Scientific Update | June 2021

Subchondral bone cysts are widely observed but poorly understood. Patients with proximal tibial subchondral cyst had lower tibial cartilage volume and more structural changes than patients without a subchondral cyst. Subchondral cysts commonly coexist with bone marrow lesions (BMLs), especially those with Grade 3 BML or higher. Almost 50% of knee osteoarthritis (OA) patients have subchondral bone cysts while only 13.6% of healthy individuals have a  subchondral bone cyst. Females had more and larger subchondral cysts in the lateral compartment than the males. This finding is perhaps due to the loading effect as females also showed more valgus loading knee.

In this case report, Dr. Alberto Gobbi and Dr. Ignacio Dallo from O.A.S.I. Bioresearch Foundation in Milan/Italy show that Osteo-Core-Plasty with Marrow Cellution™ is a viable option in treating proximal tibia subchondral cyst by reducing pain over the affected area.

Osteo-Core-Plasty (Marrow Cellution™) is a minimally invasive subchondral bone augmentation procedure that provides biologic and structural components to provide an optimized environment for regeneration.

It is a fluoroscopic guided, minimally invasive, autologous, biologic approach that allows necrotic bone segment resection and transplant living, live, intact bone segments that have the capabilities to reincorporate naturally without foreign body implantation.

It is an approach that could potentially overcome centrifugation techniques wherein there is an increased level of peripheral blood nucleated cells containing very few stem or progenitor cells. It uses multiple small volumes draws (1mL) from a single puncture that utilizes lateral flow from multiple sites near the inner cortical bone space in bone marrow (SSLM method). It is identified that this anatomical location contains many bone marrow stem or progenitor cells.