Osteonecrosis of the knees

Question

Hi, I’m 25years old, male and I’ve had Crohn’s disease since 1999. I have taken a lot of prednisone all these years and I have developed osteonecrosis of the knees. I’m suffering from it 4 years now and I can’t find a solution at least for the pain. Doctors that I have visited so far,are not helping at all. How can I relieve my knee pain, I need something drastic and not simple pain killers that do nothing. I have stopped taking prednisone 2 months now and my Crohn’s is in remission at the moment.

Answer

It depends on the stage of osteonecrosis. If there is destruction bone visible on x-ray, there may be few options other than analgesics and possible joint replacement. If there is no evidence on bony collapse on plain x-ray but changes seen only on MRI scan, you may be a candidate for core decompression in which surgeons remove a section of bone. If you do not have a lot of bony changes on x-ray, now that you are off prednisone, the osteonecrosis may heal.

Alan Matsumoto, M.D.

About Alan Matsumoto, M.D.

Part-time Faculty, Division of Rheumatology
Johns Hopkins University