Percutaneous Skeletal Fixation of Painful Subchondral Bone Marrow Edema of the Knee.

Publication/Presentation Date

10-1-2020

Abstract

PURPOSE: To investigate the change in patient-reported pain after percutaneous skeletal fixation (PSF) and to determine the success rate of PSF in the prevention of additional intervention for the treatment of painful subchondral bone marrow edema (SBME) of the knee over a 2-year postoperative period.

METHODS: This was a retrospective, single-surgeon analysis of patients undergoing PSF for painful, atraumatic SBME of the knee confirmed on preoperative magnetic resonance imaging with a minimum 2-year follow-up. Inclusion criteria were age >18 years, pain localized to the area of edema, failure of nonsurgical intervention (4 weeks of physical therapy and non-steroidal medication use), and absence of tricompartmental Kellgren-Lawrence grade 4 osteoarthritis. All patients underwent arthroscopy, followed by isolated PSF without additional chondral procedures. Pre- and postoperative visual analog scale scores were compared. The primary outcome measure of success was defined as a lack of additional intervention. This included viscosupplementation, corticosteroid injection, or conversion to arthroplasty.

RESULTS: A total of 74 patients with a mean age of 47.2 years and average follow-up time of 38.9 months (range 24-61 months) were evaluated. Successful treatment was noted in 61 patients (82.4%). Of the 13 patients who did not respond to PSF, 5 (6.8%) had been converted to arthroplasty, 11 received viscosupplementation, and 8 required cortisone injections. The average visual analog scale score decreased from 7.55 preoperatively to 3.16 at 2-year follow-up (

CONCLUSIONS: Patients undergoing PSF for the treatment of painful SBME may expect a decrease in knee pain and low rates of additional intervention over a 2-year postoperative period.

LEVEL OF EVIDENCE: Level IV; Therapeutic Case Series.

Volume

2

Issue

5

First Page

583

Last Page

583

ISSN

2666-061X

Disciplines

Medicine and Health Sciences

PubMedID

33134998

Department(s)

Department of Surgery

Document Type

Article

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