Awl-fun Results With BMS and OCLs

by Vince Vacketta, DPM

Bone marrow stimulation/micro fracture (BMS) has been a longstanding technique within orthopedics and remains a widely used treatment for osteochondral lesions (OCLs) in the ankle. Research has indicated that BMS causes damage to the subchondral plate, and cartilage restoration is not as predictable as once thought. Invested parties, like insurance companies, want BMS to be the answer. But where does it rank with other options? 

While the best option may still be up for debate, recent literature demonstrate BMS to potentially be the worst option. In their study on the subject, Vreeken et al. used second-look arthroscopy for evaluation of cartilage healing and quality following multiple different surgical techniques, and found BMS to have a measly 57% success rate. All techniques evaluated demonstrated successful cartilage restoration, exception for BMS, which showed a statistically significant decrease in cartilage healing.