Subchondroplasty - a new, minimally invasive technique that replaces the weak areas of bone marrow lesions (BMLs) with strong, healthy bone - is offering renewed hope to sufferers of chronic knee pain. The technique may often prevent, or at least delay, the need for total knee replacement.
Dr. Forest T. Heis describes how it works: "It is a minimally invasive surgery. I do it in conjunction with arthroscopy. I'll scope the knee first, which allows me to look at all the different parts of the knee, clean up the knee and address any problems with the knee one at a time. Then, using an X-ray machine as well as MRI images, I can locate the BMLs and inject into them a bone substitute that fills the area of weak bone."
Once the bone substitute is injected, it hardens almost immediately, providing a strong, pain-free surface within the knee joint. What's more, over the course of 18 months, the body makes new bone that gradually replaces the bone substitute. That new bone is strong, healthy and lasts the rest of the patient's life.
"It's all done through this small hole; there are no external stitches, and most patients can bear weight on their knee almost immediately," Dr. Heis says. Most patients use crutches or a walker, as well as pain medication, for about a week. Rehab and physical therapy starts two to three days post-op. "The majority of my patients come back to see me a week to 10 days later and feel much better, with elimination of their chronic knee pain issues," Dr. Heis says.