Expanding Applications of the Subchondroplasty Procedure for the Treatment of Bone Marrow Lesions Observed on Magnetic Resonance Imaging

Increase in signal on T2-weighted fat-suppressed magnetic resonance imaging is referred to as a bone marrow lesion (BML). Although there is overlap with avascular necrosis, a subset of BMLs is unique and typically associated with overlying chondrosis in a high-load region of the joint. These lesions are often associated with localized knee pain. Several current studies demonstrate improvement in patient-reported outcomes after internally splinting the cancellous bone injuries of the femoral condyles and tibial plateaus with synthetic calcium phosphate bone substitute. As BMLs are often not isolated entities at the tibiofemoral articulation, it follows that the use of the same technique may be applied to the patellofemoral articulation when other pathologies are treated or used in other articulating areas of the knee, specifically the trochlea and patella. This article presents a proposed surgical technique to treat BMLs of these articulating areas.