The role of joint distraction in the treatment of knee osteoarthritis: a systematic review and quantitative analysis
File(s)
Author(s)
Goh, En Lin
Lou, Winston Choong Ngan
Chidambaram,, Swathikan
Ma, Shaocheng
Type
Journal Article
Abstract
Introduction: Knee osteoarthritis is a major cause of pain and disability for which joint distraction is a potential treatment to delay the need for knee arthroplasty. This systematic review aims to assess the short- and long-term clinical and structural outcomes following knee joint distraction (KJD).
Methods: MEDLINE, EMBASE, Scopus and Web of Science databases were searched from the date of inception to 26th June 2019. Clinical studies investigating joint distraction for knee osteoarthritis with outcomes including ∆WOMAC index, ∆VAS pain score and ∆joint space width were included. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) – CRD42018087032.
Results: Nine studies comprising a total of 507 patients were included. There were four randomised controlled trials (RCTs), five open prospective cohort studies and one case series. Overall, there were significant improvements in WOMAC index, VAS pain score and joint space width following KJD, which persisted up till nine years. KJD also demonstrated comparable clinical outcomes with HTO and TKA.
Conclusion: There is moderate quality evidence supporting the beneficial outcomes of joint distraction for knee osteoarthritis. Larger RCTs with longer follow-up (>1 year) are necessary to establish the true effect size of this procedure.
Methods: MEDLINE, EMBASE, Scopus and Web of Science databases were searched from the date of inception to 26th June 2019. Clinical studies investigating joint distraction for knee osteoarthritis with outcomes including ∆WOMAC index, ∆VAS pain score and ∆joint space width were included. The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) – CRD42018087032.
Results: Nine studies comprising a total of 507 patients were included. There were four randomised controlled trials (RCTs), five open prospective cohort studies and one case series. Overall, there were significant improvements in WOMAC index, VAS pain score and joint space width following KJD, which persisted up till nine years. KJD also demonstrated comparable clinical outcomes with HTO and TKA.
Conclusion: There is moderate quality evidence supporting the beneficial outcomes of joint distraction for knee osteoarthritis. Larger RCTs with longer follow-up (>1 year) are necessary to establish the true effect size of this procedure.
Date Issued
2019-08-01
Date Acceptance
2019-07-02
Citation
Orthopedic Research and Reviews, 2019, 11, pp.79-92
ISSN
1179-1462
Start Page
79
End Page
92
Journal / Book Title
Orthopedic Research and Reviews
Volume
11
Copyright Statement
© 2019 Goh et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php
and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work
you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For
permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work
you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For
permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
Subjects
Science & Technology
Life Sciences & Biomedicine
Orthopedics
osteoarthritis
knee joint distraction
total knee arthroplasty
high tibial osteotomy
clinical outcomes
structural outcomes
CARTILAGINOUS TISSUE-REPAIR
ARTICULATED DISTRACTION
CLINICAL BENEFIT
FOLLOW-UP
ARTHROPLASTY
HIP
clinical outcomes
high tibial osteotomy
knee joint distraction
osteoarthritis
structural outcomes
total knee arthroplasty
1103 Clinical Sciences
Publication Status
Published