While joint cartilage thickness is emphasized on MRI & X Ray, new research suggests that bone marrow lesions (BML) seen on MRI may correlate more with function and pain. These lesions which feel like “wet wood” in the operating room light up on MRI & indicate that total joint replacement may be required in the near future. A new treatment called Subchondroplasty (SCP) is a minimally invasive procedure that involves injecting a cement-like cocktail into the marrow lesion in the bone beneath the cartilage. This theoretically stabilizes the foundation of the joint and reduces pain according to early studies.
At the Orthohealing Center, we are collaborating with Neil Ghodadra of Beverly Hills, to arthroscopically debride a knee joint and deliver the cement injection. 2-3 weeks after the scope we administer Bone Marrow Concentrate injection to maximize healing. Dr Steven Sampson just presented case studies of this procedure in Venice Italy & will discuss it further at the International Cartilage Repair Society meeting in Bologna Italy Dec 6, 2013. More studies are needed but with our increased understanding of osteoarthritis, comes new procedures to potentially avoid a total joint replacement in active individuals. Combining cell based therapies like PRP and BMC with minimally invasive knee arthroscopy appears to hold great promise although more trials are needed.