AJR December 2016

Christoph A. Agten Department of Radiology NYU Langone Medical Center New York, NY

“Subchondroplasty: What the Radiologist Needs to Know”

Postoperative imaging appearances and potential complications for patients treated with subchondroplasty, a novel minimally invasive procedure for painful bone marrow edema, are discussed in this AJR study co-written by Christoph Agten.

1. Describe the study’s purpose?

Our article describes imaging findings that radiologists may view in patients who have been treated with subchondroplasty, a procedure for osteoarthritis-related bone marrow edema and insufficiency fractures. Subchondroplasty is a rather new treatment modality with specific postoperative imaging findings that we wanted to describe to an imaging audience.

Our patient outcomes after subchondroplasty were published in the paper, “Subchondral Calcium Phosphate is Ineffective for Bone Marrow Edema Lesions in Adults With Advanced Osteoarthritis,” Clinical Orthopaedics and Related Research (2015)

. The imaging or postoperative imaging aspect was not reported, therefore, we selected patients from that study who were imaged at our institution, New York University Langone Medical Center.

3. What are the study’s limitations?

Subchondroplasty, which is not widely performed, should be regarded as experimental therapy for now. Our retrospective study was limited in that the sample size was small.

4. Did you learn anything as a result of the study that surprised you?

The surgeons often did not mention in the x-ray request that a subchondroplasty procedure was performed in addition to the arthroscopy. Hence, the soft tissue contamination from injected calcium phosphate was sometimes interpreted as heterotopic or as post-traumatic calcifications.

5. What is the most important information that a radiologist needs to know about subchondroplasty?

It is important to realize that a subchondroplasty procedure has been performed and not to misinterpret specific findings that can occur after that procedure.