This morning I have some interesting MRIs from a patient who was treated by the Stematix Regenexx Cayman lab with the Regenexx-C procedure. They nicely show the concept of a Bone Marrow Lesion or BML. No single knee MRI finding over the past 5 years has been associated with pain more than a BML. We used to believe that meniscus tears were sure signs of knee pain, then research dispelled that myth. We also used to believe that the degree of arthritis was associated with pain (i.e. more arthritis equals more pain), then research dispelled that myth as well. One of the few MRI findings that has withstood the test of time and many different research studies as being related to pain is the BML. What is it? A BML is an area in the bone that’s swollen. Basically, its the bone’s reaction to bad cartilage, or a bad meniscus, or the excessive forces due to instability. For lack of a better term, it’s “pissed off bone”. Many researchers have also associated it with small fractures in the bone. Basically, you can think of a BML as the Canary in the coalmine of the knee. Many patients will get these as their cartilage or meniscus first goes bad, but then the bone and the remaining tissues react and get thicker and stronger, so they go away (as does the pain). A chronic BML is a bad sign, as it means the knee’s ability to compensate for the bad cartilage or a torn meniscus is sub par. I bring this increasingly important lesion up, as it’s the single most consistent MRI finding that we have seen change with the Regenexx-C procedure. Basically, we’ve seen many of them go away after treatment Case in point is this young elderly gentleman’s knee above. Look at the before pictures above, where the dark bone in the white dashed circle is lighting up like a Christmas tree (the BML). Now look at the after treatment images below, where the BLM is dramatically less. In addition, the size of the cartilage lesion above that bone has also diminished. The upshot? BMLs are bad news and according to many research studies a much bigger deal in terms of knee pain and overall knee health than meniscus tears or the severity of the arthritis. This is because they show a knee that’s literally falling apart and unable to fix itself. A healthy knee reacts to forces by making itself stronger, so lacks BMLs.
Not all patients treated with stem cells should expect that their bone marrow lesions will go away on follow-up MRI.
NOTE: RegenexxCayman is an independently owned and operated medical services provider operating exclusively in the Cayman Islands and is not part of or affiliated with the Centeno-Schultz Clinic or any U.S. Regenexx Network provider. The Regenexx-C procedure licensed by RegenexxCayman is not approved by the U.S. FDA for use in the United States.
Tags: knee bone marrow lesion