Skip to main content
SpringerLink
Log in

Knee Joint Distraction (Arthrodiastasis) in Knee Osteoarthritis

  • Chapter
  • First Online:
Comprehensive Treatment of Knee Osteoarthritis

  • 905 Accesses

Abstract

High tibial osteotomy (HTO) and knee joint distraction are treatments to unload the osteoarthritic joint with proven success in postponing a total knee arthroplasty (TKA). There is some controversy in the literature regarding the role of surgical knee joint distraction (KJD) in knee osteoarthritis (OA). In this chapter the benefits of KJD in knee OA have been revised. A Cochrane Library and PubMed (MEDLINE) search related to the role of KJD in knee OA was analyzed. The chief criteria for election were that the articles were centered on the aforementioned question. Three hundred and ninety articles were found until November 28, 2019; however, only 21 were selected and reviewed because of their focus on clinical experience with KJD in knee OA. Four were considered level of evidence I–II, whereas 17 had a lower level of evidence (III–IV). KJD provides considerable clinical and structural ameliorations to patients with knee OA, postponing TKA for at least 2 years. In conclusion, KJD provides benefits in delaying TKA for at least 2 years, but there is a risk of pin tract infection. Moreover, of the nine articles reviewed in this paper, seven were reported by Dutch authors, potentially limiting the generalizability of the results. My view is that the role of KJD in knee OA is currently quite controversial and should not be recommended until further research is conducted.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Rodriguez-Merchan EC. Intraarticular injections of platelet-rich plasma (PRP) in the management of knee osteoarthritis. Arch Bone Jt Surg. 2013;1:5–8.

    PubMed  PubMed Central  Google Scholar 

  2. Rodriguez-Merchan EC. Intra-articular injections of hyaluronic acid and other drugs in the knee joint. HSS J. 2013;9:180–2.

    Article  Google Scholar 

  3. Makhmalbaf H, Moradi A, Ganji S. Distal femoral osteotomy in genu valgum: internal fixation with blade plate versus casting. Arch Bone Jt Surg. 2014;2:246–9.

    PubMed  PubMed Central  Google Scholar 

  4. Rodriguez-Merchan EC. Medial unicompartmental osteoarthritis (MUO) of the knee: unicompartmental knee replacement (UKR) or total knee replacement (TKR). Arch Bone Jt Surg. 2014;2:137–40.

    PubMed  PubMed Central  Google Scholar 

  5. Rodriguez-Merchan EC. Unicompartmental knee osteoarthritis (UKOA): unicompartmental knee arthroplasty (UKA) or high tibial osteotomy (HTO)? Arch Bone Jt Surg. 2016;4:307–13.

    PubMed  PubMed Central  Google Scholar 

  6. Sabzevari S, Ebrahimpour A, Roudi MK, Kachooei AR. High tibial osteotomy: a systematic review and current concept. Arch Bone Jt Surg. 2016;4:204–12.

    PubMed  PubMed Central  Google Scholar 

  7. Fernandez-Fernandez R, Rodriguez-Merchan EC. Better survival of total knee replacement in patients older than 70 years: a prospective study with 8 to 12 years follow-up. Arch Bone Jt Surg. 2015;3:22–8.

    PubMed  PubMed Central  Google Scholar 

  8. Flouzat-Lachaniette CH, Roubineau F, Heyberger C, Bouthors C. Distraction to treat knee osteoarthritis. Joint Bone Spine. 2017;84:141–4.

    Article  Google Scholar 

  9. van der Woude JA, Wiegant K, van Heerwaarden RJ, Spruijt S, Emans PJ, Mastbergen SC, et al. Knee joint distraction compared with total knee arthroplasty: a randomised controlled trial. Bone Jt J. 2017;99:51–8.

    Article  Google Scholar 

  10. van der Woude JA, Wiegant K, van Heerwaarden RJ, Spruijt S, van Roermund PM, Custers RJ, et al. Knee joint distraction compared with high tibial osteotomy: a randomized controlled trial. Knee Surg Sports Traumatol Arthrosc. 2017;25:876–86.

    Article  Google Scholar 

  11. Takahashi T, Baboolal TG, Lamb J, Hamilton TW, Pandit HG. Is knee joint distraction a viable treatment option for knee OA? A literature review and meta-analysis. J Knee Surg. 2019;32:788–95.

    Article  Google Scholar 

  12. Goh EL, Lou WCN, Chidambaram S, Ma S. The role of joint distraction in the treatment of knee osteoarthritis: a systematic review and quantitative analysis. Orthop Res Rev. 2019;11:79–92.

    PubMed  PubMed Central  Google Scholar 

  13. Aly TA, Hafez K, Amin O. Arthrodiatasis for management of knee osteoarthritis. Orthopedics. 2011;34:338–43.

    Article  Google Scholar 

  14. Intema F, Van Roermund PM, Marijnissen AC, Cotofana S, Eckstein F, Castelein RM, et al. Tissue structure modification in knee osteoarthritis by use of joint distraction: an open 1-year pilot study. Ann Rheum Dis. 2011;70:1441–6.

    Article  Google Scholar 

  15. van der Woude JA, Nair SC, Custers RJ, van Laar JM, Kuchuck NO, Lafeber FP, et al. Knee joint distraction compared to total knee arthroplasty for treatment of end stage osteoarthritis: simulating long-term outcomes and cost-effectiveness. PLoS One. 2016;11(5):e0155524.

    Article  Google Scholar 

  16. van der Woude JA, van Heerwaarden RJ, Spruijt S, Eckstein F, Maschek S, van Roermund PM, et al. Six weeks of continuous joint distraction appears sufficient for clinical benefit and cartilaginous tissue repair in the treatment of knee osteoarthritis. Knee. 2016;23:785–91.

    Article  Google Scholar 

  17. van der Woude JA, Welsing PM, van Roermund PM, Custers RJ, Kuchuk NO, Lafeber FP. Prediction of cartilaginous tissue repair after knee joint distraction. Knee. 2016;23:792–5.

    Article  Google Scholar 

  18. Wiegant K, van Roermund PM, Intema F, Cotofana S, Eckstein F, Mastbergen SC, et al. Sustained clinical and structural benefit after joint distraction in the treatment of severe knee osteoarthritis. Osteoarthr Cartil. 2013;21:1660–7.

    Article  CAS  Google Scholar 

  19. Jansen MP, van der Weiden GS, Van Roermund PM, Custers RJH, Mastbergen SC, Lafeber FPJG. Initial tissue repair predicts long-term clinical success of knee joint distraction as treatment for knee osteoarthritis. Osteoarthr Cartil. 2018;26:1604–8.

    Article  CAS  Google Scholar 

  20. Besselink NJ, Vincken KL, Bartels LW, van Heerwaarden RJ, Concepcion AN, et al. Cartilage quality (dGEMRIC index) following knee joint distraction or high tibial osteotomy. Cartilage. 2018. https://doi.org/10.1177/1947603518777578.

  21. Jansen MP, Besselink NJ, van Heerwaarden RJ, Custers RJH, Emans PJ, Spruijt S, et al. Knee joint distraction compared with high tibial osteotomy and total knee arthroplasty: two-year clinical, radiographic, and biochemical marker outcomes of two randomized controlled trials. Cartilage. 2019. https://doi.org/10.1177/1947603519828432.

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic Surgery, “La Paz” University Hospital, Madrid, Spain

    E. Carlos Rodríguez-Merchán

Authors
  1. E. Carlos Rodríguez-Merchán
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain

    E. Carlos Rodríguez-Merchán

  2. Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain

    Primitivo Gómez-Cardero

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Rodríguez-Merchán, E.C. (2020). Knee Joint Distraction (Arthrodiastasis) in Knee Osteoarthritis. In: Rodríguez-Merchán, E., Gómez-Cardero, P. (eds) Comprehensive Treatment of Knee Osteoarthritis. Springer, Cham. https://doi.org/10.1007/978-3-030-44492-1_7

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-44492-1_7

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-44491-4

  • Online ISBN: 978-3-030-44492-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation