Bone augmentation

Over 75% of patients with painful arthritis have BMLs (bone marrow lesions). Bone augmentation relieves pain by treating those lesions.

BMLs cause pain alone and that compounds the pain of osteoarthritis. We can relieve pain by treating BMLs with bone augmentation, also known as subchondroplasty. Bone augmentation not only relieves pain but provides support to the bone underneath the cartilage.

Bone marrow lesions

Wear and tear on the knee causes microfractures to the bone, keeping it in a constant cycle of repair. BMLs are evidence of this fixed state of reparation. In recent studies, people with BMLs are nine times more likely to need total knee replacement surgery.

BMLs are painful. We used to believe that where there was more pain, there was more arthritis. We now know that is wrong – BMLs often appear alongside osteoarthritis and contribute to the pain of it.

Treating these lesions can reduce pain in knee joint arthritis.

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The benefits

How bone augmentation works

Bone augmentation is a simple procedure:

1 The surgeon uses an x-ray to place a small cannula, a thin tube, into the defective area of your joint.
2 Your surgeon uses the cannula to deliver bone substitute material into the defect.
3 The bone substitute hardens with the same porous properties as cancellous - or spongy - bone.
4 Your bone resorbs and replaces the material with new bone over time.

We attack BMLs from two angles with bone augmentation. The material used:

  • Provides support to the bone.
  • Allows your body to replace it with new bone over time.


Bone augmentation is best suited to patients with painful BMLs and poor response to other treatments.

Despite using keyhole techniques, bone augmentation is a surgical procedure. With any surgery, there comes a set of risks and contraindications. You may be unsuitable if you have:

  • A BMI over 40
  • Severe malalignment of the knee joint
  • Cardiovascular disease