Short-Term Outcomes of the Subchondroplasty Procedure for the Treatment of Bone Marrow Edema Lesions in Patients with Knee Osteoarthritis

OBJECTIVES: To determine the short-term outcomes, effectiveness and perception of the subchondroplasty (SCP) procedure in patients with radiographic evidence of bone marrow edema (BME) in the setting of knee osteoarthritis (OA). METHODS: A retrospective chart review in conjunction with a follow-up questionnaire was conducted on fifty patients with radiographic evidence of BME lesions who underwent the SCP procedure performed at a single academic medical institution. All patients failed prior conservative measures, including medications, injections, physical therapy, and bracing. The questionnaire focused on symptoms before and after the procedure, the perception of the procedure, any other interventions performed after the procedure, and willingness to undergo SCP again. RESULTS: The average patient age was 55 years (range 36-82 years) and 53.2% of patients were male. The average follow-up period was 14.6 months (range 12.9-25.1 months). Preliminary data from 50 patients demonstrated an average 4.7 point improvement in pain on a 10 point visual analog scale (pre-SCP 8.3, post-SCP 3.6). Eighty-eight percent (44 of 50) of patients experienced improvement in their pain and 72% (36 of 50) experienced improvement in pain-free walking distance. Forty-eight percent (24 of 50) of patients required additional interventions: eighteen received cortisone or hyaluronic acid injections, two required serial aspirations, and four went on to total knee arthroplasty. The average satisfaction level was 7.8 on a 10 point scale. Seventy-eight percent (39 of 50) of patients stated they would undergo SCP again and 86% (43 of 50) would recommend the procedure to a friend or family member. CONCLUSION: SCP is an effective treatment modality in the management of patients with knee OA and BME lesions. The goal of the procedure is to provide enduring pain relief caused by BME, hopefully delaying the need for TKA in this select patient population. Future studies are necessary to evaluate the long-term outcomes of SCP.