The Subchondroplasty® Procedure (SCP) is a new minimally invasive procedure used by Dr. Michael J. Sumko at Hedley Orthopaedic Institute to fill subchondral bone defects – also known as Bone Marrow Lesions (BML). These bone defects, which commonly occur in the bone just beneath the cartilage in the knee joint, are known to be associated with osteoarthritis knee pain. Some researchers believe that measurable changes in the subchondral bone can serve as warning signs of osteoarthritis development.
Who Could Benefit from Subchondroplasty?
Subchondroplasty treats painful defects in the spongy cancellous bone (the inside of the bone). Dr. Sumko may diagnose a subchondral bone defect based on your medical history, a physical exam and an MRI, which could reveal an abnormal defect within the bone.
These painful Bone Marrow Lesions typically develop within the bone near a joint. The top part of the shinbone (directly beneath the kneecap) and the ankle are two areas where BML’s are more likely to develop. While BML’s are more common in bones that are near joints, weight-bearing or subject to repetitive motion stress, they can develop anywhere in the body.
The surgeons at Hedley Orthopaedic Institute treat patients who have developed BML’s through:
- Bone injuries that failed to heal properly
- Overuse of a joint or poor joint mechanics
- Quickly increasing activity level
- Poor joint alignment
- Obesity and/or long-term poor diet
While BML’s are more common in middle-aged patients than younger patients, anyone can develop this injury.
About The Subchondroplasty Procedure
The goal of subchondroplasty procedure is to fill the subchondral defect with a bone substitute material that will harden (mimicking the body’s natural cancellous bone). The body then replaces this material with new, healthy bone matter through its natural resorption process.
The SCP procedure may be done under local and/or regional anesthetic or general anesthesia. During the procedure, the surgeon uses fluoroscopic guidance (a real-time x-ray) to see the operative area. The bone substitute material is injected into a tiny hole drilled into the damaged area of the bone. Over time, this calcium phosphate mineral compound is resorbed by the body and replaced with actual bone material.
Patients typically return home the same day of their procedure. While the recovery process varies, most patients find…
- Discomfort or pressure for the first 48-72 hours following the SCP procedure, which may be mitigated with pain medications prescribed by the orthopaedic surgeon.
- Crutch support for walking and standing in the initial recovery period.
- Physical therapy and activities for regaining strength and joint mobility.
It’s important to note that having an SCP procedure does not preclude a patient from having a total joint replacement surgery at a later time. Additionally, patients should ask their physicians about more conservative therapies for Bone Marrow Lesions, which may include pain medications, crutches, joint injections, physical therapy and braces. The Subchondroplasty Procedure is typically recommended after one or more conservative approaches have been found unsuccessful.
See a Subchondroplasty Specialist Near You
For more information about subchondroplasty for bone marrow lesions, or to schedule an appointment with Dr. Sumko, contact Hedley Orthopaedic Institute by calling (602) 553-3113.