Are You A Candidate for Minimally Invasive Knee Procedure, Subchondroplasty®

Subchondroplasty BlogSubchondroplasty is a minimally-invasive surgery that targets and treats subchondral defects associated with chronic Bone Marrow Lesions (BML), an often-painful defect of the spongy cancellous bone that underlies and supports the cartilage of your joint.

Some quick facts about Subchondroplasty include:
— Utilizes a minimally invasive technique
— Performed in a outpatient setting
— Requires a short rehabilitation period
— Future treatment options, such as total knee replacement, remain open

Despite negative x-rays and physical examination, when Bone Marrow Lesions (BMLs) are the cause of pain, the minimally invasive Subchondroplasty Procedure may relieve the pain.

You may be a candidate for the procedure if you have:
— Symptomatic knee pain for 3+ months
— Discomfort when walking or standing
— Limited benefits from NSAIDs, bracing, injections or physical therapy
— Symptoms that returned after an arthroscopy

How are BMLs diagnosed?

BMLs can only be seen on certain MRI sequences, where they are marked by edmatous or “inflamed” areas that have been shown to represent a healing response surrounding a microscopic insufficiency fracture within the subchondral bone. The bright white areas on an MRI show stress in the bone that is a result of micro-cracks.  These cracks can be the result of early arthritis.

mri of chronic bone marrow edema

How is Subchondroplasty performed?

The procedure is usually performed along with arthroscopy (image guided) of the affected joint, allowing your surgeon to see and treat lesions inside the joint that may also be causing pain. Subchondroplasty is a mini-open procedure that provides patients a treatment option between conservative therapies and surgical intervention, such as joint replacement.

Below is a picture outlining the procedure. The subchondroplasty is a same-day procedure done with minimally invasive techniques.

SCP Surgical Procedure

How do I get started?

Call Charleston Sports Medicine for a consultation to see if you are a candidate for the Subchondroplasty procedure for joint pain relief. Dr. McConnell will do a complete assessment of possible risks before deciding if this procedure is a good fit for you. Conservative care options such as bone grafting may need to be explored as an alternative prior to recommending surgery.

Will The SCP® Procedure keep me from having total joint surgery?

Many patients delay or avoid progressing to more-invasive procedures such as total joint replacement. However, results of any surgical procedure vary from patient to patient. Should it become necessary, total joint replacement is still an option for you after SCP®.

How do I Know if SCP® is Right for Me?

Do some or all of these statements describe you?

  • I have experienced ongoing joint or bone pain for 3 months or more
  • I have increasing discomfort when walking, running, or standing
  • I have had limited or no relief from NSAIDs, bracing, injections or physical therapy
  • I had little benefit from arthroscopy, or my symptoms returned after the procedure

You may be a candidate.

Will I be anesthetized during the procedure?

Anesthesia is a way to control pain during a procedure. Some surgeons use a local and/or regional anesthetic that numbs the operative area, which allows you to remain awake but pain-free during surgery. Other surgeons prefer general anesthesia. With general anesthesia, you will be unconscious and not feel pain during the procedure.

What are the precautions and risks for this treatment?

Only your health care team can determine if you are healthy enough for surgery. Consult your doctor for a complete assessment of possible risks before deciding to have surgery.  If you and your doctor determine that total joint replacement is necessary, a prior Subchondroplasty® Procedure does not prevent this as an option. Should it become necessary, total joint replacement is still an option for you.

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