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Updated: Apr 21, 2026
Autologous Microfractured and Purified Adipose Tissue for Arthroscopic Management of Osteochondral Lesions of the Talus
Published on: January 23, 2018
Relationships Among Bone Marrow Lesions, Cartilage Improvement, and Short- to Midterm Patient-Reported Outcomes After
Kosuke Kawamura1, Eiji Sasaki1, Takahiro Tsushima1
1Department of Orthopedic Surgery, Hirosaki University, Graduate School of Medicine, Hirosaki, Japan.
Background:
Bone marrow lesions (BMLs) are associated with knee pain and predict structural changes and joint replacement. Their significance in the context of opening-wedge high tibial osteotomy (OWHTO) is, however, unclear.
Purpose:
To investigate whether preoperative BMLs are associated with cartilage regeneration-like tissue and postoperative patient-reported outcomes after OWHTO and to evaluate how 1-year changes in BMLs (ΔBML) relate to these outcomes.
Study Design:
Cohort study: Level of evidence, 3.
Methods:
In this retrospective study, 138 knees underwent arthroscopy during OWHTO, and 85 knees underwent follow-up arthroscopy. Participants also completed questionnaires and underwent magnetic resonance imaging (MRI). Cartilage status at the medial femoral condyle (MFC) and medial tibial plateau (MTP) was evaluated using the International Cartilage Research Society (ICRS) grading system during initial and follow-up arthroscopies to assess improvement after OWHTO. Postoperative outcomes were assessed using the Knee injury and Osteoarthritis Outcome Score (KOOS). BMLs were scored according to the MRI Osteoarthritis Knee Score, and ΔBML was calculated.
Results:
The preoperative BML score weakly correlated with the initial ICRS grade at the MFC (r = 0.306; P < .001) and MTP (r = 0.353; P < .001). At the MTP, a preoperative smaller BML score was significantly associated with cartilage improvement (P = .030). In addition, preoperative large BML significantly correlated with improvement in ΔBML scores at the MFC (r = 0.643; P < .001) and the MTP (r = 0.757; P < .001). Regression analysis demonstrated that postoperative valgus alignment and low body mass index (BMI) were correlated with cartilage improvement in MFC; in contrast, cartilage improvement in MTP was correlated with low BMI, preoperative higher ICR grade, and a smaller preoperative BML. Also, improvement in BML scores on MTP was correlated with better KOOS symptoms 1 year after high tibial osteotomy (HTO) (P = .045).
Conclusion:
Smaller preoperative BMLs were associated with greater postoperative cartilage improvement in MTP after OWHTO. Furthermore, BML improvement was significantly related to better knee symptoms in short- to midterm patient-reported outcomes after OWHTO.
