Subchondroplasty Procedure

The Subchondroplasty® (SCP®) Procedure is a minimally-invasive, fluoroscopically-assisted procedure that targets and fills subchondral bone defects through the delivery of AccuFill® Bone Substitute Material (BSM), a nanocrystalline, highly porous injectable calcium phosphate (CaP).

The SCP® Procedure is usually performed along with arthroscopy for visualization and treatment of findings inside the joint. In some cases, an open or mini-open procedure is necessary for access to the defect.

The Clinical Problem

Dr. Isaacson will base a diagnosis of a subchondral bone defect on your clinical history, physical exam and MRI findings.

A subchondral bone defect, often referred to as a Bone Marrow Lesion, or BML, is a term for a finding on an MRI that represents an abnormal area or defect inside the bone.

What is a Bone Marrow Lesion (BML)?

Bone marrow lesions (sometimes called Bone Marrow Edema) are small defects typically found in subchondral bone, the region below the cortical bone near a joint. They can only be seen on certain MRI sequences, appearing as a hazy white area against the background of darker bone.

Pathologists have shown that BML represent a healing response surrounding small defects in the subchondral bone, such as micro trabecular fractures.

This type of defect can be found throughout the extremities and pelvis. They can be found near any joint that sees weight-bearing or repetitive motion stress.

Talar Dome BML (ankle)

What Causes a BML?

In some cases, BML defects are a result of a bone injury that doesn’t heal properly. In other cases, BML may be a stress reaction that forms from overuse or poor joint mechanics. Other factors that correlate to chronic BML include:

  • Obesity and poor diet are thought to increase the likelihood of developing BML
  • BML are more commonly found in middle-aged patients than in younger patients
  • Patients with poor joint alignment are more likely to develop BML
  • Adults who quickly increase activity may develop BML

If you are interested in our Subchondroplasty Procedure or are in need of a podiatrist to help diagnose your condition, contact Dr. Isaacson to schedule an appointment.

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