Distraction to treat knee osteoarthritis.

Abstract:

:The objective of this article is to review data on joint distraction used to treat knee osteoarthritis. Joint distraction is a surgical procedure in which the two bony ends of the joint are gradually pulled apart then kept separated for 2 months in an external fixation frame. Weight bearing is continued to ensure variations in hydrostatic pressure within the joint. In published studies, joint distraction provided substantial clinical and structural improvements in patients with knee osteoarthritis, delaying joint replacement surgery for at least 2 years. Animal studies showed that joint distraction was associated with decrease in the secondary inflammatory response, cartilage breakdown, and subchondral bone remodeling. In vitro, the intermittent application of hydrostatic pressure stimulated the production of extracellular matrix, particularly in joints with osteoarthritis. Nevertheless, several considerations invite caution when considering the more widespread use of joint distraction. Published studies have short follow-ups and small sample sizes. In addition, the high frequency of pin tract infection is of concern, since most patients eventually require knee replacement surgery. These two considerations indicate a need for longer-term prospective studies of patient cohorts.

journal_name

Joint Bone Spine

journal_title

Joint bone spine

authors

Flouzat-Lachaniette CH,Roubineau F,Heyberger C,Bouthors C

doi

10.1016/j.jbspin.2016.03.004

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

141-144

issue

2

eissn

1297-319X

issn

1778-7254

pii

S1297-319X(16)30028-8

journal_volume

84

pub_type

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