Orthobiologics Procedures
SUBCHONDRAL BONE
MARROW LESIONS
TREATMENT
Addressing subchondral bone marrow lesions (BMLs) and avascular necrosis is paramount within the realm of orthopaedics and musculoskeletal health. Often detected through MRI imaging, these conditions signal an array of underlying issues, from osteoarthritis to traumatic injuries and even certain cancers. Frequently affecting weight-bearing joints, they can inflict pain and hinder mobility.
ORTHOPLASTY™ is an innovative surgical toolkit specially designed to combat subchondral bone marrow oedema.
Employing a minimally invasive, percutaneous approach akin to vertebroplasty, this toolkit enables the precise delivery of autologous bone marrow or cutting-edge synthetic biomaterials.
This method significantly reinforces subchondral bone, offering several advantages such as reduced infection risk, rapid functional recovery, pain alleviation within a few days, and the presentation of anatomical integrity across various joints for future interventions. The provided synthetic material is biologic, radio-opaque, and bioresorbable, hardening solely in wet environments. Its ultimate compressive strength surpasses that of healthy cancellous bone, ensuring durability.
SURGICAL PROCEDURE
1.
IDENTIFY THE LESION AND PLAN THE ACCESS
Preoperatively identify the bone marrow lesion (BML) via MRI, which is crucial as the lesion is not visible under fluoroscopy. Use imaging to plan the optimal trajectory and access point.
2.
ESTABLISH BONE ACCESS
Insert the access trocar from the kit following the pre-planned trajectory. Once the target is reached, remove the internal stylet and leave the outer cannula in place to serve as a working channel.
3.
CREATE THE DELIVERY CANAL
Insert the provided drill through the working cannula. Rotate the cannula and drill together to create a canal in the bone, facilitating subsequent infusion of the filling material. Then remove the drill.
4.
PREPARE THE DELIVERY OF BONE GRAFT
Insert the bone filler pre-filled with hardening bone graft into the working cannula. Alternatively, if using a dispensing system, connect it directly to the cannula.
5.
INFUSE THE BONE GRAFT
Slowly inject the hardening bone graft through the cannula into the prepared subchondral site, ensuring even distribution within the lesion area. Monitor infusion pressure and volume.
6.
COMPLETE THE PROCEDURE
After the bone graft has been successfully delivered, remove the working cannula from the patient, completing the treatment of the BML.
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