![]() ![]() Non-operative treatments, in general, focus on the proper balance of weight bearing and bone density. SIFK treatment has no standardized guidelines. The presence of SIFK can be a sign of both a local degree of osteopenia as well as a process of degeneration. After 30 months, the patient reported no further knee pain and a successful return to ultra-marathon running. Following her first presentation, she was referred for a second course of bisphosphonate infusion therapy, which she began 12 months later. After an MRI follow-up, there was some improvement in both the volume and intensity of the bone marrow oedema in the lateral femoral condyle (Fig. The patient presenting with SIF of the knee is poorly understood and described, with the majority of the symptoms occurring in the weight bearing compartment of her knee. The patient was eventually persuaded to take bisphosphonates and declined. The patient’s surgical management, which included an offload osteotomy, a demineralized femoral osteotomy, and a resurfacing procedure, was discussed with him due to the severity of his symptoms and the restriction of his life. Using magnetic resonance imaging (MRI), a subchondral insufficiency fracture was discovered on the extensor surface of the lateral femoral condyle, as well as bone marrow oedema that was 2.5 cm in the anteroposterior plane and 2.1 cm in the transverse plane. On a physical exam, a grade one effusion of tenderness was discovered on the patient’s left knee. The patient had a successful recovery and is now back to full athletic activity. This was followed up by a course of conservative management using bisphosphonates. A subchondral fracture of the knee (SIFK) was diagnosed as a result of magnetic resonance imaging. In the absence of trauma, there is an acute onset of severe and worsening knee pain.Īn ultra-marathon runner in her sixties was referred to our clinic after experiencing left lateral knee pain for the previous five months. ![]() Long-term weight bearing or repetitive impaction forces to the bone can lead to subchondral fractures in the knee. Young military recruits and elderly patients with poor bone health are two groups that are disproportionately affected. Subclavian fracture in the femoral head is one of the most common causes of hip pain, and it is the result of a fracture in the femoral head without any trauma. Although low bone density may appear concurrently with a subchondral fracture, this is not the underlying cause of the fracture in the majority of cases. Subchondral fractures, which are not traumatic, occur immediately beneath the joint’s cartilage. SIF results from frequent physiological force being applied to an area of bone that has been compromised by non-cancer disease, resulting in bone fractures. In more severe cases, surgery may be necessary.Ī subchondral fracture is a type of stress fracture in which the bone’s weight bearing surface is below the cartilage. Treatment for a subchondral compression fracture typically involves rest, ice, and pain medication. These fractures are most commonly seen in the elderly population and can be caused by a number of different things, including trauma, osteoporosis, and cancer. A subchondral compression fracture is a type of fracture that occurs beneath the cartilage of a joint. ![]()
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