Subchondroplasty for treating bone marrow lesions in the knee – initial experience

Marcelo Batista Bonadio, Pedro Nogueira Giglio, Camilo Partezani Helito, José Ricardo Pécora, Gilberto Luis Camanho, Marco Kawamura Demange

To evaluate the use of subchondroplasty in the treatment of bone marrow lesions in an initial series of five cases. The study included patients aged between 40 and 75 years old, with pain in the knee for at least six months, associated with high-signal MRI lesion on T2 sequences, on the tibia or femur. Patients were assessed using the visual analog pain scale and the KOOS score, one week before surgery and one, three, six, 12, and 24 weeks after the procedure. Subchondroplasty was performed with a technique developed for filling the area of the bone marrow lesion with a calcium phosphate bone substitute. The filling was performed on the medial femoral condyle in four patients and medial tibial plateau in one case. The assessment by the KOOS score presented a preoperative average of 38.44 points and 62.7, 58.08, 57.92, 63.34, and 71.26 points with one, three, six, 12, and 24 weeks after surgery, respectively. In the evaluation by the VAS, the average was 7.8 points preoperatively and 2.8, 3, 2.8, 1.8, and 0.6 points over the same periods. All patients were able to ambulate without additional support, on the first day after the procedure. One patient had a minimal graft dislocation to the soft tissue, with local pain, which resolved completely after a week. The subchondroplasty technique provided significant improvements in the parameters of pain and functional capacity in the short-term assessment.