{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T09:30:19Z","timestamp":1788255019027,"version":"build-2803163510"},"reference-count":25,"publisher":"Georg Thieme Verlag KG","issue":"06","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Zimmer Biomet"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Bone marrow lesions (BMLs) have a strong correlation to patient-reported pain, functional limitations, joint deterioration, and rapid progression to total knee arthroplasty. The Subchondroplasty (SCP) procedure uses AccuFill, a calcium phosphate bone substitute material (BSM), to treat bone defects such as microtrabecular fractures and BML. This observational, prospective, multicenter, cohort study evaluated the effect of the SCP procedure at the 2-year follow-up for 70 patients with knee BML. Under arthroscopic and fluoroscopic guidance, the BML was injected with AccuFill. Patient-reported outcomes, including Visual Analog Scale (VAS) pain, Knee Injury and Osteoarthritis Outcome Score (KOOS), International Knee Documentation Committee (IKDC), and modified Knee Society Score (mKSS) were collected through 24 months postoperatively. Radiographs and magnetic resonance imaging (MRI) were performed at baseline and up to 24 months postoperatively. Patient selection was not limited based on the degree of osteoarthritis (OA) as determined radiologically by the Kellgren\u2013Lawrence (K-L) grade. For a subset of patients, patient-reported outcomes were collected up to 5 years including pain evaluation, patient knee global assessment, and satisfaction with the procedure. Preoperative radiographs indicated moderate to severe OA (K-L grades 2\u20134) in 65 patients (92.8%). Significant improvements (p\u2009&lt;\u20090.0001) in mean VAS pain, IKDC, mKSS, and KOOS scores were observed compared with baseline. Kaplan\u2013Meier survivorship free from conversion to knee arthroplasty was 76.2% at 2 years. The subset of patients followed for 5 years demonstrated low pain scores and high procedure satisfaction. This study presents statistically significant and clinically meaningful evidence of improvement in clinical outcomes following SCP for BMLs of the knee after 2 years. The survivorship rate from arthroplasty at 2 years was 76.2%. SCP for BMLs can relieve pain with a minimally invasive procedure and may delay the need for knee arthroplasty.<\/jats:p><jats:p>\n          Registration\u2003NCT01621893 (ClinicalTrials.gov).<\/jats:p><jats:p>\n          Level of Evidence\u2003Level II, Prospective Cohort Therapeutic Study.<\/jats:p>","DOI":"10.1055\/a-2501-0910","type":"journal-article","created":{"date-parts":[[2024,12,13]],"date-time":"2024-12-13T00:05:21Z","timestamp":1734048321000},"page":"290-299","source":"Crossref","is-referenced-by-count":4,"title":["Prospective Evaluation of Clinical Outcomes of the Subchondroplasty Procedure for Treatment of Symptomatic Bone Marrow Lesions of the Knee"],"prefix":"10.1055","volume":"38","clinical-trial-number":[{"clinical-trial-number":"nct01621893","registry":"10.18810\/clinical-trials-gov"}],"author":[{"given":"Steven B.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Rothman Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Hajnik","sequence":"additional","affiliation":[{"name":"CORE Orthopaedic Medical Center, Orthopaedic Surgeons, Encinitas, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory J.","family":"Loren","sequence":"additional","affiliation":[{"name":"CORE Orthopaedic Medical Center, Orthopaedic Surgeons, Encinitas, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Akhavan","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick J.","family":"DeMeo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas J.","family":"Wyland","sequence":"additional","affiliation":[{"name":"Prisma Health Steadman Hawkins Clinic of the Carolinas, Greenville, South Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Youm","sequence":"additional","affiliation":[{"name":"NYU Hospital for Joint Diseases, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laith M.","family":"Jazrawi","sequence":"additional","affiliation":[{"name":"NYU Hospital for Joint Diseases, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Daley","sequence":"additional","affiliation":[{"name":"Hinsdale Orthopaedics, A Division of Illinois Bone and Joint Institute, Hinsdale, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Farr","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine and OrthoIndy Hospital, Indianapolis, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Reischling","sequence":"additional","affiliation":[{"name":"Zimmer Biomet, Inc. Warsaw, Indiana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1650-5831","authenticated-orcid":false,"given":"Jennifer E.","family":"Woodell-May","sequence":"additional","affiliation":[{"name":"Zimmer Biomet, Inc. 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