Orthopedic Procedures

Have you had knee pain for more than 3 months?

Have you had increasing discomfort when walking or standing?

Have you had limited benefits from NSAIDs, bracing, injections or physical therapy?

Have your symptoms returned after an arthroscopy?

If you answered yes to any of the questions above, a Subchondroplasty may be your answer.

Why am I having pain?

Made up of bone, cartilage, tendons, ligaments, muscles and fluid, the knee is a complex machine. If one part of the machine is not working properly, intense discomfort can ensue. One of these system malfunctions is a bone marrow lesion (BML), a micro-fracture or swelling in the soft bone right below the knee joint. In the past, this problem was treated with bracing, limited activity or knee surgery.

How is BML diagnosed?

Subchondroplasty is a very effective treatment for individuals who suffer chronic knee pain as a result of bone marrow edema (BME) surrounding mi-microscopic insufficiency fractures within the upper layer of bone. Through physical examination and MRI imaging, Dr. Hayter can determine your eligibility for a Subchondroplasty. General criteria for candidacy includes:

  • Knee pain that has affected mobility and quality of life
  • Failure to achieve relief with bracing, injections, NSAIDs, or physical therapy
  • 40-75 years of age
  • No severe malalignment of the joint
  • BMI less than 40
How is the procedure performed?

Under general anesthesia, Dr. Hayter will use imaging to visualize the exact location of the damaged bone. He will place 3 holes and then inject a paste made of calcium phosphate (also referred to as “bone-void filler”) directly into that damaged area. After about 10 minutes, the paste will harden into a bone-like substance that can adequately support the joint, allowing the fracture to heal and the edema to subside. This sub-stance solidifies soon after injection, and is then gradually absorbed over time allowing healthier bone to develop in the location of the BMLs.

Recovery and Post Operative Plan

Subchondroplasty is an Outpatient procedure and has a short rehabilitation period. Some pain and discomfort in the operated area is usually experienced for 1-2 days after the procedure. Pain medications will be prescribed to manage it. Crutches may be recommended for 1-2 weeks after the surgery to reduce weight bearing on the operated leg. Elevation and ice is also recommended to reduce swelling and discomfort. Dr. Hayter will discuss your post operative plan prior to your surgery.

Please contact the office or our Nurse Coordinator, Jamie Flores, R.N. at 727-278-3996 if you have any questions or concerns.