Hyaluronic-Acid Enhanced Calcium Phosphate Subchondroplasty on Bone Marrow Lesion Outcomes
Document Type
Event
Location
LSUHSC-NO Lions Building
Start Date
11-4-2025 3:30 PM
End Date
11-4-2025 5:00 PM
Description
Introduction: Subchondral calcium phosphate injections are rising in popularity as a method to address bone marrow lesions (BMLs) due to minimal invasiveness and promising improvements in knee pain and function. While several studies have investigated the short-term outcomes of these injections, little research has explored the results of a newer hyaluronic acid-enhanced, calcium phosphate (HACP) bone graft substitute material. The goal of this study is to investigate the short-term outcomes of these HACP injections, and to confirm that they reflect the results seen with similar injections in other studies. Methods: This retrospective observational cohort study includes 39 patients who received HACP injections between August 2022 and M 2024 for treatment of BML by a single orthopedic surgeon. All patient data, including demographics, BML characteristics, follow-up appointment dates, and subsequent interventions were acquired through the Ochsner Epic electronic medical records. All patients have a documented diagnosis of bone marrow lesions in the knee joint, confirmed through magnetic resonance imaging (MRI) or X-ray. The primary outcome of the study is the change in pain reported outcomes between pre-injection and subsequent follow up visits. The secondary outcome of the study will consist of the time from initial injection to any subsequent interventions. Results: Of the 39 patients included in this study, majority were female (82%), black (46%), with varus deformity (97%), and contained a single BML (87%). No patients experienced complications from the HACP injection. The average number of intraarticular injections before attempting HACP injection per patient was 3.03 (SD= 1.96), and the average time to intervention after HACP injection per patient was 3.33 (SD= 2.39). The mean and median preoperative pain scores for this patient set were 6.59 and 7, respectively. The median pain score change at 2 weeks post-HACP injection and at 3 months post-HACP injection were -2 (p<0.001) and -3 (p=0.0255) respectively, indicating a decrease in pain at both points in the postoperative course. Discussion and Conclusion: HACP injections are a minimally invasive option to address BMLs. Complication rate is minimal, and these injections can reliably decrease knee pain within the 3 month postoperative period.
Recommended Citation
Nelson, Cade, "Hyaluronic-Acid Enhanced Calcium Phosphate Subchondroplasty on Bone Marrow Lesion Outcomes" (2025). Medicine Research Day. 12.
https://digitalscholar.lsuhsc.edu/mrd/2025/tr/12
Hyaluronic-Acid Enhanced Calcium Phosphate Subchondroplasty on Bone Marrow Lesion Outcomes
LSUHSC-NO Lions Building
Introduction: Subchondral calcium phosphate injections are rising in popularity as a method to address bone marrow lesions (BMLs) due to minimal invasiveness and promising improvements in knee pain and function. While several studies have investigated the short-term outcomes of these injections, little research has explored the results of a newer hyaluronic acid-enhanced, calcium phosphate (HACP) bone graft substitute material. The goal of this study is to investigate the short-term outcomes of these HACP injections, and to confirm that they reflect the results seen with similar injections in other studies. Methods: This retrospective observational cohort study includes 39 patients who received HACP injections between August 2022 and M 2024 for treatment of BML by a single orthopedic surgeon. All patient data, including demographics, BML characteristics, follow-up appointment dates, and subsequent interventions were acquired through the Ochsner Epic electronic medical records. All patients have a documented diagnosis of bone marrow lesions in the knee joint, confirmed through magnetic resonance imaging (MRI) or X-ray. The primary outcome of the study is the change in pain reported outcomes between pre-injection and subsequent follow up visits. The secondary outcome of the study will consist of the time from initial injection to any subsequent interventions. Results: Of the 39 patients included in this study, majority were female (82%), black (46%), with varus deformity (97%), and contained a single BML (87%). No patients experienced complications from the HACP injection. The average number of intraarticular injections before attempting HACP injection per patient was 3.03 (SD= 1.96), and the average time to intervention after HACP injection per patient was 3.33 (SD= 2.39). The mean and median preoperative pain scores for this patient set were 6.59 and 7, respectively. The median pain score change at 2 weeks post-HACP injection and at 3 months post-HACP injection were -2 (p<0.001) and -3 (p=0.0255) respectively, indicating a decrease in pain at both points in the postoperative course. Discussion and Conclusion: HACP injections are a minimally invasive option to address BMLs. Complication rate is minimal, and these injections can reliably decrease knee pain within the 3 month postoperative period.