A Rare Case of Lateral Femoral Condyle Osteonecrosis of Knee in a Young Patient Treated with Robotic Total Knee Replacement: A Case Report

Authors: K T Rajashekhar et al. (2025)

Link: https://pubmed.ncbi.nlm.nih.gov/40520727/

Background Information:

Osteonecrosis (bone death from poor blood supply) of the femoral condyle in the knee is rare, especially in younger people. It typically affects older women and most often occurs on the inner (medial) side of the knee. When the bone collapses, it can lead to severe osteoarthritis and joint pain.

Purpose of the Study:

This case report aimed to describe the rare occurrence of osteonecrosis in the lateral femoral condyle of a 17-year-old male’s knee and explain why the surgical team decided on robotic-assisted total knee replacement (TKA) as the treatment option.

Methods and Data Analysis:

The authors detail the patient’s history and symptoms—left knee pain, difficulty walking, squatting, and sitting cross-legged. Clinical examination and X-rays, CT, and MRI confirmed osteonecrosis affecting the lateral condyle and trochlea, along with early arthritis. After counseling, they chose a robotic-assisted TKA for precise implant placement and optimal alignment. The report includes imaging before and after surgery, and describes intraoperative findings such as cartilage fissuring and necrosis.

Key Findings and Conclusions:

Postoperative imaging at three months showed properly aligned implants, and the patient regained knee function—walking, squatting, and cross-legged sitting without pain. The report concludes that in rare cases of severe osteonecrosis in young patients, joint-preserving treatments aren’t enough. Robotic-assisted TKA, though unconventional for a 17-year-old, can restore function and quality of life when extensive damage is present. The precision of robotic surgery may also improve outcomes over manual techniques.

Applications & Limitations:

This case emphasizes the importance of personalized treatment planning. While joint preservation is usually preferred for younger patients, advanced bone damage may necessitate total joint replacement. Robotic TKA offers precise implant placement and alignment, which can enhance functional outcomes in complex cases. However, the long-term durability of a knee replacement in a teenager remains unknown, and this is a single case—meaning results may not apply to all patients. More follow-up is needed to confirm how well the replacement performs over time.