ArticleSkeletal radiology2019
Subchondral insufficiency fracture of the knee: grading, risk factors, and outcome.
Article in Skeletal radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 1 of them a synthesis that pooled it.
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Who cites it
33 citing papers in PubMed, 1 synthesis or guideline pooled it, 61 citations in OpenAlex.
- Comparison of the efficacy of Oxford unicondylar replacement for the treatment of spontaneous osteonecrosis of the knee versus medial knee osteoarthritis: a meta-analysis.Journal of orthopaedic surgery and research · 2024Pooled it
- Artificial Intelligence-Based Prediction of Prognosis After Nonsurgical Treatment for Medial Meniscus Posterior Root Tear.Orthopaedic journal of sports medicine · 2026Article
- Association between low bone mineral density and subchondral insufficiency fractures of the knee in women, and influence of radial meniscal root tears.Diagnostic and interventional imaging · 2026Article
- Association between radial meniscal tears with and without posterior root involvement and subchondral insufficiency fracture of the knee on MRI: The mediating role of meniscal extrusion.Diagnostic and interventional imaging · 2026Article
- Surgical treatments of bone marrow lesions.Journal of experimental orthopaedics · 2026Review
- Medial femoral condyle bone mineral density is associated with subchondral insufficiency fractures in female patients with medial meniscus posterior root tears.Journal of experimental orthopaedics · 2026Article
- [Research advances on subchondral insufficiency fracture and osteonecrosis of the knee].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026Review
- Subchondral Insufficiency Fracture of the Knee Previously Diagnosed as Spontaneous Osteonecrosis: A Case Report With Histological Analysis.Case reports in orthopedics · 2026Article
- Clinical outcomes of unicompartmental knee arthroplasty in early osteoarthritis without bone-on-bone contact.Archives of orthopaedic and trauma surgery · 2025Article
- Subchondral and Osteochondral Unit Bone Damage in the Fetlock Region of Sport Horses Using Low-Field MRI: Case Series.Animals : an open access journal from MDPI · 2025Article
- Biointegrative Nail Raftering Improves Pain and Function in Patients With Subchondral Insufficiency of the Knee.Arthroscopy, sports medicine, and rehabilitation · 2025Article
- Bone marrow lesions related to bone marrow edema syndromes and osteonecrosis.Orthopadie (Heidelberg, Germany) · 2025Review
- Conservative treatments of bone marrow lesions.Journal of experimental orthopaedics · 2025Article
- Degenerative medial and lateral menisci root tears: demographics, clinical presentation, imaging features, and associated findings.Skeletal radiology · 2025Article
- A nosographic and etiopathogenetic framework for subchondral bone marrow lesions in the knee: A narrative review.Journal of experimental orthopaedics · 2025Article
- Meniscal extrusion: Proposal for a novel qualitative classification.Journal of experimental orthopaedics · 2025Review
- Association of Spontaneous Osteonecrosis of the Knee with Ipsilateral Meniscus and Posterior Root Tear: Systematic Review and Meta-analysis.Indian journal of orthopaedics · 2024Review
- Advantages of cone beam computed tomography for evaluation of subchondral insufficiency fractures of the knee compared to MRI.Scientific reports · 2024Article
- Osteoporosis, Osteoarthritis, and Subchondral Insufficiency Fracture: Recent Insights.Biomedicines · 2024Review
- Bilateral trochlear subchondral insufficieny fracture of the knee in a professional cyclist.BMJ case reports · 2023Article
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo propose an magnetic resonance imaging (MRI) grading system for subchondral insufficiency fracture of the knee (SIFK) to predict outcome and assess risk factors. MATERIALS AND
methodsA total of 50 SIFK patients were retrospectively reviewed utilizing two MRI examinations approximately a year apart and compared them with 51 control subjects. A grading system was introduced that classifies lesions as low- vs high-grade. Lesion location 3D dimensions, extent of bone marrow edema (BME), location of meniscal tears and associated extrusion, degree of chondrosis and among other parameters were stratified according to lesion grade and compared with follow-up examinations. Statistical analyses were performed (Pearson's correlation, binary logistic regression, and Chi-squared analysis).
resultsThe majority of SIFK lesions were low-grade (LG; 78%) and most of them (70%) were observed in the medial femoral condyle. Predictor variables comparing low-grade and high-grade SIFK lesions included meniscal tear (p = 0.01), degree of extrusion (p < 0.003), chondrosis (p = 0.01), medial chondrosis grade (p = 0.001), medial femoral condyle (p = 0.01), surface collapse (p < 0.0001), marrow edema improvement (p < 0.0001), first MRI anteroposterior dimension (p = 0.001), transverse dimension (p < 0.001), and ellipsoid volume (p = 0.02). Predictor variables found to be significantly different between controls and patients were meniscal tear (p = 0.024), location of the medial meniscal tear (p < 0.0001), degree of extrusion (p < 0.0001), chondrosis (p < 0.0001), joint effusion (p < 0.0001), Baker's cyst (p < 0.0001), knee lock (p = 0.03) and buckle (p = 0.01), and history of trauma (p = 0.01).
conclusionA SIFK grading system for MRI is introduced. Surrogate markers of high-grade lesions include medial meniscus posterior root tears with associated moderate to severe extrusion, high-grade chondrosis, larger lesion sizes (anteroposterior/transverse), and articular surface collapse. Improvement of BME on follow-up was highly predictive of low-grade disease.
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