Review Article

Bone Marrow Edema and Zoledronic Acid - A Narrative Review

Christiana Zidrou¹, Efstathios Chronopoulos²

1. 2^nd Orthopedic Department, G. Papageorgiou General Hospital, Thessaloniki, Greece
2. National and Kapodistrian University of Athens, Athens, Greece

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Keywords: Ankle, Bone marrow edema, Hip, Knee, Zoledronic acid

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Abstract

The objective of this study was to investigate and evaluate the effectiveness of a single dose of zoledronic acid in the treatment of bone marrow edema syndrome (BMES) in all lower extremity locations (hip, knee, foot, and ankle). A literature search was conducted on electronic databases (PubMed, Scopus, and Google Scholar) to identify clinical studies on the therapeutic use of zoledronic acid for patients with bone marrow edema syndrome. Until today, very few studies have been conducted using zoledronic acid in patients with bone marrow edema syndrome. The majority of them are retrospective. This narrative review suggests the effectiveness of a single dose of intravenously administered zoledronic acid in patients with bone marrow edema syndrome in three anatomical locations: the hip, knee, and foot/ankle. Zoledronic acid, often used in combination with partial-weight bearing, appears to reduce pain intensity, improve range of motion, and decrease lesion size in MRI imaging findings. The administration of a single dose of intravenous zoledronic acid is a reasonable therapeutic option for patients with bone marrow edema (BMES). It accelerates the time to pain resolution and simultaneously improves imaging findings in MRI. Further prospective clinical studies with a larger number of patients and longer follow-up periods are needed.

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