Subchondrplasty Joint Preservation Treatment Less Invasive Than Joint Replacement Surgery.
|MRI of BME-Xray normal|
From Zimmer Institute
Rather than replacing the entire knee, this treatment aims to stimulate nature to heal the bone lesion which can lead to reduced knee pain and better knee function. Subchondroplasty is an arthroscopic knee surgical procedure done as an outpatient. This is a safer and less invasive procedure than Total or Partial knee replacement and as such may be carried out in higher risk surgical patients, such as the obese patient, with less fear of an adverse outcome such as infection or blood clot.
From Zimmer Institute
Bone Marrow Edema (BME), or Bone Marrow Lesions (BML) are thought to cause pain in knees with early or late osteoarthritis. These lesions can only be diagnosed with high resolution 3 T MRI scans. In 2001 Felson identified BME/BML as the strongest predictor of the presence of pain associated with knee OA. They also determined that arthroscopy alone will not predictably relieve knee pain associated with arthritis.
This observation has been confirmed by other investigators. However, the novel Subchondroplasty® Procedure is a percutaneous outpatient intervention that addresses the painful defects associated with subchondral bone marrow lesions (BME/BML). BMLs are related to stress fractures or micro-fractures, that can only be visualized using MRI scans. Left untreated, these defects have been shown to lead to cartilage degeneration, limited function, pain and greater risk for joint deterioration.
Theoretically, mechanical enhancement and/or biologic stimulation of chronically damaged and structurally compromised SubChondral bone, juxtaposed to a region of the joint with deficient cartilage, will relieve Knee pain emanating from the SubChondral bone and slow progression both bone and cartilage deterioration.
|From Zimmer Institute|
In this minimally invasive, arthroscopically-assisted procedure, navigation instruments are used to inject specialized Ceramic Calcium Phosphate bone filler (Etex), without violating the joint. As the bone filler is resorbed, the pain due to BML subsides as the lesion is replaced with new, healthy bone. The substitution of abnormal bone with healthy bone is the reason patients experience pain relief. The Subchondroplasty Procedure is the first procedure to treat bone-based changes within a painful joint, and addresses an unmet clinical need between early interventions, such as NSAIDs and joint arthroscopy, and total joint replacement. Subchondroplasty was introduced in November 2010. This procedure is now available in the Greater Phoenix area from Stefan D. Tarlow, M.D. of Advanced Knee Care, PC.