2017 ISAKOS Biennial Congress ePoster #1619

 

Subchondroplasty For Treating Bone Marrow Lesions In The Knee - Initial Experience

Marcelo B. Bonadio, MD, São Paulo, SP BRAZIL
Pedro N. Giglio, MD, São Paulo, SP BRAZIL
Camilo P. Helito, MD, PhD, São Paulo, SP BRAZIL
Luís Eduardo P. Tírico, MD, São Paulo, SP BRAZIL
Riccardo Gomes Gobbi, MD, PhD, São Paulo, SP BRAZIL
Fabio J. Angelini, MD, Sao Paulo, SP BRAZIL
Roberto Freire da Mota e Albuquerque, MD, PhD, São Paulo, SP BRAZIL
José R. Pécora, Prof., São Paulo, SP BRAZIL
Gilberto L. Camanho, MD, São Paulo, SP BRAZIL
Marco K. Demange, MD, PhD, São Paulo, SP BRAZIL

University Of São Paulo, São Paulo, São Paulo, BRAZIL

The FDA has not cleared the following pharmaceuticals and/or medical device for the use described in this presentation. The following pharmaceuticals and/or medical device are being discussed for an off-label use: LAS Brasil, EasyFill

Summary

Clinical result of the initial experience with the Subchondroplaty technique in Brazil.

Abstract

Objective

Evaluate the use of Subchondroplasty procedure in the treatment of bone marrow lesions in an initial series of five cases outside of the United States.

Methods

Were included five patients aged between 40 to 75 years old, with pain in the knee for at least 6 months, associated with high signal MRI lesion on T2 sequences, on the tibia or femur. Patients were assessed using the visual analogue pain scale and the KOOS score, a week before surgery and 1, 3, 6, 12 and 24 weeks after the procedure.
The subchondroplasty was performed using a 8 gauge cannula with a lateral opening for filling the area of bone marrow lesion, with a calcium phosphate bone substitute.

Results

The filling was performed on the medial femoral condyle in 4 patients and medial tibial plateau in one case.
The assessment by the KOOS score presented a preoperative average of 38.44 points and 62.7(p<0.05), 58.08(p<0.05), 57.92(p<0.05), 63.34(p=0.07) and 71.26(p<0.05) points with 1, 3, 6, 12 and 24 weeks after surgery, respectively. In the evaluation by the VAS, the average was 7.8 points preoperatively and 2.8(p<0.05), 3(p<0.05), 2.8(p<0.05), 1.8(p<0.05) and 0.6(p<0.05) points over the same periods. All patients were able to ambulate without additional support, on the first day after the procedure.
One patient had a minimal graft extravasation for soft tissue, with local pain, which resolved completely after a week.

Discussion

The patients presented a significant improvement in pain and function, during the period of six months. In our knowledge, this is the first series of case submitted to the Subchondroplasty outside the United States.
The good results presented in a short period, without significant complications, encourages the further development of the Subchondroplasty and new studies with a longer follow-up and a larger number of patients.

Conclusion

The developed subchondroplasty technique provided significant improvements in the parameters of pain and functional capacity in the short-term assessment.