Knee Joint Distraction as Treatment for Osteoarthritis Results in Clinical and Structural Benefit: A Systematic Review and Meta-Analysis of the Limited Number of Studies and Patients Available
Jansen, Mylène P.; Boymans, Tim A.E.J.; Custers, Roel J.H.; Van Geenen, Rutger C.I.; Van Heerwaarden, Ronald J.; Huizinga, Maarten R.; Nellensteijn, Jorm M.; Sollie, Rob; Spruijt, Sander; Mastbergen, Simon C.
(2021) Cartilage, volume 13, issue 1_suppl, pp. 1113S - 1123S
(Article)
Abstract
OBJECTIVE: Knee joint distraction (KJD) is a joint-preserving osteoarthritis treatment that may postpone a total knee arthroplasty (TKA) in younger patients. This systematic review and meta-analysis evaluates short- and long-term clinical benefit and tissue structure changes after KJD. DESIGN: MEDLINE, EMBASE, and Web of Science were searched for eligible clinical
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studies evaluating at least one of the primary parameters: WOMAC, VAS-pain, KOOS, EQ5D, radiographic joint space width or MRI cartilage thickness after KJD. Random effects models were applied on all outcome parameters and outcomes were compared with control groups found in the included studies. RESULTS: Eleven articles reporting on 7 different KJD cohorts with in total 127 patients and 5 control groups with multiple follow-up moments were included, of which 2 were randomized controlled trials. Significant improvements in all primary parameters were found and benefit lasted up to at least 9 years. Overall, outcomes were comparable with control groups, including high tibial osteotomy, although TKA showed better clinical response. CONCLUSIONS: Current, still limited, evidence shows KJD causes clear benefit in clinical and structural parameters, both short- and long-term. Longer follow-up with more patients is necessary, to validate outcome and to potentially improve patient selection for this intensive treatment. Thus far, for younger knee osteoarthritis patients, KJD may be an option to consider.
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Keywords: Arthroplasty, Replacement, Knee, Humans, Knee Joint/surgery, Osteoarthritis, Knee/surgery, Osteotomy/methods, Randomized Controlled Trials as Topic, Treatment Outcome, joint-preserving treatment, osteoarthritis, review, meta-analysis, knee joint distraction, Immunology and Allergy, Biomedical Engineering, Physical Therapy, Sports Therapy and Rehabilitation, Research Support, Non-U.S. Gov't, Meta-Analysis, Journal Article
ISSN: 1947-6035
Publisher: SAGE Publications Inc.
Note: Funding Information: The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Unrestricted funding by ZonMW and FOREUM supported this work; funders had no involvement with this article. Publisher Copyright: © The Author(s) 2020.
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