CI (0.1150, 0.3711), and the prevalence of ipsilateral posterior root tears was 0.1667, 95% CI (0.1071, 0.2424).

Conclusions

SONK is significantly associated with meniscus or root tears, which limit meniscus function and lead to changes in the stress environment between the knee and the tibiofemur, increasing the chance of incomplete fracture. We suggest that the expression of SONK can be replaced with subchondral insufficiency fracture of the knee.

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Data Availability

The data sets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code Availability

Not applicable.

Abbreviations

SONK:

Spontaneous osteonecrosis of the knee

SIFK:

Subchondral insufficiency fracture of the knee

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Acknowledgements

Thank you for the support provided by the “Fund Program for the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province”.

Funding

“Fund Program for the Scientific Activities of Selected Returned Overseas Professionals in Shanxi Province” (Grant number: 20210008).

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Authors and Affiliations

  1. Department of Orthopedics, Second Hospital of Shanxi Medical University, No. 382, Wuyi Road, Taiyuan, 030001, Shanxi, China

    Yuhua Feng, Jiaju Yang, Min Zhang, Haohao Wang & Gang Xi

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Contributions

Yuhua Feng and Min Zhang contributed to the study conception and design. Yuhua Feng drafted the initial manuscript. Yuhua Feng and Jiaju Yang collected the data. Yuhua Feng and Haohao Wang analyzed the data and prepared the figures. All authors reviewed and revised the manuscript. All authors read and approved the final manuscript.

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Correspondence to Min Zhang.

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Feng, Y., Yang, J., Zhang, M. et al. Association of Spontaneous Osteonecrosis of the Knee with Ipsilateral Meniscus and Posterior Root Tear: Systematic Review and Meta-analysis. JOIO (2024). https://doi.org/10.1007/s43465-024-01140-4

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