{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:30:35Z","timestamp":1788255035389,"version":"build-2803163510"},"reference-count":31,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T00:00:00Z","timestamp":1601337600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Knee surg. sports traumatol. arthrosc."],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>Subchondroplasty\u00ae is a novel minimally invasive procedure for painful subchondral bone marrow lesions (BMLs). The aim of this systematic review was to characterize the clinical outcomes of the Subchondroplasty\u00ae procedure, a novel minimally invasive procedure for the treatment of BMLs. The hypothesis tested was that patients experience improvements in pain and functional outcomes following the Subchondroplasty\u00ae procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE, Embase, Web of Science, and Clinicaltrials.gov were searched from database inception to search date (June 10, 2020) for all clinical studies which discussed Subchondroplasty\u00ae. Two reviewers independently screened 45 unique results and 17 studies were included in the final analysis. Data were collected regarding patient demographics, indications, pain, functional scores, conversion to TKA, and complications of the procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All but one study were level IV evidence; the mean MINORS score was 9\u2009\u00b1\u20092. There were 756 patients included, 45.1% were female, and the mean age was 54 years (range 20\u201385). Thirteen studies investigated the effect Subchondroplasty\u00ae to the knee, while four studied the impact on the foot and ankle. Median length of follow\u2010up was 12\u00a0months. The most common indication for Subchondroplasty\u00ae was joint pain with corresponding BML. Major contraindications to Subchondroplasty\u00ae included severe OA, joint instability, and malalignment. Mean pain score on visual analogue scale (VAS) prior to Subchondroplasty\u00ae was 7.8\u2009\u00b1\u20090.6, but decreased to 3.4\u2009\u00b1\u20090.7 postoperatively. All studies investigating functional scores reported improvement following Subchondroplasty\u00ae (IKDC 31.7\u2009\u00b1\u20091.9\u201354.0\u2009\u00b1\u20094.2 and KOOS 38.1\u2009\u00b1\u20090.6\u201370.0\u2009\u00b1\u20094.1). There were consistently high levels of patient satisfaction; 87\u2009\u00b1\u20098% of patients would be willing to undergo the procedure again. Seven cases of complications were reported, most seriously osteomyelitis and avascular necrosis. Conversion to knee arthroplasty ranged from 12.5 to 30% with length of follow\u2010up ranging from 10\u00a0months to 7 years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Existing low\u2010quality studies show Subchondroplasty\u00ae to benefit patients with BMLs through reduction in pain and improvement in function, along with a high degree of satisfaction following the procedure. The low short\u2010to\u2010medium term conversion rate to arthroplasty suggests that Subchondroplasty\u00ae may play a role in delaying more invasive and expensive procedures in patients with BMLs. Subchondroplasty\u00ae is a novel procedure that has promising initial findings, but requires further high\u2010quality, comparative studies with long\u2010term follow\u2010up to better understand the outcomes of the procedure and impact clinical practice recommendations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>Systematic Review of Level III and IV Studies, Level IV.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00167-020-06294-w","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T10:03:57Z","timestamp":1601373837000},"page":"3599-3607","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Safety and early results of Subchondroplasty\u00ae for the treatment of bone marrow lesions in osteoarthritis: a systematic review"],"prefix":"10.1002","volume":"29","author":[{"given":"Leah N.","family":"Nairn","sequence":"first","affiliation":[{"name":"<!--<label>1<\/label>--> Michael G. 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