Please confirm topic selection

Are you sure you want to trigger topic in your Anconeus AI algorithm?

Please confirm action

You are done for today with this topic.

Would you like to start learning session with this topic items scheduled for future?

Review Question - QID 485

In scope icon L 3 C
QID 485 (Type "485" in App Search)
A 59-year-old female librarian complains of progressively worsening left knee pain over the last 4 months. She does not recall any traumatic injury to the knee. Physical exam is noteable for tenderness isolated to the medial joint line. She has full ROM and no instability of the knee. Radiographs and MRI image are provided in figures A,B, and C. Which of the following is the best management?
  • A
  • B
  • C

Open biopsy

1%

62/4182

Chest CT and bone scan

2%

104/4182

Osteochondral autograft transfer

23%

951/4182

Unicompartmental knee arthroplasty

70%

2918/4182

Valgus-producing high tibial osteotomy

3%

118/4182

  • A
  • B
  • C

Select Answer to see Preferred Response

bookmode logo Review TC In New Tab

The radiograph and MRI demonstrate osteonecrosis of the knee. Spontaneous osteonecrosis occurs most commonly in females over 55 years of age and most frequently involves the medial femoral condyle. Treatment is arthroplasty when conservative management fails. Open biopsy is incorrect as there is no matrix or periosteal reaction suspicious for malignancy and primary malignancy in a 59-year-old would be rare. Chest CT and bone scan is incorrect as the subchondral femoral condyle is not a site of bony metastases and the patient is otherwise healthy. Osteochondral autograft would be a poor choice given the size of the defect and the patient's age. HTO would be a poor choice for a 59-year-old and there is no significant varus deformity present. In a systematic review, Myers found that TKA and UKA treatment for spontaneous ostenecrosis achieved similar results compared to TKA/UKA for osteoarthritis when the appropriate indications are exercised.

REFERENCES (1)
Authors
Rating
Please Rate Question Quality

3.2

  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon
  • star icon star icon star icon

(37)

Attach Treatment Poll
Treatment poll is required to gain more useful feedback from members.
Please enter Question Text
Please enter at least 2 unique options
Please enter at least 2 unique options
Please enter at least 2 unique options