Osteo-core plasty: minimally invasive approach for subchondral pathologies

The subchondral bone is a critical part of the osteochondral unit, providing nutrients to the overlying articular cartilage, thereby maintaining viability of the chondral tissue. The subchondral bone also provides firm mechanical support to assist with stability of the articular cartilage and distribution of stress. Subchondral bone pathology, diagnosed as a bone marrow lesion (BML) on magnetic resonance imaging, may be seen in a variety of pathologic conditions, including knee osteoarthritis (OA). Bone marrow lesions accelerate degenerative changes in the knee joint, and treatment of these lesions may prolong joint longevity. Presently, treatment options for subchondral bone lesions are limited. Osteo-core plasty is a minimally invasive treatment for subchondral bone pathology that consists of two parts: (1) decompression of bone marrow and the administration of bone marrow aspirate concentrate (BMAC) to promote tissue healing, and (2) implantation of bone autograft to provide mechanical support. In an observational study 24 patients with bone marrow lesions have been treated with Osteo-core plasty due to symptomatic bone marrow lesions. At 2 year follow-up they showed a significant improvement in patient-reported scores compared to the preoperative assessment. Based on early clinical data Osteo-core plasty has demonstrated clinical efficacy in treatment of symptomatic bone marrow lesions associated with knee osteoarthritis.