Knee joint distraction compared with total knee arthroplasty

Knee joint distraction compared with total knee arthroplasty
J. A. D. van der Woude, K. Wiegant, R. J. van Heerwaarden,
S. Spruijt, P. J. Emans, S. C. Mastbergen, F. P. J. G. Lafeber

Bone Joint J 2017;99-B:51–8.



 Knee joint distraction (KJD) is a relatively new, knee-joint preserving procedure with the goal of delaying total knee arthroplasty (TKA) in young and middle-aged patients. We present a randomised controlled trial comparing the two.
Patients and Methods:

 The 60 patients ≤ 65 years with end-stage knee osteoarthritis were randomised to either KJD (n = 20) or TKA (n = 40). Outcomes were assessed at baseline, three, six, nine, and 12 months. In the KJD group, the joint space width (JSW) was radiologically assessed, representing a surrogate marker of cartilage thickness.
In total 56 patients completed their allocated treatment (TKA = 36, KJD = 20). All patient reported outcome measures improved significantly over one year (p < 0.02) in both groups.
At one year, the TKA group showed a greater improvement in only one of the 16 patientrelated outcome measures assessed (p = 0.034). Outcome Measures in Rheumatology- Osteoarthritis Research Society International clinical response was 83% after TKA and 80% after KJD. A total of 12 patients (60%) in the KJD group sustained pin track infections. In the KJD group both mean minimum (0.9 mm, standard deviation (SD) 1.1) and mean JSW (1.2 mm, SD 1.1) increased significantly (p = 0.004 and p = 0.0003).
In relatively young patients with end-stage knee osteoarthritis, KJD did not  demonstrate inferiority of outcomes at one year when compared with TKA. However, there is a high incidence of pin track infection associated with KJD.


LEER MÁS: distracción articular vs prótesis en artrosis de rodilla

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