Summary

The Osteo-Core Plasty technique provides efficient and safe treatment for subchondral bone lesions of knee joint at two years follow-up

Abstract

Background

The subchondral bone is a critical joint element and is considered an integral part of the osteochondral unit. In fact, it provides nutrients to the avascular cartilage, therefore participating in the healing process while also providing firm support and shock absorption to the cartilage. Subchondral bone pathology is seen as a bone marrow lesion (BML) on MRI and is visible in different pathologies, including knee osteoarthritis (OA). BML if not treated, accelerate osteoarthritic changes in the joint. Treatment options for subchondral bone lesions are still limited and no gold standard has been established. Osteo-Core Plasty is a minimally invasive treatment for subchondral pathologies to prevent the progression of OA. It consists of 2 parts: decompression of bone marrow to decrease intraosseous pressure, and the administration of bone marrow aspirate concentrate to enhance healing potential and bone autograft to provide supportive tissue.

Purpose

To report the clinical outcomes and safety of Osteo-core Plasty for treating symptomatic BMLs in the knee at a 2 years follow-up.

Methods

24 patients (mean age 53 ± 17 years) with symptomatic BML of the knee treated with the Osteo-core Plasty technique were included and followed prospectively for an average of 2.5 years. Patients were recruited from 2017 to 2021. Each patient was evaluated before the surgery and at 2 years using the Knee Injury and Osteoarthritis Outcome Score (KOOS): symptoms, pain, activity of daily living (ADL), sport, and quality of life.

Results

All patients showed a significant improvement at final follow-up, compare to the initial state, with KOOS scores all significantly improved: symptoms (p = 0.0005), pain (p = 0.0003), ADL (p = 0.0053), sport (p = 0.0014), and quality of life (p < 0.0001). Median [IQR] KOOS symptoms improved from 48.00 [36.25 – 68.00] to 85.50 [61.75 – 100.0], KOOS pain 51.50 [39.25 – 67.75] to 90.50 [69.25 – 100.0], KOOS ADL from 51.50 [40.00 – 79.50] to 90.00 [62.00 – 100.0], KOOS sport from 27.50 [15.00 – 48.75] to 75.00 [26.25 – 100.0], KOOS quality of life from 30.00 [25.00 – 43.00] to 72.00 [44.00 – 100.0]. No serious adverse event was observed during the study.

Conclusions

This study provides evidence of the efficacy and safety of the Osteo-core Plasty technique in treating painful BMLs in the knee joints at a 2 years follow-up.