inovmedИнновационная медицина КубаниInnovative Medicine of Kuban2541-9897Scientific Research Institute – Ochapovsky Regional Clinical Hospital No. 110.35401/2500-0268-2020-20-4-58-64inovmed-335Research ArticleОБЗОРЫREVIEWSОтек костного мозга в рамках суставной патологииBone marrow edema in terms of joint pathologyhttps://orcid.org/0000-0001-7507-7772АйрапетовГ. А.AirapetovG. A.

Айрапетов Георгий Александрович, к. м. н., доцент кафедры травматологии и ортопедии

355006, Ставрополь, ул. Мира, 310

Georgii A. Airapetov, Cand. of Sci. (Med.), Associate Professor, Department of Traumatology and Orthopedics

ul. Mira, 310, Stavropol, 355006

AirapetovGA@yandex.ruhttps://orcid.org/0000-0002-2453-3675ВоротниковА. А.VorotnikovA. A.

Воротников Александр Анатольевич, д. м. н., профессор, заведующий кафедрой травматологии и ортопедии

Ставрополь

Alexandr A. Vorotnikov, Dr. of Sci. (Med.), Professor, Head of the Department of Traumatology and Orthopedics

Stavropol

https://orcid.org/0000-0001-9862-1726ВасюковВ. А.VasyukovV. A.

Васюков Вячеслав Анатольевич, ассистент кафедры травматологии и ортопедии

Ставрополь

Vyacheslav A. Vasyukov, Assistant Professor, Department of Traumatology and Orthopedics

Stavropol

Ставропольский государственный медицинский университетРоссияStavropol State Medical UniversityRussian Federation202030122020045864Copyright © Айрапетов Г.А., Воротников А.А., Васюков В.А., 20202020Айрапетов Г.А., Воротников А.А., Васюков В.А.Airapetov G.A., Vorotnikov A.A., Vasyukov V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.innovmedkub.ru/jour/article/view/335

Новые возможности современной медицинской науки открывают перспективы инструментальной и лабораторной диагностики многих патологических состояний, неизвестных или не выявляемых ранее в практике ортопеда. К ним можно отнести отек костного мозга. Не только травматологи-ортопеды, но и врачи-ревматологи, нейрохирурги, врачи общей практики, реабилитологи, морфологи и другие сталкиваются с этим понятием в самых разных определениях, представлениях об этиологии, патогенезе, клинических рекомендациях по лечению.

В работе использованы открытые интернет-ресурсы: электронная научная библиотека (elibrary), PubMed, SciVerse (Science Direct), Scopus.

Сложность патологии заключается в том, что в каждом конкретном случае выработка лечебной тактики требует персональной интерпретации всего многообразия полученных данных и индивидуального подхода

New possibilities of modern medical science open up prospects for instrumental and laboratory diagnostics of many pathological conditions, unknown or not previously diagnosed in the practice of an orthopedist. These include bone marrow edema. Not only orthopedic traumatologists, but also rheumatologists, neurosurgeons, general practitioners, rehabilitation therapists, morphologists, and many others today face this concept in a variety of definitions, concepts of etiology, pathogenesis, and clinical recommendations for treatment.

The authors performed a systematic review by using four open resources: electronic scientific library (elibrary), PubMed, SciVerse (Science Direct), and Scopus.

The complexity of pathology lies in the fact that in each specific case, the development of treatment tactics requires a personal interpretation of the entire variety of data obtained and a case by case approach.

костный мозготек костного мозгаповреждение костного мозгаМРТотек костиbone marrowbone marrow edemabone marrow damageMRIbone edemaReferencesWilson AJ, Murphy WA, Hardy DC, Totty WG. Transient osteoporosis: transient bone marrow edema? Radiology. 1988;167:757–60. PMID: 3363136. https://doi.org/10.1148/radiology.167.3.3363136Wilson AJ, Murphy WA, Hardy DC, Totty WG. Transient osteoporosis: transient bone marrow edema? Radiology. 1988;167:757–60. PMID: 3363136. https://doi.org/10.1148/radiology.167.3.3363136Patel S. Primary bone marrow oedema syndromes. Rheumatology (Oxford). 2014;53:785–92. PMID: 24080251. https://doi.org/10.1093/rheumatology/ket324Patel S. Primary bone marrow oedema syndromes. Rheumatology (Oxford). 2014;53:785–92. PMID: 24080251. https://doi.org/10.1093/rheumatology/ket324Kon E, Ronga M, Filardo G, et al. Bone marrow lesions and subchondral bone pathology of the knee. Knee Surg Sports Traumatol Arthrosc. 2016;24:1797–814. PMID: 27075892. https://doi.org/10.1007/s00167-016-4113-2Kon E, Ronga M, Filardo G, et al. Bone marrow lesions and subchondral bone pathology of the knee. Knee Surg Sports Traumatol Arthrosc. 2016;24:1797–814. PMID: 27075892. https://doi.org/10.1007/s00167-016-4113-2Vassalou EE, Spanakis K, Tsifountoudis IP, Karantanas AH. MR imaging of the hip: an update on bone marrow edema. Semin Musculoskelet Radiol. 2019;23:276–88. PMID: 31163502. https://doi.org/10.1055/s-0039-1677872Vassalou EE, Spanakis K, Tsifountoudis IP, Karantanas AH. MR imaging of the hip: an update on bone marrow edema. Semin Musculoskelet Radiol. 2019;23:276–88. PMID: 31163502. https://doi.org/10.1055/s-0039-1677872Шушарин А.Г., Прохоренко В.М., Половинка М.П. Лечение отека костного мозга головки бедренной кости внутрисуставными инъекциями перфторана с димексидом (клинические случаи). Сибирский научный медицинский журнал. 2017;37(4):73–8.Shusharin AG, Prokhorenko VM, Polovinka MP. Treatment of bone marrow edema head by intraarticular injections perftoran with dimexidum. Clinical cases. The Siberian Scientific Medical Journal. 2017;37(4):73–8. (In Russ.)Starr AM, Wessely MA, Albastaki U, Pierre-Jerome C, Kettner NW. Bone marrow edema: pathophysiology, differential diagnosis, and imaging. Acta Radiol. 2008;49:771–86. PMID: 18608031. https://doi.org/10.1080/02841850802161023Starr AM, Wessely MA, Albastaki U, Pierre-Jerome C, Kettner NW. Bone marrow edema: pathophysiology, differential diagnosis, and imaging. Acta Radiol. 2008;49:771–86. PMID: 18608031. https://doi.org/10.1080/02841850802161023Foti G, Faccioli N, Silva R, Oliboni E, Zorzi C, Calborgnin G. Bone marrow edema around the hip in non-traumatic pain: dual-energy CT vs MRI. Eur Radiol. 2020;30:4098–106. PMID: 32166490. https://doi.org/10.1007/s00330-020-06775-zFoti G, Faccioli N, Silva R, Oliboni E, Zorzi C, Calborgnin G. Bone marrow edema around the hip in non-traumatic pain: dual-energy CT vs MRI. Eur Radiol. 2020;30:4098–106. PMID: 32166490. https://doi.org/10.1007/s00330-020-06775-zMeizer R, Radda C, Stolz G, et al. MRI-controlled analysis of 104 patients with painful bone marrow edema in different joint localizations treated with the prostacyclin analogue iloprost. Wien Klin Wochenschr. 2005;117:278–86. PMID: 15926619. https://doi.org/10.1007/s00508-005-0326-yMeizer R, Radda C, Stolz G, et al. MRI-controlled analysis of 104 patients with painful bone marrow edema in different joint localizations treated with the prostacyclin analogue iloprost. Wien Klin Wochenschr. 2005;117:278–86. PMID: 15926619. https://doi.org/10.1007/s00508-005-0326-yRoemer FW, Guermazi A, Javaid MK, et al. Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: the MOST Study. A longitudinal multicentre study of knee osteoarthritis. Ann Rheum Dis. 2009;68:1461–5. PMID: 18829615. PMCID: PMC2905622. https://doi.org/10.1136/ard.2008.096834Roemer FW, Guermazi A, Javaid MK, et al. Change in MRI-detected subchondral bone marrow lesions is associated with cartilage loss: the MOST Study. A longitudinal multicentre study of knee osteoarthritis. Ann Rheum Dis. 2009;68:1461–5. PMID: 18829615. PMCID: PMC2905622. https://doi.org/10.1136/ard.2008.096834Yusuf E, Kortekaas MC, Watt Ia, Huizinga TW, Kloppenburg M. Do knee abnormalities visualized on MRI explain knee pain in knee osteoarthritis? A systematic review. Ann Rheum Dis. 2011;70:60–7. PMID: 20829200. https://doi.org/10.1136/ard.2010.131904Yusuf E, Kortekaas MC, Watt Ia, Huizinga TW, Kloppenburg M. Do knee abnormalities visualized on MRI explain knee pain in knee osteoarthritis? A systematic review. Ann Rheum Dis. 2011;70:60–7. PMID: 20829200. https://doi.org/10.1136/ard.2010.131904Schett G. Bone marrow edema. Ann N Y Acad Sci. 2009;1154:35–40. PMID: 1925229. https://doi.org/10.1111/j.1749-6632.2009.04383.xSchett G. Bone marrow edema. Ann N Y Acad Sci. 2009;1154:35–40. PMID: 1925229. https://doi.org/10.1111/j.1749-6632.2009.04383.xVande Berg BC, Lecouvet FE, Koutaissoff S, Simoni P, Malghem J. Bone marrow edema of the femoral head and transient osteoporosis of the hip. Eur J Radiol. 2008;67:68–77. PMID: 18468828. https://doi.org/10.1016/j.ejrad.2008.01.061Vande Berg BC, Lecouvet FE, Koutaissoff S, Simoni P, Malghem J. Bone marrow edema of the femoral head and transient osteoporosis of the hip. Eur J Radiol. 2008;67:68–77. PMID: 18468828. https://doi.org/10.1016/j.ejrad.2008.01.061Appel H, Kuhne M, Spiekermann S, et al. Immunohistochemical analysis of hip arthritis in ankylosing spondylitis: evaluation of the bone-cartilage interface and subchondral bone marrow. Arthritis Rheum. 2006;54:1805–13. PMID: 16736521. https://doi.org/10.1002/art.21907Appel H, Kuhne M, Spiekermann S, et al. Immunohistochemical analysis of hip arthritis in ankylosing spondylitis: evaluation of the bone-cartilage interface and subchondral bone marrow. Arthritis Rheum. 2006;54:1805–13. PMID: 16736521. https://doi.org/10.1002/art.21907Aigner N, Meizer R, Meraner D, Becker S, Radda C, Landsiedl F. Tapping test in patients with painful bone marrow edema of the knee. Clin J Pain. 2008;24:131–4. PMID: 18209519. https://doi.org/00002508-200802000-00007Aigner N, Meizer R, Meraner D, Becker S, Radda C, Landsiedl F. Tapping test in patients with painful bone marrow edema of the knee. Clin J Pain. 2008;24:131–4. PMID: 18209519. https://doi.org/00002508-200802000-00007Eriksen EF. Treatment of bone marrow lesions (bone marrow edema). Bonekey Rep. 2015;4:755. PMID: 26644910. PMCID: PMC4662576. https://doi.org/10.1038/bonekey.2015.124Eriksen EF. Treatment of bone marrow lesions (bone marrow edema). Bonekey Rep. 2015;4:755. PMID: 26644910. PMCID: PMC4662576. https://doi.org/10.1038/bonekey.2015.124Emad Ya, Ragab Ya, El-Shaarawy N, Rasker JJ. Transient osteoporosis of the hip, complete resolution after treatment with alendronate as observed by MRI description of eight cases and review of the literature. Clin Rheumatol. 2012;31:1641–7. PMID: 22933125. https://doi.org/10.1007/s10067-012-2060-yEmad Ya, Ragab Ya, El-Shaarawy N, Rasker JJ. Transient osteoporosis of the hip, complete resolution after treatment with alendronate as observed by MRI description of eight cases and review of the literature. Clin Rheumatol. 2012;31:1641–7. PMID: 22933125. https://doi.org/10.1007/s10067-012-2060-yRobinson Ph. Impingement syndromes of the ankle. Eur Radiol. 2007;17:3056–65. PMID: 17503050. https://doi.org/10.1007/s00330-007-0675-1Robinson Ph. Impingement syndromes of the ankle. Eur Radiol. 2007;17:3056–65. PMID: 17503050. https://doi.org/10.1007/s00330-007-0675-1Фетисов В.А., Кулинкович К.Ю. МРТ-диагностика отека костного мозга и его значение в судебно-медицинской оценке повреждений костей и суставов. Судебно-медицинская экспертиза. 2017;60:50–6. PMID: 28656955. https://doi.org/10.17116/sudmed201760350-56Fetisov VA, Kulinkovich KYu. MRI diagnostics of bone marrow oedema and its significance for the forensic medical evaluation of the injuries to bones and articulations. Sud Med Ekspert. 2017;60:50–6. (In Russ.). PMID: 28656955. https://doi.org/10.17116/sudmed201760350-56Дьячкова Г.В., Суходолова Л.B., Степанов Р.В., Дьячков К.А., Бакарджиева А.Н., Карасев Е.А. МРТ в изучении процесса перестройки костей коленного сустава после переломов. Медицинская визуализация. 2008;5:111–6.Diachkova GV, Sukhodolova LV, Stepanova RV, Diachkov KA, Bakardzhyeva AN, Karasyev EA. MRI of reconstruction of knee joint bones after fractures. Medical Visualization. 2008;5:111–6. (In Russ.)Shabshin N, Schweitzer ME, Morrison WB, Carrino JA, Keller MS, Grissom LE. High-signal T2 changes of the bone marrow of the foot and ankle in children: red marrow or traumatic changes. Pediatr Radiol. 2006;36:670–6. PMID: 16770670. https://doi.org/10.1007/s00247-006-0129-yShabshin N, Schweitzer ME, Morrison WB, Carrino JA, Keller MS, Grissom LE. High-signal T2 changes of the bone marrow of the foot and ankle in children: red marrow or traumatic changes. Pediatr Radiol. 2006;36:670–6. PMID: 16770670. https://doi.org/10.1007/s00247-006-0129-yChoi YuS, Cohen NA, Potter HG, Mintz DN. Magnetic resonance imaging in the evaluation of osteochondritis dissecans of the patella. Skeletal Radiol. 2007;36:929–35. PMID: 17694305. https://doi.org/10.1007/s00256-007-0357-8Choi YuS, Cohen NA, Potter HG, Mintz DN. Magnetic resonance imaging in the evaluation of osteochondritis dissecans of the patella. Skeletal Radiol. 2007;36:929–35. PMID: 17694305. https://doi.org/10.1007/s00256-007-0357-8Felson DT, Chaisson CE, Hill CL, et al. The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med. 2001;134:541–9. PMID: 11281736. https://doi.org/10.7326/0003-4819-134-7-200104030-00007Felson DT, Chaisson CE, Hill CL, et al. The association of bone marrow lesions with pain in knee osteoarthritis. Ann Intern Med. 2001;134:541–9. PMID: 11281736. https://doi.org/10.7326/0003-4819-134-7-200104030-00007Sowers MF, Hayes C, Jamadar D, et al. Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis. Osteoarthritis Cartilage. 2003;11:387–93. PMID: 12801478. https://doi.org/10.1016/s1063-4584(03)00080-3Sowers MF, Hayes C, Jamadar D, et al. Magnetic resonance-detected subchondral bone marrow and cartilage defect characteristics associated with pain and X-ray-defined knee osteoarthritis. Osteoarthritis Cartilage. 2003;11:387–93. PMID: 12801478. https://doi.org/10.1016/s1063-4584(03)00080-3Kornaat PR, Kloppenburg M, Sharma R, et al. Bone marrow edema-like lesions change in volume in the majority of patients with osteoarthritis; associations with clinical features. Eur Radiol. 2007;17:3073–8. PMID: 17823802. PMCID: PMC2077908. https://doi.org/10.1007/s00330-007-0711-1Kornaat PR, Kloppenburg M, Sharma R, et al. Bone marrow edema-like lesions change in volume in the majority of patients with osteoarthritis; associations with clinical features. Eur Radiol. 2007;17:3073–8. PMID: 17823802. PMCID: PMC2077908. https://doi.org/10.1007/s00330-007-0711-1Felson DT, McLaughlin S, Goggins J, et al. Bone marrow edema and its relation to progression of knee osteoarthritis. Ann Intern Med. 2003;139:330–6. PMID: 12965941. https://doi.org/10.7326/0003-4819-139-5_part_1-200309020-00008Felson DT, McLaughlin S, Goggins J, et al. Bone marrow edema and its relation to progression of knee osteoarthritis. Ann Intern Med. 2003;139:330–6. PMID: 12965941. https://doi.org/10.7326/0003-4819-139-5_part_1-200309020-00008Снигирева А.В., Носков С.М., Максимов М.Л. Клиническое значение отека костного мозга на поздних стадиях остеоартрита. Медицинский совет. 2019;21:224–30. https://doi.org/10.21518/2079-701X-2019-21-224-230Snigireva AV, Noskov SM, Maksimov ML. Clinical significance of bone marrow edema in the late stages of osteoarthritis. Meditsinskiy sovet = Medical Council. 2019;21:224–30. (In Russ.) https://doi.org/10.21518/2079-701X-2019-21-224-230Koenig H, Lucas D, Meissner R. The wrist: a preliminary report on high-resolution MR imaging. Radiology. 1986;160:463–7. PMID: 3726128. https://doi.org/10.1148/radiology.160.2.3726128Koenig H, Lucas D, Meissner R. The wrist: a preliminary report on high-resolution MR imaging. Radiology. 1986;160:463–7. PMID: 3726128. https://doi.org/10.1148/radiology.160.2.3726128McQueen FM. Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspective. Arthritis Res Ther. 2012;14:224. PMID: 23043770. PMCID: PMC3580509. https://doi.org/10.1186/ar4035McQueen FM. Bone marrow edema and osteitis in rheumatoid arthritis: the imaging perspective. Arthritis Res Ther. 2012;14:224. PMID: 23043770. PMCID: PMC3580509. https://doi.org/10.1186/ar4035Kubo T, Yamamoto T, Inoue S, et al. Histological findings of bone marrow edema pattern on MRI in osteonecrosis of the femoral head. J Orthop Sci. 2000;5:520–3. PMID: 11180912. https://doi.org/10.1007/s00776007003364Kubo T, Yamamoto T, Inoue S, et al. Histological findings of bone marrow edema pattern on MRI in osteonecrosis of the femoral head. J Orthop Sci. 2000;5:520–3. PMID: 11180912. https://doi.org/10.1007/s00776007003364Корячкин В.А. Комплексный регионарный болевой синдром. Травматология и ортопедия России. 2014;3:147–56.Koryachkin VA. Complex regional pain syndrome. Traumatology and Orthopedics of Russia. 2014;3:147–56. (In Russ.)Crozier F, Champsaur P, Pham T, et al. Magnetic resonance imaging in reflex sympathetic dystrophy syndrome of the foot. Joint Bone Spine. 2003;70:503–8. PMID: 14667563. https://doi.org/10.1016/s1297-319x(03)00142-8Crozier F, Champsaur P, Pham T, et al. Magnetic resonance imaging in reflex sympathetic dystrophy syndrome of the foot. Joint Bone Spine. 2003;70:503–8. PMID: 14667563. https://doi.org/10.1016/s1297-319x(03)00142-8Peters EJ, Lipsky BA. Diagnosis and management of infection in the diabetic foot. Med Clin North Am. 2013;97: 911–46. PMID: 23992901. https://doi.org/10.1016/j.mcna.2013.04.005Peters EJ, Lipsky BA. Diagnosis and management of infection in the diabetic foot. Med Clin North Am. 2013;97: 911–46. PMID: 23992901. https://doi.org/10.1016/j.mcna.2013.04.005Elder GJ. From marrow oedema to osteonecrosis: common paths in the development of posttransplant bone pain. Nephrology (Carlton). 2006;11:560–7. PMID: 17199798. https://doi.org/10.1111/j.1440-1797.2006.00708.xElder GJ. From marrow oedema to osteonecrosis: common paths in the development of posttransplant bone pain. Nephrology (Carlton). 2006;11:560–7. PMID: 17199798. https://doi.org/10.1111/j.1440-1797.2006.00708.xGhasemi RA, Sadeghi S, Rahimee N, Tahmasebi M. Technologies in the treatment of bone marrow edema syndrome. Orthop Clin North Am. 2019;50:131–8. PMID: 30477703. https://doi.org/10.1016/j.ocl.2018.08.008Ghasemi RA, Sadeghi S, Rahimee N, Tahmasebi M. Technologies in the treatment of bone marrow edema syndrome. Orthop Clin North Am. 2019;50:131–8. PMID: 30477703. https://doi.org/10.1016/j.ocl.2018.08.008Perry TA, Parkes MJ, Hodgson R, Felson DT, O’Neill TW, Arden NK. Effect of Vitamin D supplementation on synovial tissue volume and subchondral bone marrow lesion volume in symptomatic knee osteoarthritis. BMC Musculoskelet Disord. 2019;20:76. PMID: 30764805. PMCID: PMC637663. https://doi.org/10.1186/s12891-019-2424-4Perry TA, Parkes MJ, Hodgson R, Felson DT, O’Neill TW, Arden NK. Effect of Vitamin D supplementation on synovial tissue volume and subchondral bone marrow lesion volume in symptomatic knee osteoarthritis. BMC Musculoskelet Disord. 2019;20:76. PMID: 30764805. PMCID: PMC637663. https://doi.org/10.1186/s12891-019-2424-4Flores-Robles BJ, Sanz-Sanz J, Sanabria-Sanchinel AA, et al. Zoledronic acid treatment in primary bone marrow edema syndrome. J Pain Palliat Care Pharmacother. 2017;31:52–6. PMID: 28287351. https://doi.org/10.1080/15360288.2016.1276993Flores-Robles BJ, Sanz-Sanz J, Sanabria-Sanchinel AA, et al. Zoledronic acid treatment in primary bone marrow edema syndrome. J Pain Palliat Care Pharmacother. 2017;31:52–6. PMID: 28287351. https://doi.org/10.1080/15360288.2016.1276993Eriksen EF, Shabestari M, Ghouri A, Conaghan PhG. Bisphosphonates as a treatment modality in osteoarthritis [published online ahead of print]. Bone. 2020 Apr 2;115352. PMID: 32247817. https://doi.org/10.1016/j.bone.2020.115352Eriksen EF, Shabestari M, Ghouri A, Conaghan PhG. Bisphosphonates as a treatment modality in osteoarthritis [published online ahead of print]. Bone. 2020 Apr 2;115352. PMID: 32247817. https://doi.org/10.1016/j.bone.2020.115352Varenna M, Zucchi F, Failoni S, Becciolini A, Berruto M. Intravenous neridronate in the treatment of acute painful knee osteoarthritis: a randomized controlled study. Rheumatology (Oxford). 2015;54:1826–32. PMID: 25998450. https://doi.org/10.1093/rheumatology/kev123Varenna M, Zucchi F, Failoni S, Becciolini A, Berruto M. Intravenous neridronate in the treatment of acute painful knee osteoarthritis: a randomized controlled study. Rheumatology (Oxford). 2015;54:1826–32. PMID: 25998450. https://doi.org/10.1093/rheumatology/kev123Jäger M, Tillmann FP, Thornhill TS, et al. Rationale for prostaglandin I2 in bone marrow oedema – from theory to application. Arthritis Res Ther. 2008;10:R120. PMID: 18834533. PMCID: PMC2592809. https://doi.org/10.1186/ar2526Jäger M, Tillmann FP, Thornhill TS, et al. Rationale for prostaglandin I2 in bone marrow oedema – from theory to application. Arthritis Res Ther. 2008;10:R120. PMID: 18834533. PMCID: PMC2592809. https://doi.org/10.1186/ar2526Hörterer H, Baumbach SF, Gregersen J, et al. Treatment of bone marrow edema of the foot and ankle with the prostacyclin analog Iloprost. Foot Ankle Int. 2018;39:1183–91. PMID: 29862844. https://doi.org/10.1177/1071100718778557Hörterer H, Baumbach SF, Gregersen J, et al. Treatment of bone marrow edema of the foot and ankle with the prostacyclin analog Iloprost. Foot Ankle Int. 2018;39:1183–91. PMID: 29862844. https://doi.org/10.1177/1071100718778557Pountos I, Giannoudis PV. The role of Iloprost on bone edema and osteonecrosis: safety and clinical results. Expert Opin Drug Saf. 2018;17:225–33. PMID: 29315006. https://doi.org/10.1080/14740338.2018.1424828Pountos I, Giannoudis PV. The role of Iloprost on bone edema and osteonecrosis: safety and clinical results. Expert Opin Drug Saf. 2018;17:225–33. PMID: 29315006. https://doi.org/10.1080/14740338.2018.1424828Claßen T, Becker A, Landgraeber S, et al. Long-term clinical results after iloprost treatment for bone marrow edema and avascular necrosis. Orthop Rev (Pavia). 2016;31:6150. PMID: 27114807. PMCID: PMC4821225. https://doi.org/10.4081/or.2016.6150Claßen T, Becker A, Landgraeber S, et al. Long-term clinical results after iloprost treatment for bone marrow edema and avascular necrosis. Orthop Rev (Pavia). 2016;31:6150. PMID: 27114807. PMCID: PMC4821225. https://doi.org/10.4081/or.2016.6150Vitali M, Rodriguez NN, Pedretti A, et al. Bone marrow edema syndrome of the medial femoral condyle treated with extracorporeal shockwave therapy: a clinical and MRI retrospective comparative study. Arch Phys Med Rehabil. 2018;99:873–9. PMID: 29223709. https://doi.org/10.1016/j.apmr.2017.10.025Vitali M, Rodriguez NN, Pedretti A, et al. Bone marrow edema syndrome of the medial femoral condyle treated with extracorporeal shockwave therapy: a clinical and MRI retrospective comparative study. Arch Phys Med Rehabil. 2018;99:873–9. PMID: 29223709. https://doi.org/10.1016/j.apmr.2017.10.025Etemadifar M, Kooskzari M, Khalilollah N, Ali MK, Mahsa B. The results of core decompression treatment in patients with avascular necrosis of femoral head in patients at Isfahan City educational hospitals in 2010–2011. Adv Biomed Res. 2014;3:93. PMID: 24800182. PMCID: PMC4007334. https://doi.org/10.4103/2277-9175.129363Etemadifar M, Kooskzari M, Khalilollah N, Ali MK, Mahsa B. The results of core decompression treatment in patients with avascular necrosis of femoral head in patients at Isfahan City educational hospitals in 2010–2011. Adv Biomed Res. 2014;3:93. PMID: 24800182. PMCID: PMC4007334. https://doi.org/10.4103/2277-9175.129363Levy AS, Cousins K. The rational for and efficacy of subchondroplasty in the injured worker. J Orthop. 2020;22:48–52. PMID: 32280168. PMCID: PMC7138934. https://doi.org/10.1016/j.jor.2020.03.047Levy AS, Cousins K. The rational for and efficacy of subchondroplasty in the injured worker. J Orthop. 2020;22:48–52. PMID: 32280168. PMCID: PMC7138934. https://doi.org/10.1016/j.jor.2020.03.047Chotivichit A, Korwutthikulrangsri E, Pornrattanamaneewong Ch, Achawakulthep Ch. Core decompression with bone marrow injection for the treatment of femoral head osteonecrosis. J Med Assoc Thai. 2014;97:S139–43. PMID: 25365907.Chotivichit A, Korwutthikulrangsri E, Pornrattanamaneewong Ch, Achawakulthep Ch. Core decompression with bone marrow injection for the treatment of femoral head osteonecrosis. J Med Assoc Thai. 2014;97:S139–43. PMID: 25365907.Kasik CS, Martinkovich S, Mosier B, Akhavan S. Short-term outcomes for the biologic treatment of bone marrow edema of the knee using bone marrow aspirate concentrate and injectable demineralized bone matrix. Arthrosc Sports Med Rehabil. 2019;26:7–14. PMID: 32266336. PMCID: PMC7120815. https://doi.org/10.1016/j.asmr.2019.07.001Kasik CS, Martinkovich S, Mosier B, Akhavan S. Short-term outcomes for the biologic treatment of bone marrow edema of the knee using bone marrow aspirate concentrate and injectable demineralized bone matrix. Arthrosc Sports Med Rehabil. 2019;26:7–14. PMID: 32266336. PMCID: PMC7120815. https://doi.org/10.1016/j.asmr.2019.07.001

The authors declare that there are no conflicts of interest present.