{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T04:26:52Z","timestamp":1793680012789,"version":"4.5.1"},"reference-count":54,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100012630","name":"Zimmer Biomet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012630","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["CARTILAGE"],"published-print":{"date-parts":[[2026,12]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To report 24-month clinical outcomes, surgery-free survivorship, and radiological variations after Calcium-Phosphate (CaP) Subchondroplasty (SCP) procedures in patients with symptomatic knee bone marrow lesions (BMLs) in the context of mild-to-moderate knee osteoarthritis (OA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adults with tibiofemoral BMLs (Kellgren\u2013Lawrence [KL] 1\u20133) underwent CaP SCP using a standardized protocol. Prespecified outcomes were KOOS (primary: KOOS Pain), EQ-5D-5L, and pain NRS at baseline, 1, 3, 6, 12, and 24 months; surgery-free survivorship (Kaplan\u2013Meier); and structural status by KL and MOAKS (available-case imaging). Analyses compared time points with paired tests and 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ninety-two knees were treated. KOOS Pain improved from 45.9 \u00b1 14.3 preoperatively to 81.3 \u00b1 18.1 at 24 months (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .0001). All other KOOS subscales improved from baseline to 24 months (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .0001) and pain NRS decreased from 6.8 \u00b1 1.5 to 3.3 \u00b1 2.6 (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; .0001). Kaplan\u2013Meier surgery-free survivorship was 97.7% (95% CI, 90.9\u201399.4) at 12 months and 91.5% (95% CI, 82.9\u201395.8) at 24 months; 7\/92 knees (7.6%) underwent reoperation. KL distributions showed no significant change versus baseline at 12 months (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .5089) or 24 months (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .9801). MOAKS improved at 12 months (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .0435) but not at 24 months (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = .2517) in the available MRI subset. No serious device-related adverse events were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In BML-positive knees with KL 1\u20133 OA, SCP yielded large and durable improvements in pain, function, and health-related quality of life through 24 months, with &gt;90% surgery-free survivorship and radiographic stability.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19476035261476205","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T21:01:45Z","timestamp":1788210105000},"page":"1560-1572","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Calcium-Phosphate Subchondroplasty Provides Durable 24-Month Pain Relief and &gt;90% Surgery-free Survivorship for Tibiofemoral Bone Marrow Lesions in Mild-To-Moderate Knee Osteoarthritis: A Prospective Multicenter Study"],"prefix":"10.1177","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9327-5350","authenticated-orcid":false,"given":"Giuseppe","family":"Anzillotti","sequence":"first","affiliation":[{"name":"IRCCS Humanitas Research Hospital"},{"name":"Humanitas University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizaveta","family":"Kon","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital"},{"name":"Humanitas University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5425-0652","authenticated-orcid":false,"given":"Pietro","family":"Conte","sequence":"additional","affiliation":[{"name":"IRCCS Humanitas Research Hospital"},{"name":"Humanitas University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2335-1087","authenticated-orcid":false,"given":"Peter","family":"Angele","sequence":"additional","affiliation":[{"name":"University Hospital Regensburg"},{"name":"Sporthopaedicum Regensburg\/Straubing, Regensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter","family":"Emans","sequence":"additional","affiliation":[{"name":"Maastricht University Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Minguell-Monyart","sequence":"additional","affiliation":[{"name":"Vall d\u2019Hebron University Hospital"},{"name":"Universidad Aut\u00f2noma de Barcelona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Woodell-May","sequence":"additional","affiliation":[{"name":"Zimmer 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