ArticleJournal of orthopaedic surgery and research2026
Subchondral bone marrow aspirate concentrate injection improves clinical outcomes and reduces bone marrow lesions in knee osteoarthritis: 12-month retrospective analysis.
Article in Journal of orthopaedic surgery and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeThis study had two primary aims: (1) to evaluate the clinical efficacy of fluoroscopically-guided subchondral autologous bone marrow aspirate concentrate (BMAC) injection for reducing pain and improving function in patients with knee osteoarthritis (OA)-associated bone marrow lesions (BMLs), we hypothesized significant improvements across validated outcome measures at 12 months; and (2) to assess early radiologic changes in BML severity using MRI, hypothesizing a significant reduction in MOAKS scores at 3 months. Secondary aims evaluated subgroup differences by age and body mass index (BMI), with age stratified as ≤ 50, 50-60, 60-70, and > 70 years, and hypothesizing superior outcomes in younger patients and those with lower BMI.
methodsRetrospective evaluation of consecutive patients aged ≥ 18 years, with symptomatic knee OA and MRI-confirmed femoral or tibial subchondral BMLs, who underwent treatment between September 2022 and March 2024, with 12-month follow-ups ending in March 2025. Inclusion required BMI 18-30 kg/m
results62 patients (mean age 57.7 ± 12.9 years; 56.5% female; mean BMI 24.4 ± 3.7 kg/m
conclusionIn this retrospective case series, fluoroscopically guided subchondral BMAC injection was associated with significant and sustained clinical improvement in pain and function over 12 months, alongside an early reduction in MRI-detected bone marrow lesion severity at 3 months. Because MRI assessment was limited to the early postoperative period, no conclusions can be drawn regarding the durability of structural changes or lesion resolution. These findings are encouraging and warrant confirmation in randomized controlled trials incorporating longer-term and quantitative MRI follow-up. LEVEL OF EVIDENCE: IV.
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