Abstract
Subchondroplasty is a relatively new joint preserving procedure, which involves the
localized injection of calcium pyrophosphate bone substitute into the bone marrow
lesion. The advent of magnetic resonance imaging (MRI) has greatly facilitated the
identification of these bone marrow lesions. We investigated the clinical efficacy
of subchondroplasty in the treatment of symptomatic bone marrow lesions in the knee,
including knees with preexisting osteoarthritis. This study comprised of 12 patients
whose knees were evaluated with standard radiographs and MRI to identify and localize
the bone marrow lesions. They then underwent subchondroplasty under intraoperative
radiographic guidance. Preoperative and postoperative visual analog scale (VAS) pain
scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores,
and Knee Injury and Arthritis Outcome Scores (KOOS) were obtained. VAS scores improved
significantly from 7.5 ± 1.8 before surgery to 5.2 ± 2.7 after surgery. This further
improved to 2.1 ± 2.4 at the one-year follow-up. KOOS scores improved significantly
from 38.5 ± 17.0 before surgery to 73.2 ± 19.0 at the one-year follow-up. WOMAC scores
improved significantly from 47.8 ± 20.5 before surgery to 14.3 ± 13.2 at the one-year
follow-up. Subchondroplasty offers an effective way to treat subchondral bone marrow
lesions in the arthritic knee, resulting in improvement in symptoms and early return
to activity. Long-term studies are required to evaluate if these benefits can last.
This is a Level II study.
Keywords
bone marrow lesion - subchondroplasty - osteoarthritis - knee pain - calcium phosphate
bone substitute
