Inclusion Criteria:  Atraumatic knee pain for at least 3 months; Failure of conservative treatment (including NSAIDs, physical therapy, intra- articular injection with steroids or hyaluronic acid and bisphosphonates); Mild to moderate osteoarthritis (Kellgren-Lawrence18 grade ≤ 3) BML on a loading area at MRI imaging (femoral condyles and/or tibial plateau)  Exclusion Criteria:  Knee pain and functional limitation related to other causes like osteonecrosis Fractures or inflammatory arthritis Ligamentous instabilities Malalignment on the coronal axis greater than 10 degrees in varus/valgus Severe tri-compartmental arthritis (Kellgren-Lawrence grade 4)