Five-Year Follow-up of Knee Joint Distraction: Clinical Benefit and Cartilaginous Tissue Repair in an Open Uncontrolled Prospective Study
| Autor: | Jan Ton A.D. van der Woude, Floris P J G Lafeber, Peter M. van Roermund, Roel J.H. Custers, Felix Eckstein, Jaap M van Laar, Simon C. Mastbergen, K. Wiegant, F. Intema |
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| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
Radiography Biomedical Engineering Arthritis Physical Therapy Sports Therapy and Rehabilitation Osteoarthritis Knee Joint 03 medical and health sciences 0302 clinical medicine Journal Article Cartilaginous Tissue Immunology and Allergy Medicine cartilage Prospective cohort study Clinical Research Articles 030203 arthritis & rheumatology therapy 030222 orthopedics medicine.diagnostic_test business.industry Cartilage Magnetic resonance imaging medicine.disease Surgery knee joint distraction osteoarthritis medicine.anatomical_structure business MRI |
| Zdroj: | Cartilage, 8(3), 263. SAGE Publications Inc. |
| ISSN: | 1947-6043 1947-6035 |
| DOI: | 10.1177/1947603516665442 |
| Popis: | Objective In end-stage knee osteoarthritis, total knee arthroplasty (TKA) may finally become inevitable. At a relatively young age, this comes with the risk of future revision surgery. Therefore, in these cases, joint preserving surgery such as knee joint distraction (KJD) is preferred. Here we present 5-year follow-up data of KJD. Design Patients ( n = 20; age Results Five-years posttreatment, patients still reported clinical improvement from baseline: ΔWOMAC (Western Ontario and McMaster Universities Arthritis Index) +21.1 points (95% CI +8.9 to +33.3; P = 0.002), ΔVAS (visual analogue scale score) pain −27.6 mm (95%CI −13.3 to −42.0; P < 0.001), and minimum radiographic joint space width (JSW) of the most affected compartment (MAC) remained increased as well: Δ +0.43 mm (95% CI +0.02 to +0.84; P = 0.040). Improvement of mean JSW (x-ray) and mean cartilage thickness (MRI) of the MAC, were not statistically different from baseline anymore (Δ +0.26 mm; P = 0.370, and Δ +0.23 mm; P = 0.177). Multivariable linear regression analysis indicated that KJD treatment was associated with significantly less progression in mean and min JSW (x-ray) and mean cartilage thickness (MRI) compared with natural progression (all Ps Conclusions KJD treatment results in prolonged clinical benefit, potentially explained by an initial boost of cartilaginous tissue repair that provides a long-term tissue structure benefit as compared to natural progression. Level of evidence, II. |
| Databáze: | OpenAIRE |
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