A Knee Subchondroplasty is a minimally invasive surgical procedure used to treat chronic knee pain caused by a specific type of bone defect known as a bone marrow lesion (BML). BMLs are areas of abnormal bone formation or damage that can develop in the subchondral bone, which is the layer of bone just beneath the cartilage in the knee joint.

During a Knee Subchondroplasty, the surgeon injects a bone substitute material, such as calcium phosphate, into the affected area of the subchondral bone. This material helps to support and strengthen the damaged bone while stimulating the body's natural healing response. The procedure is usually outpatient, and patients can often return to normal activities within a few days to a week.

While the procedure does not cure the underlying condition causing the BML, it can help to alleviate symptoms and improve the quality of life for many patients.

Who Needs It

Patients who are good candidates for Knee Subchondroplasty include those with chronic knee pain and have been diagnosed with a bone marrow lesion (BML) in the subchondral bone of the knee joint. BMLs are often seen in patients with knee osteoarthritis but can also occur in patients with other knee conditions, such as osteonecrosis or post-traumatic arthritis.

The procedure may be an option when other non-surgical treatments such as rest, physical therapy, or medication have not provided sufficient relief. It may also be considered as part of a comprehensive treatment plan that includes other knee procedures such as arthroscopy or joint replacement surgery.

It is important to note that Knee Subchondroplasty is not appropriate for all cases of knee pain or BMLs, and a thorough evaluation by a physician is needed to determine the best course of treatment. Patients with severe arthritis or other advanced joint diseases may not be good candidates for this procedure.

How Does It Work

During a Knee Subchondroplasty, your surgeon makes a small incision and inserts a needle into the affected area of the subchondral bone using image guidance technology, such as X-ray or MRI. The needle is used to inject a bone substitute material, such as calcium phosphate, into the bone defect.

The bone substitute material helps to support and strengthen the damaged bone while also stimulating the body's natural healing response. As the material hardens, it forms a scaffold that supports the surrounding bone, promoting the growth of new, healthy bone tissue.

The procedure is typically performed on an outpatient basis, using local or general anesthesia, and patients can usually return to normal activities within a few days to a week. Patients may need to use crutches for a short period to protect the knee while it heals.

Recovery

Recovery from a Knee Subchondroplasty typically varies depending on the extent of the procedure and the patient's health and fitness. However, in general, the recovery period for this procedure is usually faster and less painful than other knee surgeries such as knee replacement or osteotomy.

After the procedure, the knee may be wrapped in a compression bandage, and ice may be applied to help control swelling and pain. Pain medication may also be prescribed to manage pain in the early stages of recovery.

Patients are typically advised to keep weight off the affected leg and use crutches for the first few days after the surgery. Most patients can resume normal daily activities within a few days to a week, but more strenuous activities such as sports or heavy lifting should be avoided for several weeks. Physical therapy may be recommended to help restore the knee's range of motion, strength, and function. The length of physical therapy will vary depending on the extent of the procedure and the individual patient's needs.

As with all procedures, it is essential to follow the surgeon's post-operative instructions and attend all follow-up appointments to ensure a safe and successful recovery. Most patients can expect to resume normal activities within 4 to 6 weeks after a Knee Subchondroplasty.