Often times, patients come into the office complaining of knee pain without one specific injury. When discussing their case, many things “look” negative — such as their x-rays and even their physical examination. What we are finding is that something called Bone Marrow Lesions (BMLs) can be causing their pain, and we have a new minimally invasive technique, called the Subchondroplasty Procedure that can relieve their pain.

What is Subchondroplasty?
The Subchondroplasty® (SCP®) procedure is a minimally invasive surgery designed to access and treat bone defects associated with chronic bone marrow lesions (BMLs) by filling them with a biomimetic bone substitute material (BSM).

SCP® leads to healing as the BSM is resorbed and replaced with new, healthy bone.

How are BMLs diagnosed?
BMLs can only be seen on certain MRI sequences, where they are marked by edmatous or “inflamed” areas that have been shown to represent a healing response surrounding a microscopic insufficiency fracture within the subchondral bone. Below is an example of an MRI with a BMLs. Notice how there is a bright area in the center of the bone.

MRI of Bone Marrow Lesions (BMLs).  The bright white areas show stress in the bone that is a result of micro-cracks.  These cracks can be the result of early arthritis. (Taken from Zimmer Knee Creations Website)

MRI of Bone Marrow Lesions (BMLs). The bright white areas show stress in the bone that is a result of micro-cracks. These cracks can be the result of early arthritis. (Taken from Zimmer Knee Creations Website)

What is the procedure?
The procedure is based on standard theories of fracture healing. Since the BMLs are a sign of micro-cracks in the bone, the theory is to fill those defects with a natural calcium cement that stabilizes the micro-cracks so that your pain goes away. Then with time your body also resorbs the calcium cement.

Below is a picture outlining the procedure. The subchondroplasty is a same-day procedure done with minimally invasive techniques. Often times, you are left with only a couple of small “poke holes” in the skin.

This is a graphic showing the subchondroplasty procedure.  (Taken from Zimmer Knee Creations website)

This is a graphic showing the subchondroplasty procedure. (Taken from Zimmer Knee Creations website)

How do I know if Subchondroplasty is right for me?
Dr. Bicos is trained in the procedure, and as always he would be happy to see you for a consultation to evaluate your specific knee problem to see if you are a candidate. There are many options — even if you do not qualify for the Subchondroplasty procedure, there are usually other treatment choices you can consider.

More specifically for the Subchondroplasty:
Does this describe you?

    — I have experienced symptomatic knee pain for 3+ months
    — I have increasing discomfort when walking or standing
    — I have seen limited benefits from NSAIDs, bracing, injections or physical therapy
    — My symptoms returned after an arthroscopy

If you answered yes to the questions above, you may be a candidate for the procedure!

Subchondroplasty Quick Facts

    — Utilizes a minimally invasive technique
    — Performed in a outpatient setting
    — Requires a short rehabilitation period
    — Future treatment options remain open
For more information on Subcondroplasty — please visit their website.

Find Dr. Bicos’ Bio here.

Please call us at 248-988-8085 for an appointment with Dr. Bicos!

Comments(1)

  1. Thanks for sharing valuable information on Injections to Relieve knee Pain

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