Inclusion Criteria:
* Patient 18 years of age or older;
* Patient with a Body Mass Index ≤35 (BMI=kg/m2);
* Patient with Kellgren-Lawrence grade 3-4 Osteoarthritis, as reviewed on MRI and plain radiography;
* Patient with knee bone marrow lesions confirmed by MRI result at least 3 months before the intervention;
* Patients with degenerative knee pathology at the prosthetic stage (outdated medical treatments), with a frontal deformity of less than 12°, (and wishing to avoid or delay the prosthetic procedure as much as possible) / goniometry);
* Patient with unbearable mechanical pain with a walking perimeter limited at 500 m
* Patient with non-surgical treatment failure (infiltration of Platelet Rich Plasma (PRP), corticoids, acid hyaluronic);
* Patient who agrees to participate in the study and who signed the informed non-opposition form;
* Patient physically and mentally willing and able, in the Investigator's opinion at the time of enrolment, to be compliant with the protocol including all follow-up visits, survey completion, weight- bearing restrictions, and post-operative rehabilitation;
* Patient with social protection.
Exclusion Criteria:
* Patient with a Body Mass Index \> 35 (BMI=kg/m2);
* Patient with inflammatory rheumatic pathologies;
* Patient with frontal deformities (varus, valgus) of more than 12°;
* Patient with degenerative pathologies at the operative stage but likely to benefit from a conservative intervention (osteotomy), except if the knee is centred;
* Patient with stiff knees (more than 20° of flexum and/or less than 90° of flexion);
* Patient with painful severe femoro-patellar osteoarthritis;
* Patient with contraindications for Magnetic Resonance Imaging (MRI);
* Patient with history of systemic diseases which could contribute to secondary arthropathies (e.g., sickle cell disease, hemochromatosis, or autoimmune disease);
* Patient with history of cognitive-behavioural disorders that could interact with assessment by self-questionnaire;
* Patient with local or general infection or suspicion of infection;
* Patient with severe coagulation disorders;
* Patient with primary bone tumour in the knee area,
* Patient with undercurrent serious pathology with life expectance \< 2 years;
* Female patient of childbearing age that are known to be pregnant during inclusion visit or wishing to become pregnant before treatment;
* Patient who has forfeited their freedom by administrative or legal award, or is under guardianship or under limited judicial protection;
* Patient participating in another interventional clinical trial or testing an experimental drug within 30 days of inclusion in the study;
* Patients who cannot read or write French
