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J Knee Surg 2021; 34(06): 665-671
DOI: 10.1055/s-0039-1700568
Original Article

Subchondroplasty for Bone Marrow Lesions in the Arthritic Knee Results in Pain Relief and Improvement in Function

Kenon Chua
1   Department of Orthopaedics, Singapore General Hospital, Singapore
,
Joseph Yida Benjamin Kang
1   Department of Orthopaedics, Singapore General Hospital, Singapore
,
Favian Ding Jie Ng
2   Duke-NUS Medical School, Singapore
,
Hee Nee Pang
1   Department of Orthopaedics, Singapore General Hospital, Singapore
,
Denny Tjiauw Tjoen Lie
1   Department of Orthopaedics, Singapore General Hospital, Singapore
,
Amila Silva
1   Department of Orthopaedics, Singapore General Hospital, Singapore
,
Paul Chee Cheng Chang
1   Department of Orthopaedics, Singapore General Hospital, Singapore
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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


Publikationsverlauf

Eingereicht: 07. Dezember 2019

Angenommen: 18. September 2019

Artikel online veröffentlicht:
21. November 2019

© 2019. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

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