Clinical and Radiological Outcomes of Subchondroplasty in the Treatment of Bone Marrow Edema of the Knee

Short Term Clinical and Radiological Outcomes of Subchondroplasty in the Treatment of Bone Marrow Edema of the Knee

Bone marrow lesions (BMLs) of the knee are common subchondral defects, often associated with pain and functional limitation. Subchondroplasty is a percutaneous procedure in which calcium phosphate is injected inside BML areas, ensuring stability and promoting the deposition of new bone. Primary outcome of this study was to obtain a reduction of the Numeric Rating Scale score of 4 points or more at 6 months follow-up in more than 75% of patients. The secondary outcome was to evaluate the osteoarthritic and bone marrow structure evolution in the months after the procedure.

Inclusion Criteria:

• Atraumatic knee pain for at least 3 months;
• Failure of conservative treatment (including NSAIDs, physical therapy, intra- articular injection with steroids or hyaluronic acid and bisphosphonates);
• Mild to moderate osteoarthritis (Kellgren-Lawrence18 grade ≤ 3)
• BML on a loading area at MRI imaging (femoral condyles and/or tibial plateau)

Exclusion Criteria:

• Knee pain and functional limitation related to other causes like osteonecrosis
• Fractures or inflammatory arthritis
• Ligamentous instabilities
• Malalignment on the coronal axis greater than 10 degrees in varus/valgus
• Severe tri-compartmental arthritis (Kellgren-Lawrence grade 4)