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Войти в исследования Orthopadie (Heidelberg, Germany) · 2025
[Pharmacological therapy for subchondral pathologies of the knee joint].
Аннотация на английскомСтатьяОбзорНазвание и аннотация: Перевод в очереди
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Orth Patrick, Brockmeyer Matthias, Stachel Niklas, Madry Henning
Аннотация
BACKGROUND: Pathologies of the subchondral bone include both structural alterations such as osteonecrosis and bone marrow edema. Both entities are amenable to pharmacological therapy.
OBJECTIVE: Presentation of current recommendations for drug therapy of osteonecrosis and bone marrow edema of the knee joint based on the clinical data.
METHODS: The currently available literature is evaluated and discussed.
RESULTS: Antiresorptives such as bisphosphonates and denosumab and the osteoanabolic agent teriparatide therapeutically address the locally diminished bone density potentially resulting in insufficiency fractures. In contrast, vitamin K antagonists, heparin and new/direct oral anticoagulants, as well as iloprost exert their effects at the vascular and hemostatic level. All drug treatment concepts are "off-label" use. They are particularly promising in the early stages of primary, idiopathic osteonecrosis and bone marrow edema.
CONCLUSION: In osteonecrosis and bone marrow edema of the knee joint, complementary drug therapy may be beneficial. However, the available data is not yet sufficiently robust for general treatment recommendations.
OBJECTIVE: Presentation of current recommendations for drug therapy of osteonecrosis and bone marrow edema of the knee joint based on the clinical data.
METHODS: The currently available literature is evaluated and discussed.
RESULTS: Antiresorptives such as bisphosphonates and denosumab and the osteoanabolic agent teriparatide therapeutically address the locally diminished bone density potentially resulting in insufficiency fractures. In contrast, vitamin K antagonists, heparin and new/direct oral anticoagulants, as well as iloprost exert their effects at the vascular and hemostatic level. All drug treatment concepts are "off-label" use. They are particularly promising in the early stages of primary, idiopathic osteonecrosis and bone marrow edema.
CONCLUSION: In osteonecrosis and bone marrow edema of the knee joint, complementary drug therapy may be beneficial. However, the available data is not yet sufficiently robust for general treatment recommendations.