Evaluation and Management of Subchondral Calcium Phosphate Injection Technique to Treat Bone Marrow Lesion

Cartilage. 2019 Oct;10(4):395-401. doi: 10.1177/1947603518770249. Epub 2018 Apr 18.


Purpose: This study aimed to compile available data in medical literature about subchondral calcium phosphate injection, comparing results obtained with this technique, as well as indications, complications, and other important factors in treatment of bone marrow lesions.

Designs: A literature review using PubMed and Medline database in order to identify works with terms "subchondral calcium phosphate injection," " subchondroplasty®," "bone marrow lesion," and "knee." Eight relevant articles were found.

Results: A total of 164 patients with bone marrow lesion mainly on femoral condyle and tibial plateau recovered with significant functional improvement of knee after subchondral calcium phosphate treatment. Although 25% of them still had some type of pain complaint, they also showed improvement. There were few complications reported and return to activities occurred after 3 months on average.

Conclusions: Few studies evaluate the result of using subchondral calcium phosphate injection technique. However, all presented favorable results regarding pain and improvement of knee function. In addition, within 2 years, there was a 70% reduction in conversion to total knee arthroplasty in patients with previous surgical indication who choose calcium phosphate treatment.

Keywords: bone marrow lesions; cartilage; subchondral calcium phosphate; subchondral injury; subchondroplasty.

Publication types

  • Evaluation Study
  • Review

MeSH terms

  • Bone Marrow Diseases / drug therapy*
  • Bone Marrow Diseases / physiopathology
  • Bone Substitutes / administration & dosage*
  • Bone Substitutes / therapeutic use
  • Calcium Phosphates / administration & dosage*
  • Calcium Phosphates / therapeutic use
  • Humans
  • Injections, Intra-Articular
  • Knee Injuries / drug therapy*
  • Knee Injuries / physiopathology
  • Knee Joint / physiopathology
  • Recovery of Function


  • Bone Substitutes
  • Calcium Phosphates
  • calcium phosphate