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Bone Joint J. 2017 Jan;99-B(1):51-58. doi: 10.1302/0301-620X.99B1.BJJ-2016-0099.R3.

Knee joint distraction compared with total knee arthroplasty: a randomised controlled trial.

Author information

1
Maartenskliniek Woerden, Woerden, The Netherlands.
2
UMC Utrecht, Utrecht, The Netherlands.
3
MUMC Maastricht, Maastricht, The Netherlands.

Abstract

AIMS:

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.

RESULTS:

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 patient-related 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).

CONCLUSION:

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. Cite this article: Bone Joint J 2017;99-B:51-8.

KEYWORDS:

Cartilage repair; Joint distraction; Knee osteoarthritis; Randomised controlled trial; Total knee arthroplasty

[Indexed for MEDLINE]

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