Carboplasty, a Minimally Invasive Procedure for Knee Osteoarthritis: Surgical Technique and Clinical Evidence

Abstract

Knee osteoarthritis affects ~16% of adults in the world and is considered one of the most incapacitating diseases. Despite the advances in scientific knowledge and biological treatments in the field of orthopedics, available nonsurgical treatments for knee osteoarthritis are limited and still ineffective in delaying or stopping the progression of arthritis. Biologics such as platelet-rich plasma, bone marrow aspirate, and progenitor cells have emerged as potential treatments for osteoarthritis; however, the results are still not as expected. Carboplasty is a new treatment that involves the application of bone marrow aspirate into the bone-cartilage interface and intra-articularly, with the intention of stopping the progression of osteoarthritis and delaying the need for total knee replacement. By applying bone marrow directly in the bone-cartilage interface, the communication between subchondral bone and articular cartilage may be reestablished, promoting the delivery of nutrients to the cartilage, and it is hoped that preserving, regenerating, and restoring knee cartilage. Thirteen patients with knee osteoarthritis underwent carboplasty. Patients showed a statistically significant improvement in the Veterans RAND 12 Item Health Survey, the visual analog scale for knee pain, the Western Ontario and McMaster University Osteoarthritis Index, and the Knee Injury and Osteoarthritis Outcome Score for Joint Replacement at 3 and 6 months postprocedure. No adverse events were reported during the follow-up. Carboplasty is promising and worthy of further research.