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Joint distraction in treatment of osteoarthritis: a two-year follow-up of the ankle.

Abstract：

OBJECTIVE:Osteoarthritis (OA) is a degenerative joint disease with an incidence exceeding 10% of the adult population. In end stages, OA can result in severe restriction of activity and consequent disability. For these severe cases of OA, no effective remedy is available yet. Joint distraction is a new experimental approach in treatment of OA. Studied in retrospect it appeared that this treatment results in prolonged clinical improvement in the case of ankle OA. Presently the results of a prospective two-year follow-up are given. METHODS:Patients with severe ankle OA, who were considered for joint fusion (arthrodesis), were treated with distraction, by use of an Ilizarov external ring fixator. Distraction was carried out for 3 months during which full weight bearing (walking) was allowed. Standardized clinical examination was conducted before and at yearly intervals after treatment, including physical examination, functional ability questionnaire, pain scale, joint mobility, and radiographic evaluation. RESULTS:More than two thirds of the patients improved significantly as shown by physical examination, functional ability questionnaires and pain scale; effects were progressive in the second year of follow-up. On average, joint mobility and radiographic joint space were preserved, whilst improvement was observed in a significant number of patients. DISCUSSION:Results of the present prospective study confirm the findings of the previous retrospective study and suggest that Ilizarov joint distraction is a promising treatment for severe ankle OA, at least delaying the need for a joint fusion. Considering the high prevalence of OA and the lack of a remedy for this disorder, Ilizarov joint distraction as a treatment for OA may have great medical, social and economic impact.

journal_name

Osteoarthritis Cartilage

journal_title

Osteoarthritis and cartilage

authors

van Valburg AA,van Roermund PM,Marijnissen AC,van Melkebeek J,Lammens J,Verbout AJ,Lafeber FP,Bijlsma JW

doi

10.1053/joca.1998.0242

keywords:

subject

Has Abstract

pub_date

1999-09-01 00:00:00

pages

474-9

issue

eissn

1063-4584

issn

1522-9653

pii

S1063-4584(98)90242-4

journal_volume

pub_type

临床试验,杂志文章,多中心研究

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Joint distraction in treatment of osteoarthritis: a two-year follow-up of the ankle.