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The effect of bone growth stimulators on venous congestion in osteoarthritis of the knee

Kenneth Willeford MD, Breanna Willeford DO & Sierra Willeford DO

Background: The aim of the present study was to determine if there is an effect to decrease intraosseous venous congestion in osteoarthritis of the knee with the use of bone growth stimulators. This is based on the understanding that osteoarthritis of the knee is primarily a disease of subchondral bone and the joint changes are secondary. Bone growth stimulators are a promising future treatment modality because of the effects of bone remodeling. Methods: WOMAC scores, RAND health survey scores, and intraossous venous congestion were measured prior to and after treatment with noninvasive bone growth stimulators utilizing ultrasound technology on twenty patients with osteoarthritis of the knee. There were twenty participants in the treatment group and ten in the control group. Results: There was a 100% response rate with a high level of statistical significance with decreased venous congestion. The mean intraosseous pressure before treatment was 29.48 mm Hg and after treatment was 15.13 mm Hg. There was also a high level of significance for all portions of the two independent quality of life scales. Conclusions: This is the second study in the world’s literature of treatment of subchondral bone in osteoarthritis of the knee. Intraosseous venous congestion is discussed as initiating a cascade of events culminating in the constellation of molecular, biochemical and structural changes and is the unifying factor leading to impaired nutrition of the subchondral bone and cartilage, micro-fractures and alterations of trabecular microarchitecture, subchondral bone stiffening from intraosseous hypertension and fibrosis, culminating in the loss of the articular cartilage and in osteophyte formation.