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Olubusola A Brimmo, Chantelle C Bozynski, Cristi R Cook, Keiichi Kuroki, Seth L Sherman, Ferris M Pfeiffer, Aaron M Stoker, James L Cook
This study characterizes long-term outcomes associated with subchondroplasty (SCP) treatment for impact-induced subchondral bone marrow lesions (BML) using a validated pre-clinical canine model. With IACUC approval, purpose-bred research hounds (n = 16) underwent arthroscopic impact injury (40N) to both medial femoral condyles. At 3 months, functional assessments, arthroscopy and MRI were performed and knees (n = 32) were randomly assigned to SCP (3 mL fluoroscopically guided percutaneous injection of AccuFill BSM into BML bone defects) or sham injection (Control)...
May 10, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Diego Costa Astur, Eduardo Vasconcelos de Freitas, Pedro Barreira Cabral, Caio Carvalho Morais, Bruno Silveira Pavei, Camila Cohen Kaleka, Pedro Debieux, Moises Cohen
Purpose This study aimed to compile available data in medical literature about subchondral calcium phosphate injection, comparing results obtained with this technique, as well as indications, complications, and other important factors in treatment of bone marrow lesions. Designs A literature review using PubMed and Medline database in order to identify works with terms "subchondral calcium phosphate injection," " subchondroplasty®," "bone marrow lesion," and "knee." Eight relevant articles were found...
April 1, 2018: Cartilage
Qais Naziri, Patrick J Mixa, Daniel P Murray, Roby Abraham, Bashir A Zikria, Akhilesh Sastry, Preetesh D Patel
INTRODUCTION: Unicompartmental knee arthroplasty (UKA) effectively improves pain and function associated with isolated compartmental knee arthritis. The developments of computer-navigated and robotic-assisted UKA are among the most significant changes that have improved patient outcomes. This study aimed to systematically review the literature to identify differences between computer-navigated and robotic-assisted UKAs. MATERIALS AND METHODS: Twenty total articles were identified...
March 29, 2018: Surgical Technology International
Andrew Dold, Donato Perretta, Thomas Youm
Subchondroplasty is a relatively new procedure developed to treat bone marrow lesions by injecting a calcium phosphate bone substitute into the pathologic, subchondral area of bone under fluoroscopic guidance. The procedure is described as a minimally invasive strategy that provides reliable relief of pain while preserving the native joint with minimal risk of significant complications. No prospective, randomized clinical trials have reported the efficacy of the procedure. Here, we present the case of a 64-year-old healthy male who developed Staphylococcus aureus osteomyelitis following subchondroplasty requiring further surgical intervention and intravenous antibiotic therapy...
December 2017: Bulletin of the Hospital for Joint Diseases
Marcelo Batista Bonadio, Pedro Nogueira Giglio, Camilo Partezani Helito, José Ricardo Pécora, Gilberto Luis Camanho, Marco Kawamura Demange
OBJECTIVE: To evaluate the use of subchondroplasty in the treatment of bone marrow lesions in an initial series of five cases. METHODS: The study included patients aged between 40 and 75 years old, with pain in the knee for at least six months, associated with high-signal MRI lesion on T2 sequences, on the tibia or femur. Patients were assessed using the visual analog pain scale and the KOOS score, one week before surgery and one, three, six, 12, and 24 weeks after the procedure...
May 2017: Revista Brasileira de Ortopedia
Marcelo Batista Bonadio, Alipio Gomes Ormond Filho, Camilo Partezani Helito, Xavier Mgrg Stump, Marco Kawamura Demange
In this article, the cause, histology, imaging characteristics, clinical presentation, and treatment of these lesions are thoroughly discussed. Bone marrow edema is the generic term classically used to describe the high-signal-intensity alterations detected on magnetic resonance fluid-sensitive sequences. The significance of bone marrow edema for the patient's clinical condition and the prognosis of the affected joint is being increasingly investigated and discussed, and situations characterized by subchondral insufficiency are receiving increasing attention...
2017: Magnetic Resonance Insights
Christoph A Agten, Daniel J Kaplan, Laith M Jazrawi, Christopher J Burke
OBJECTIVE: Subchondroplasty is a novel minimally invasive procedure that is used to treat painful bone marrow lesions in patients with knee osteoarthritis or insufficiency fractures. The objective of this article is to describe the surgical technique and the pre- and postoperative imaging findings of a small case series acquired at a single center. CONCLUSION: The radiologist should be familiar with the anticipated postoperative imaging appearances after subchondroplasty and the potential complications...
December 2016: AJR. American Journal of Roentgenology
Joanne Y Yoo, Michael J O'Malley, Laura J Matsen Ko, Steven B Cohen, Peter F Sharkey
BACKGROUND: Calcium phosphate bone substitutes (CPBS) are commonly used to augment and repair bone voids and defects after fractures around the knee joint. The purpose of this study was to determine whether prior arthroscopic application of a CPBS, for repair of magnetic resonance imaging-identified subchondral fractures associated with osteoarthritis (procedure referred to as subchondroplasty) adversely affected the performance and/or outcome of subsequent knee arthroplasty. METHODS: Twenty-two patients who had arthroscopic repair of a periarticular fracture combined with use of a CPBS who later had knee arthroplasty were identified...
October 2016: Journal of Arthroplasty
Mika T Nevalainen, Peter F Sharkey, Steven B Cohen, Johannes B Roedl, Adam C Zoga, William B Morrison
Bone marrow lesions observed in magnetic resonance imaging (MRI) have been recognized as a source of knee pain. Subchondroplasty was developed to treat these lesions with a percutaneous injection of calcium phosphate bone substitute into the bone. As subchondroplasty may potentially become a more common procedure in the treatment of knee osteoarthritis, it is important for radiologists to recognize the typical MRI findings and not to confuse them with other pathology. Here we report the MRI findings for two patients following subchondroplasty...
March 2016: Clinical Imaging
Jason A Collins, Bryan G Beutel, Eric Strauss, Thomas Youm, Laith Jazrawi
Bone marrow edema of the knee occurs secondary to a myriad of causes. The hallmark of a bone marrow lesion (BML) is an area of decreased signal intensity on T1 weighted MRI with a corresponding area of increased signal intensity on a T2 weighted MRI. Recently, chronic bone marrow lesions have been correlated with knee pain and progression of osteoarthritis. These lesions have also been associated with other degenerative conditions such as meniscal tears, cartilage deterioration, subchondral cyst formation, mechanical malalignment, and ultimately progression to arthroplasty...
March 2016: Bulletin of the Hospital for Joint Diseases
Steven Brad Cohen, Peter F Sharkey
The prognosis of osteoarthritis (OA) is worsened by persistent subchondral defects known as bone marrow lesions (BMLs), which herald severe joint degeneration and the need for joint replacement. Joint-preserving treatments that reverse the progression of pain and immobility are limited. Subchondroplasty is a procedure developed to treat BMLs by injecting a calcium phosphate bone substitute into compromised subchondral bone, under fluoroscopic guidance. Here we evaluate the effectiveness of this approach for relieving pain and improving function in patients with documented BMLs and advanced knee OA, in a retrospective study...
October 2016: Journal of Knee Surgery
Dinely A Colon, Byung Jo Victor Yoon, Thomas Anthony Russell, Frank P Cammisa, Celeste Abjornson
BACKGROUND: Bone substitute materials (BSMs) have been commercially available for over 30 years and have been used extensively in orthopedic procedures. Some BSMs are described as "injectable." With rising focus on minimally invasive surgical procedures, the range of applications in which these materials are injectable is of clinical interest. Specifically, their performance in closed, pressurized environments in the trabecular bone with microdamage or abnormal bone remodeling have not been well characterized...
December 2015: Knee
Geoffrey D Abrams, Eduard Alentorn-Geli, Joshua D Harris, Brian J Cole
Osteochondritis dissecans lesions occur frequently in children and adolescents. Treatment can be challenging and depends on the status of the articular cartilage and subchondral bone. Injection of calcium phosphate bone substitute into the area of subchondral bone edema (Subchondroplasty; Knee Creations, West Chester, PA) may be an option. We present a case of a lateral tibial plateau osteochondritis dissecans lesion treated with subchondral injection of nanocrystalline calcium phosphate. Preoperative magnetic resonance imaging is used to determine the area of subchondral edema, and intraoperative fluoroscopy is used to localize this area with the injection cannula...
2013: Arthroscopy Techniques
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