During disease processes in many joints, the cartilage covering over the end of the bone can fail in its structural integrity and ultimately results in osteoarthritis. Injury or other causes may contribute to the cartilage loss. In certain cases, the damage will result in damage and weakening of the BONE under this cartilage. There is a “chicken or egg” concept here: we know that sometimes the bone damage precedes the cartilage damage and vice versa.
When this structural damage occurs below the cartilage layer, arthritis problems can rapidly accelerate. This process proceeds through many phases, however pain is usually present throughout.
These problems only show up on plain x-rays after the damage becomes very advanced and severe. MRI studies often show these lesions very clearly.
Until recently, there was no treatment available to treat this condition in it’s EARLY stages, prior to severe, permanent bone and cartilage changes. This new treatment, coined subchondroplasty, is aimed at restoring the supporting structure of bone, reducing or eliminating pain, and preserving the cartilage layer. This treatment can also potentially prevent osteoarthritis.
Once diagnosed, the treatment involves an outpatient surgical procedure. The lesion is approached through a small incision with a specialized needle inserted under x-ray guidance. Once placement is confirmed, the area is injected with a specialized bone cement that will harden and provide support to the weakened area. This reduces pain. Over a period of time, the body will absorb this material as it is replaced by new, normal bone.