Szwedowski Dawid, Dallo Ignacio, Irlandini Eleonora, Gobbi Alberto
Orthopaedic Arthroscopic Surgery International (OASI) Bioresearch Foundation Gobbi NPO, Milan, Italy.
Arthrosc Tech. 2020 Nov 20;9(11):e1773-e1777. doi: 10.1016/j.eats.2020.07.023. eCollection 2020 Nov.
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.
骨髓病变（BML）是一个常用术语，用于描述骨髓中存在液体的情况。尽管多种病理状况可导致磁共振成像上出现BML，但在本技术说明中，我们重点关注治疗膝关节骨关节炎相关的病变。软骨下骨在膝关节内传递负荷以及维持软骨内环境稳定方面的作用已得到充分证实。此外，软骨和软骨下骨越来越被视为一个骨软骨单元，而非两个独立的结构。膝关节骨关节炎以及应力性骨折是治疗疼痛性BML的主要适应症之一。如今，该领域的关注度日益增加，新的治疗方法也在不断开发。我们的技术可定义为一种直接针对软骨下骨病理状况的外科手术，名为“骨芯成形术”。它由两部分组成：第一部分是对骨髓进行减压以降低骨内压，第二部分是注入骨髓抽吸浓缩物以提高愈合潜力，并植入自体骨以提供支持组织。需要注意的是，在进行此类治疗之前，必须明确BML的病因。
