SUBCHONDRAL TREATMENT OF OSTEOARTHRITIS IN JOINTS

1 . A method for treating joint pain comprising:

identifying a subchondral defect in a subchondral region of a bone of the joint;

selecting a subchondral access path to a location near the subchondral defect; and

treating the subchondral defect, via the subchondral access, in a manner that restores normal force distribution and joint function while preserving the articular surface of the bone;

wherein the joint is a hip or shoulder joint.

2 . The method of claim 1 , wherein the subchondral defect is a bone marrow lesion or a bone marrow edema.

3 . The method of claim 1 , wherein the subchondral defect further includes sclerotic bone.

4 . The method of claim 1 , wherein treating the subchondral defect comprises injecting in the bone, via the subchondral access, a bone hardening material.

5 . The method of claim 4 , wherein the bone hardening material comprises a bone cement, bone void filler, or bone substitute material.

6 . The method of claim 1 , further comprising the step of inserting an access sleeve along the subchondral access path.

7 . The method of claim 6 , wherein the step of treating the subchondral defect comprises treating the subchondral defect through the access sleeve.

8 . The method of claim 7 , further comprising leaving the access sleeve in the bone after the treatment.

9 . The method of claim 8 , further comprising permitting boney ingrowth into the exterior surface of the access sleeve after the treatment.

10 . The method of claim 8 , further comprising performing a second surgical procedure comprising the steps of:

accessing the access sleeve;

removing a portion of the bone adjacent the sleeve;

inserting a bone implant into the access sleeve to provide a joint replacement.