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The rational for and efficacy of subchondroplasty in the injured worker
Andrew S Levy1, Kevin Cousins1
1The Center for Advanced Sports Medicine Knee and Shoulder, 90 Millburn Ave, Suite 204 Millburn, NJ, USA.
Objective:
Evaluation and treatment of workplace knee injuries with pre existing arthritis is difficult from both a causality and a clinical perspective. The current study evaluates the relevance and treatment of the bone marrow edema (BME) in injured workers.
Methods:
179 patients who injured their knee at work and were found to have arthritis and BME and subsequently underwent subchondral calcium phosphate injections (subchondroplasty) were reviewed.
Results:
Radiographic arthritic status was Kellgren Lawrence 3-4 in 56%. Cartilage status was outerbridge III/IV. 86% reported marked improvement at 6 months. 74% at 3 years and 83% at 5 years. RTW was 78% at 3 months & 85% by 6 months. Survivorship was 98% at one year, 86% at 2 years, 81% at 5 years & 76% at 7 years post op.
Conclusions:
BME (associated with trabecular fracture) is an objective measure of causality in the injured worker. The treatment of BME positive arthritis in injured workers is highly successful in terms of decreasing pain, improving function and expediting return to work.
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