North Texas GME Research Forum 2024



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North Texas


Medical City Denton


Orthopedic Surgery

Document Type


Publication Date



spontaneous osteonecrosis of the knee


Medicine and Health Sciences | Musculoskeletal Diseases | Orthopedics


Introduction: Spontaneous osteonecrosis of the knee (SPONK) is a relatively uncommon disease consisting of a focal, subchondral lesion thought to be a subchondral insufficiency fracture that has progressed to collapse and may lead to end-stage osteoarthritis of the knee. There are several treatment options, including nonsurgical and surgical measures but almost 80% of cases end up requiring surgery, usually consisting of unicompartmental or total knee arthroplasty. However, despite these treatment options, there remains no good option for young patients who present with SPONK in large areas of their distal femur or disease in both medial and lateral condyles. Case description: A 25 year old male presented after referral with MRI demonstrating SPONK in both knees. The Left knee involved both medial and lateral femoral condyles and the right knee involved lateral condyle with widespread, severe disease in both. The patient was hardly able to ambulate and had constant pain, making it impossible for him to do daily activities or hobbies without severe pain. After negative medical workup, the patient underwent osteochondral allograft transplantations for his SPONK bilaterally in a staged fashion. With both knees, the patient was pain free at 3 months and is now back to daily life and playing recreational sports with no pain almost 2 years after surgery. Discussion: This case report demonstrates a unique instance of a young, healthy male who developed spontaneous osteonecrosis of bilateral knees with involvement of both medial and lateral condyles of one knee. Our patient was successfully treated with osteochondral allograft transplantation bilaterally, demonstrating that patients in this demographic have another surgical treatment available to them that does not limit their options in the long term.

Original Publisher

HCA Healthcare Graduate Medical Education

Bilateral Spontaneous Osteonecrosis of the Knee (SPONK) in Young Male: A Case Report



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