Dawid Szwedowski, Ignacio Dallo, Eleonora Irlandini, Alberto Gobbi.
Arthroscopy Techniques. 9;11 (2020) e1773-e1777 | doi: 10.1016/j.eats.2020.07.023
“Bone marrow lesion” (BML) is a common term used to describe the presence of fluid in the bone marrow. Although various pathologies can cause BMLs seen on magnetic resonance imaging, in this Technical Note we focus on treating the lesions associated with osteoarthritis in the knee joint. The role of the subchondral bone in transferring loads within the knee joint, as well as in cartilage homeostasis, is well established. In addition, cartilage and subchondral bone are increasingly considered as an osteochondral unit, rather than as 2 separate structures. Knee osteoarthritis, along with insufficiency fracture, is one of the main indications for the treatment of painful BMLs. Nowadays, there is a growing interest in this field, and new approaches are being developed. Our technique can be defined as a surgical procedure aimed directly at pathology within the subchondral bone and is named “osteo-core plasty.” It consists of 2 parts: The first is decompression of bone marrow to decrease intraosseous pressure, and the second is administration of bone marrow aspirate concentrate for better healing potential and bone autograft to deliver supportive tissue. It should be noted that the cause of BMLs must be known before this kind of treatment is performed.
The Marrow Cellution™ System is designed to minimize and eliminate the restrictive limitations associated with “point of care” processing systems which employ inefficient traditional aspiration trocar technology and are regulated as drugs “Advanced Therapies Medicinal Products (ATMP)”. Marrow Cellution™ is a minimally invasive bone/cell enriched autograft access and retrieval system, which does not require additional manipulation or processing, it never leaves the sterile field and provides rich autograft without associated morbidity.
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