A select subset of patients can present with anterior knee pain in the setting of normal patellar tracking, no significant cartilage damage, and the presence of a bone marrow lesion (BML) involving the patella on advanced imaging. One novel treatment option for this condition is patellar subchondroplasty, where calcium phosphate is injected into the subchondral bone under fluoroscopic guidance. The purpose of this study is to report preliminary outcomes of patients who have undergone subchondroplasty of the patella. The surgical log of the senior author was retrospectively reviewed to identify patients who had undergone patellar subchondroplasty from January 2014 to June 2019. Indications for surgery included the presence of retropatellar pain refractory to conservative management without significant arthritis with a related focal BML on magnetic resonance imaging. International Knee Documentation Committee, Knee Injury and Osteoarthritis Outcome Score (KOOS), and Veterans Rand 12-item Health Survey (VR-12) were obtained preoperatively, at 6 months and at final follow-up. Eight patients (nine knees) who underwent patellar subchondroplasty with minimum 1-year follow-up participated in the study. On preoperative magnetic resonance imaging, patients had a mean BML that was 2 cm in diameter. Patients had a median Kellgren–Lawrence grade of 2 both preoperatively and at final radiographic follow-up (15.50 ± 20.52 months). No patient underwent subsequent surgery or conversion to arthroplasty. Compared with baseline, VR-12 mental (p = 0.046) and physical (p = 0.003), KOOS joint replacement (p = 0.024), KOOS pain (p = 0.033), and KOOS sports (p = 0.034) scores were significantly increased at final follow-up (24.00 ± 13.55 months). In addition, on a scale of 0 to 100, patient-reported satisfaction was 73.88 ± 33.90. This study introduces patellar subchondroplasty as a surgical treatment for patients with symptomatic BMLs of the patella without significant arthritis after failure of conservative management. Our results demonstrated good outcomes and patient satisfaction. In addition, no patients converted to patellofemoral or total knee arthroplasty. This study suggests that patellar subchondroplasty may be a reasonable treatment option in the correct patient population.

部分患者在髌骨轨迹正常的情况下可能会出现膝前痛，没有明显的软骨损伤，并且在高级成像中存在累及髌骨的骨髓病变 (BML)。针对这种情况的一种新颖的治疗选择是髌骨软骨下成形术，其中在荧光镜引导下将磷酸钙注射到软骨下骨中。本研究的目的是报告接受髌骨软骨下成形术的患者的初步结果。回顾性回顾了资深作者的手术日志，以确定2014年1月至2019年6月期间接受过髌骨软骨下成形术的患者。手术指征包括存在保守治疗难治的髌后疼痛，且无明显关节炎且磁共振成像显示相关局灶性 BML。国际膝关节文献委员会、膝关节损伤和骨关节炎结果评分 (KOOS) 以及退伍军人兰德 12 项健康调查 (VR-12) 均在术前、6 个月和最终随访时获得。八名接受髌骨软骨下成形术且随访时间至少为 1 年的患者（九个膝盖）参与了该研究。术前磁共振成像显示，患者的平均 BML 直径为 2 厘米。患者术前和最终影像学随访（15.50±20.52 个月）时的中位 Kellgren-Lawrence 等级均为 2。没有患者接受后续手术或转为关节置换术。与基线相比，p  = 0.046) 和身体 ( p  = 0.003)、KOOS 关节置换 ( p  = 0.024)、KOOS 疼痛 ( p  = 0.033) 和 KOOS 运动 ( p = 0.033) = 0.034），最终随访（24.00 ± 13.55 个月）时分数显着增加。此外，在 0 到 100 的范围内，患者报告的满意度为 73.88 ± 33.90。本研究介绍了髌骨软骨下成形术作为一种手术治疗方法，用于治疗保守治疗失败后患有症状性 BML 且无明显关节炎的患者。我们的结果证明了良好的结果和患者满意度。此外，没有患者转为髌股关节或全膝关节置换术。这项研究表明，对于正确的患者群体，髌骨软骨下成形术可能是一种合理的治疗选择。