Bilateral Knee Osteonecrosis After Intraarticular Concomitant Local Anesthetic and Corticosteroid Injection: A Case Report

Abstract

Osteoarthritis is the most common form of joint diseases that represents the most notable basis of disability. Osteoarthritis is characterized by degeneration of the articular cartilage, osteophyte formation, and subchondral changes. Conservative treatment can be preferred if articular cartilage damage is not extensive. One of the non-operative preferred modality by the clinicians is the intraarticular injection therapy with local anesthetics, corticosteroids, or combination of both. The current literature and our experience indicate that intraarticular injections have positive effects for patient satisfaction. Intraarticular corticosteroid injections provide short term reduction in osteoarthritis pain. Although these drugs reduce pain and disability, they also have side affects such as chondrocyte damage that causes early osteoarthritis or avascular necrosis. We aim to present a case who developed bilateral knee avascular necrosis in a short time due to intrarticular injection of both corticosteroid and local anesthetics.

Key Words: Intraarticular İnjections; Corticosteroid; Knee Osteoarthritis.

Keywords

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Journal of Turgut Ozal Medical Center

Abstract

Osteoartrit maluliyetin en önemli etkenlerinden biri olarak karşılaşabileceğimiz, en sık eklem hastalıkları formudur. Osteoartrit, eklem kıkırdağının dejenerasyonu, osteofit formasyonu ve subkondral kistler ile karakterizedir. Eklem kıkırdağının geniş olmadığı durumlarda konservatif tedavi tercih edilebilir. Klinisyenler tarafından tercih edilen konservatif tedavi yöntemlerden biri de lokal anestezik, kortikosteroid veya bunların her ikisinin birlikte kullanıldığı eklem içi enjeksiyonlardır. Mevcut literatür ve bizim deneyimlerimiz, eklem içi enjeksiyonların hasta memnuniyeti için olumlu etkilere sahip olduğunu göstermektedir. Eklem içi steroid uygulanımı osteoartritli hastalarda kısa dönemli ağrıyı giderir. Bu ilaçların ağrı ve maluliyeti azaltıcı etkisi olmasına rağmen kondrosit hasarına bağlı erken osteoartrit veya avasküler nekroz gibi yan etkileri de olmaktadır. Biz kortikosteroid ve lokal anestezik maddenin eklem içi enjeksiyonu sonrasında kısa dönem içerisine her iki dizde avasküler nekroz gözlenen bir olguyu sunmayı amaçladık

Keywords

• Eklem İçi Enjeksiyon, Kortikosteroid, Diz Osteoartriti

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