Subchondral Bone Injections for the Treatment of Knee Osteoarthritis.

The existing literature on whether subchondral bone injections in knee osteoarthritis is advisable for relieving patient pain is minimal and the level of evidence is low. A recent case series (2023) analyzed 30 individuals with knee OA (Kellgren-Lawrence 2-3). It showed that combined intraarticular and subchondral BMAC (bone marrow aspirate concentrate injections) provided clinical and imaging benefits up to 24 months for the treatment of symptomatic knee OA, with a low failure rate, and a significant reduction of bone marrow edema. Besides, VAS (visual analog scale) pain worsened at the final follow-up, although remained lower compared to the baseline value. Although some studies mention that subchondral bone injections can relieve pain in mild/moderate knee OA, it does not seem reasonable to advise it until better-designed research can confirm the preliminary studies discussed in this article.