Subchondroplasty for Osteonecrosis of the Knee

Subchondroplasty is a relatively new minimally invasive procedure that has been used to treat bone marrow edema associated with osteoarthritis. Subchondroplasty as treatment for early stage osteonecrosis of the knee has not been extensively studied. The authors hypothesized that subchondroplasty may be an effective treatment for relieving pain, improving function, and preventing collapse in osteonecrosis. In this study, a retrospective review of 11 cases of subchondroplasty of the distal femur was conducted. There were no surgical complications with the procedure, and patients reported statistically significant improvement in pain and function. The mean Knee injury and Osteoarthritis Outcome Score for Joint Replacement improved from 44.3±4.9 preoperatively to 65.73±17.2 postoperatively. The mean visual analog scale score for knee pain was 7.8±1.18 preoperatively and 3.7±1.57 postoperatively. There has been one case of recurrence of osteonecrosis and no cases of joint collapse since the procedures occurred between 2018 and 2021. Previously, subchondroplasty for the treatment of osteonecrosis of the talus as well as of the knee joint showed positive results. This study affirms that subchondroplasty may also be a useful treatment option for relieving pain, improving function, and preventing joint collapse in osteonecrosis of the knee. [Orthopedics. 2023;46(5):e287-e290.].