Bone marrow lesions (BMLs) are magnetic resonance image-visible defects representing a healing response to trauma, highly correlated with pain symptoms in the knee. Subchondroplasty (SCP) is distinctly a treatment for those chronic BMLs, aimed at filling subchondral osseous defects associated with BMLs using an injectable bone substitute material. The aim of the present study is to evaluate the clinical results of SCP in treatment of BMLs in the knee.
Prospective multicentric clinical study on 100 subjects affected by persistent BMLs of the knee treated with SCP. Patients affected by femoral condyle or tibial plateau persistent BMLs (³ 3 months), not responsive to conservative treatments were included. Follow-up assessments have been conducted at 1, 3, 6, 12 months and annually up to 2 years; all subjects completed NRS, KOOS, EQ-5D, subject global satisfaction scale and healthcare utilization questionnaires.
Analysis conducted on the first 55 patients who completed the 12 months of follow-up. NRS reported a mean decrease of -2.6 +/- 2.5 (p<0,0001) at 12 months’ follow-up from baseline. Statistically significant improvements on all KOOS subscales were registered from baseline (Pain: 44.8 ± 13.3; Symptoms: 56.7 ± 18.0; Sports: 15.1 ± 15.8; Activities of daily living, ADL: 53.1 ± 18.8; Quality of Life, QOL: 28.1 ± 17.0) to the 12 months’ follow-up (Pain: 73.9 ± 22.6; Symptoms: 74.6 ± 21.8; Sports: 43.3 ± 31.5; Activities of daily living, ADL: 78.5 ± 21.5; Quality of Life, QOL: 52.9 ± 28.0). EQ-5D reported a mean variation of 0.17 +/- 0.13, (p<0,0001). 62.3% of patients declared the goal of the procedure was achieved.
First results at 12 months after the surgery demonstrate how the safety profile, the global satisfaction of the patients and the improvement on clinimetric scales legitimate to confirm the SCP a safe and effective procedure to treat persistent BMLs of the knee.