Post-arthroscopic osteonecrosis of the medial tibial plateau: a case series

BACKGROUND: Avascular necrosis after arthroscopic surgery of the knee has already been published. The purpose of this article is to report on the frequently misdiagnosed entity of osteonecrosis of the medial tibial plateau. CASE PRESENTATION: Charts and radiographs of a consecutive series with isolated medial tibial plateau osteonecrosis were analyzed. The criterion for inclusion was the absence of trauma. Six caucasian female patients with an average age of 76.5 years complied with this criterion. Three of these cases had had arthroscopic intervention for medial meniscal lesion within the previous year. CONCLUSIONS: The etiology of these necroses remains unclear. Osteonecrosis must be taken into account as a possible cause of persistent knee pain after surgery. Correlation between arthroscopic treatment and necrotic processes in the tibial plateau must still be regarded with skepticism.