MBBS, FRCS (UK), M Ch Orth (UK), D.Ortho

Robotic Joint Replacement & Arthroscopy Surgeon

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Intraosseous Bioplasty (IOBP)

A Biological Solution for Early Bone Damage and Joint Preservation

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In selected patients — particularly younger and active individuals — pain may arise from damage in the subchondral bone beneath the cartilage. When recognised at the right stage, this can sometimes be treated using a minimally invasive biological procedure designed to preserve the natural joint.

Cross-sectional illustration of a bone lesion treated with an intraosseous instrument
Targeted treatment of the damaged subchondral bone.

Intraosseous Bioplasty is a joint-preserving procedure in which the damaged area within the bone is carefully decompressed and filled with a combination of concentrated bone marrow cells — Bone Marrow Aspirate Concentrate (BMAC) — and demineralised bone matrix (DBM) or another biological graft material.

This biological graft is intended to encourage new bone formation, improve bone quality, reduce pain, and support the cartilage above it.

The procedure is commonly performed under fluoroscopic or arthroscopic guidance to help achieve precise placement of the biological material within the affected bone.

Illustration of a painful subchondral bone lesion in the knee

How the Procedure is Performed

A detailed MRI is used to identify the area of bone damage. The procedure usually includes:

Who May Benefit?

Most patients are advised to use crutches and remain partial weight-bearing for a short period, followed by a structured physiotherapy programme.

Recovery varies according to the size and location of the lesion and whether additional procedures have been performed. Many patients gradually resume normal activities over several weeks, while biological healing within the bone continues over several months.

Important: suitability for IOBP depends on careful patient selection, clinical examination and MRI findings. It is not a substitute for joint replacement in advanced arthritis.

Frequently Asked Questions

Is IOBP suitable for your knee?

A clinical examination and MRI review are essential before deciding whether this joint-preserving procedure is appropriate.

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