A minimally invasive surgery designed to access and treat bone defects
associated with chronic bone marrow lesions (BMLs)

How does Subchondroplasty® work?


An MRI will identify microscopic fractures (subchondral bone defects) in your bones that are the cause of your joint pain


Dr Paley will deliver AccuFill® Bone Substitute Material into the defect, where it hardens to mimic natural bone


Your body resorbs the AccuFill® Bone Substitute Material and replaces it with your own healthy, brand new bone.

Avoid total joint replacement

Regrow your own healthy bone

If you suffer from chronic joint pain, you’ve probably wished you could somehow grow a new knee or elbow or shoulder. If your joint pain is caused by Bone Marrow Lesions, you may be able to regrow some of the damaged parts!

Dayton Orthopedic Surgery & Sports Medicine Center is delighted to offer Subchondroplasty® , a minimally-invasive surgery that allows your body to actually regrow healthy bone that is free of defects.

This is cutting edge medicine for the modern age, that will allow you to put off more invasive surgery such as total joint replacement, and reduce dependence on prescription pain medication.

How can you regrow bone?

Using a fluoroscope (intraoperative x ray), Dr Jonathan Paley will drill a tiny hole in the area of your bone defect(s), then fill that hole with AccuFill® Bone Substitute Material. It’s like a filling that you get at the dentist but FAR more advanced, because your body slowly replaces the AccuFill® Bone Substitute Material with your own bone!

What is AccuFill® Bone Substitute Material?

AccuFill® BSM is an engineered calcium phosphate mineral compound. It flows readily to fill the subchondral defect and hardens quickly into a biomimetic implant once injected. AccuFill® BSM mimics the properties of cancellous bone and is replaced with new bone during the healing process.

Frequently Asked Questions

Who is a good candidate for Subchondroplasty?

Patients diagnosed with bone marrow lesions as the primary source of pain in the knee, who have not responded to conservative treatment, may benefit from the procedure. 

Who is NOT a good candidate for Subchondroplasty?

Patients with BMI more than 40 or those with severe malalignment of the knee joint are not suitable candidates for Subchondroplasty.

What can I expect after the procedure?

Some pain and discomfort in the operated area is usually experienced for 1-2 days after the procedure. Pain medications will be prescribed to manage it. Crutches will be recommended for 1-2 weeks after the surgery to reduce weight bearing on the operated leg. Physical therapy will also be recommended to regain strength and mobility in the knee.

What are the advantages of Subchondroplasty?

Subchondroplasty is a minimally invasive procedure with the following advantages:

  • It is an outpatient procedure. The patient is usually discharged on the same day as the surgery.
  • It leads to faster recovery and quicker return to normal activities.
  • It does not hinder total knee replacement if required in the future.
How long does the procedure take?

Patients are typically treated in an outpatient setting, returning home the same day of the procedure.

Do you have more questions?

Schedule a consulation with our medical staff to find out if you are a candidate for Subchondroplasty. They will be able to answer any questions you might have about the procedure and aftercare.