EP6.8 Subchondral Phosphate Injections Are Safe in Targeting Acetabular Bone Marrow Lesions in Hip Arthroscopy for Femoro-Acetabular Impingement in Selected Patients with Early Osteoarthritis

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ID: 330979
2026
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Abstract
Abstract Introduction Arthroscopy for femoroacetabular impingement (FAI) yields inferior outcomes when subchondral edema and cystic degeneration are present. Subchondroplasty (SCP), which involves injecting osteoconductive calcium phosphate into Bone Marrow Lesions (BMLs), may enhance subchondral structural support and can be performed alongside hip arthroscopy. Materials and Methods This single-center retrospective study included patients who underwent SCP for acetabular BMLs during primary hip arthroscopy for FAI from March 2019 to March 2023. Clinical and radiographic outcomes were recorded at ≥2-year follow-up. Survivorship with treatment failure as the endpoint was assessed using Kaplan-Meier analysis. Results Thirty-four patients were evaluated at a mean 3.1-year follow-up. No perioperative, early, or late complications or adverse events occurred. No bone substitute migration or intra-articular extravasation was seen. Four patients (11.8%) showed osteoarthritis progression and required conversion to total hip arthroplasty; no intraoperative issues with acetabular preparation were encountered. All clinical scores improved significantly (p < 0.001), and 82.4% returned to sport. Conclusions SCP performed during hip arthroscopy appears safe in selected patients with early hip osteoarthritis and BMLs. Calcium phosphate injection may help restore subchondral integrity and load distribution, though the independent contribution of SCP beyond standard arthroscopic management remains uncertain.
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Authors Marco Maria Minelli, Berardo Di Matteo, Vanesa Longobardi, Marco Rosolani, Alessio D'Addona, Elizaveta Kon, Federico Della Rocca
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.364
URL
https://doi.org/10.1093/jhps/hnag043.364
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