Patient Education

The Subchondroplasty® Procedure

We treat your bone defects with a minimally invasive surgery that heals defects or wear in the bone just below the cartilage in a joint


What is the Subchondroplasty Procedure?

Patients with subchondral bone defects, otherwise referred to as Bone Marrow Lesions (BML), are ideal candidates for the Subchondroplasty (SCP®) Procedure. This approach targets and treats bone defects by using a hard-setting bone substitute material (BSM) that has similar chemical and physical characteristics to a cancellous bone. Once the body has healed, physicians will replace the BSM with a new bone.

knee_bml

What is a Bone Marrow Lesion?

BML defects are usually painful injuries of the spongy cancellous bone found near a joint. Bones close to any joint that goes through repeated motion or weight bearing stress and strain can have such defects. Some patients suffer from it because of a past bone injury that did not heal properly, for others it is due to stress reactions from altered joint mechanics.

These lesions generally can’t be seen on X-rays, which is why patients have to undergo several kinds of MRI to be properly diagnosed. In MRI results, BML stands out as a hazy white area contrasting the dark backdrop of bone. Pathologists identify BML as a healing reaction around trauma, like subchondral bone microtrabecular fractures.

In case the healing response is unsuccessful, physicians commonly prescribe a series of conservative care, including joint braces, pain medications, injections, or crutches. Some patients respond positively to this approach, which enables their body to treat the subchondral bone defect naturally. But if conservative care fails, we recommend SCP®.

What does SCP® entail?

SCP® is generally performed with arthroscopy of the nearest joint. Patients will need anesthetic for the surgery, and a narrow, drillable cannula will be embedded in a minimally invasive way in the bone defect area.

Physicians use an intraoperative X-ray to guide them during the process. They will hydrate and combine the AccuFill® Bone Substitute Material with an injectable paste, and then use the cannula to fill the bone defect. As soon as the BSM has hardened, they will remove the cannula and close the surgical wound.

long_photo_2

The majority of Subchondroplasty Procedures are outpatient treatments so you can return home on the same day. Although, you will have to undergo a short recovery course, also with arthroscopy.

Physicians’ recommendations:

  • You will feel a substantial amount of pain in the treated area for the first 42-72 hours after the surgery. Physicians mostly prescribe pain relievers to alleviate discomfort.
  • As you start to heal, we recommend standing and walking with crutch support. You can reduce the use of crutches as pain reduces and healing progresses.
  • A series of physical activities and therapy will be provided to help maintain joint mobility and restore strength.

To recover properly and to avoid any setbacks, follow this advice throughout the recovery period.