TY - JOUR
T1 - Joint distraction using a purpose-built device for knee osteoarthritis
T2 - A prospective 2-year follow-up
AU - Struik, Thijmen
AU - Mastbergen, Simon C.
AU - Brouwer, Reinoud W.
AU - Custers, Roel J.H.
AU - Van Geenen, Rutger C.I.
AU - Heusdens, Christiaan H.W.
AU - Emans, Pieter J.
AU - Huizinga, Maarten R.
AU - Jansen, Mylène P.
N1 - Funding Information:
This study was financially supported by ZonMw (grant numbers 95110008 and 95104003) and the UMC Utrecht (Vrienden UMC Utrecht project number 1814144). SM (LLP-9) and the department of Orthopedic Surgery UMC Utrecht (LLP-12) were financially supported by the Dutch Arthritis Society.
Publisher Copyright:
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2023/6/8
Y1 - 2023/6/8
N2 - Objective Knee distraction treatment for end-stage osteoarthritis successfully postpones arthroplasty for years. Studies performed thus far used general intended use, patient-personalised or custom-made devices. In this study, for the first time, a device specifically designed for knee distraction is evaluated. Design 65 patients (≤65 years) with end-stage knee osteoarthritis indicated for arthroplasty received knee distraction. Before, 1-year and 2-year post-treatment, questionnaires were filled out and knee radiographs made. Adverse events and self-reported pain medication were registered. Results Forty-nine patients completed 2-year follow-up: one patient did not complete treatment, three patients received arthroplasty in the first and four patients in the second year follow-up. Eight patients were lost to follow-up in the second year. The total Western Ontario and McMaster Universities Osteoarthritis Index score showed a clinically relevant improvement at 1 and 2 years (+26 and +24 points), as did all subscales (all p<0.001). The minimum radiographic joint space width improved over 1 (+0.5 mm; p<0.001) and 2 (+0.4 mm; p=0.015) years, as did the physical Short-Form 36 (+10 points; p<0.001). The most common adverse event was pin tract infection, experienced by 66% of patients, in 88% successfully treated with oral antibiotics. In two cases, hospitalisation and/or intravenous antibiotics were needed. Eight patients experienced device-related complications. None of the complications influenced 2-year outcomes. Before treatment, 42% of patients used pain medication, which had nearly been halved 1 (23%; p=0.02) and 2 years (29%; p=0.27) post-treatment. Conclusions Patients treated with a general applicable, for knee distraction purpose-built device showed, despite adverse events, significant clinical and structural improvement over 2 years. Trial registration number NL7986.
AB - Objective Knee distraction treatment for end-stage osteoarthritis successfully postpones arthroplasty for years. Studies performed thus far used general intended use, patient-personalised or custom-made devices. In this study, for the first time, a device specifically designed for knee distraction is evaluated. Design 65 patients (≤65 years) with end-stage knee osteoarthritis indicated for arthroplasty received knee distraction. Before, 1-year and 2-year post-treatment, questionnaires were filled out and knee radiographs made. Adverse events and self-reported pain medication were registered. Results Forty-nine patients completed 2-year follow-up: one patient did not complete treatment, three patients received arthroplasty in the first and four patients in the second year follow-up. Eight patients were lost to follow-up in the second year. The total Western Ontario and McMaster Universities Osteoarthritis Index score showed a clinically relevant improvement at 1 and 2 years (+26 and +24 points), as did all subscales (all p<0.001). The minimum radiographic joint space width improved over 1 (+0.5 mm; p<0.001) and 2 (+0.4 mm; p=0.015) years, as did the physical Short-Form 36 (+10 points; p<0.001). The most common adverse event was pin tract infection, experienced by 66% of patients, in 88% successfully treated with oral antibiotics. In two cases, hospitalisation and/or intravenous antibiotics were needed. Eight patients experienced device-related complications. None of the complications influenced 2-year outcomes. Before treatment, 42% of patients used pain medication, which had nearly been halved 1 (23%; p=0.02) and 2 years (29%; p=0.27) post-treatment. Conclusions Patients treated with a general applicable, for knee distraction purpose-built device showed, despite adverse events, significant clinical and structural improvement over 2 years. Trial registration number NL7986.
KW - Orthopedic Procedures
KW - Osteoarthritis
KW - Osteoarthritis, Knee
UR - http://www.scopus.com/inward/record.url?scp=85162887020&partnerID=8YFLogxK
U2 - 10.1136/rmdopen-2023-003074
DO - 10.1136/rmdopen-2023-003074
M3 - Article
C2 - 37290929
SN - 2056-5933
VL - 9
JO - RMD Open
JF - RMD Open
IS - 2
M1 - e003074
ER -