Subchondroplasty is a relatively new procedure developed to treat BMLs
by injecting a calcium phosphate bone substitute into pathologic subchondral bone under fluoroscopic guidance.
The presence of BMLs
after TKR has not previously been explored, primarily due to the fact that, even with optimisation of conventional MR sequences, tissues in the immediate vicinity of metallic implants are largely obscured due to image distortion and artefact.
It may thereby lower the contact stress and shrink BMLs
will not heal without treatment, and ultimately lead to severe osteoarthritis and the need for total knee replacements.
In the north of Tasmania, where BMLs
can be much smaller, it seems likely that there remain regions in which the LML is inappropriately high, and this is preventing the reasonable harvest of available resources.
"Results from several studies have linked BMLs
with pain and cartilage damage in OA patients.
Again, interventional treatment for painful BMLs
often parallels the treatment regimen for osteoarthritis.
Bone marrow lesions (BMLs
) are ill-defined, hyperintense lesions in subcortical bone detected during water-sensitive, fat-suppressed MRIs.
Cartilage volume and defects, as well as the presence of bone marrow lesions (BMLs
), were assessed on MRI.
Based on studies his group has done, about 20% of BMLs
that are associated with knee OA spontaneously enlarge over the course of 3 years, another 20% shrink in size, and about 60% remain the same, he said.
Baseline features (such as malalignment, BMLs
, or meniscal damage) are also predictive of progression, and it is hoped that these can also be used to increase the study power by selecting participants that have features which predict rapid progression in future studies.
Melanie J Adriaansen, BMLS
, Medical Laboratory Scientist