Subchondral treatment of osteoarthritis in joints

Abstract

Devices, instruments and associated methods for the subchondral treatment of osteoarthritis in hip and shoulder joints are provided. In addition, a method for treating joint pain is provided. The method comprises: identifying a subchondral defect in a subchondral region of a bone of the joint; selecting a subchondral access path to a location near the subchondral defect; and treating the subchondral defect, via the subchondral access, in a manner that restores normal force distribution and joint function while preserving the articular surface of the bone, wherein the joint is a hip or shoulder.

1 . A method for treating joint pain comprising:
 identifying a subchondral defect in a subchondral region of a bone of the joint;   selecting a subchondral access path to a location near the subchondral defect; and   treating the subchondral defect, via the subchondral access, in a manner that restores normal force distribution and joint function while preserving the articular surface of the bone;   wherein the joint is a hip or shoulder joint.   
     
     
         2 . The method of  claim 1 , wherein the subchondral defect is a bone marrow lesion or a bone marrow edema. 
     
     
         3 . The method of  claim 1 , wherein the subchondral defect further includes sclerotic bone. 
     
     
         4 . The method of  claim 1 , wherein treating the subchondral defect comprises injecting in the bone, via the subchondral access, a bone hardening material. 
     
     
         5 . The method of  claim 4 , wherein the bone hardening material comprises a bone cement, bone void filler, or bone substitute material. 
     
     
         6 . The method of  claim 1 , further comprising the step of inserting an access sleeve along the subchondral access path. 
     
     
         7 . The method of  claim 6 , wherein the step of treating the subchondral defect comprises treating the subchondral defect through the access sleeve. 
     
     
         8 . The method of  claim 7 , further comprising leaving the access sleeve in the bone after the treatment. 
     
     
         9 . The method of  claim 8 , further comprising permitting boney ingrowth into the exterior surface of the access sleeve after the treatment. 
     
     
         10 . The method of  claim 8 , further comprising performing a second surgical procedure comprising the steps of:
 accessing the access sleeve;   removing a portion of the bone adjacent the sleeve;   inserting a bone implant into the access sleeve to provide a joint replacement.