Case 39: Sustained Clinical and Structural Benefit After Five Years Following Joint Distraction in the Treatment of Severe Knee Osteoarthritis

Abstract

Treatment of severe osteoarthritis (OA) in relatively young patients is challenging. Although successful, total knee prosthesis has a limited life span, with the risk of revision surgery, especially in active young patients. Knee joint distraction (KJD) provides clinical benefit and tissue structure modification. The present case evaluates whether this benefit is preserved during the fifth year of follow-up. Clinical parameters compared with baseline (BL) were assessed by using the WOMAC questionnaire showing a clinical improvement from 62 to 75. Radiographic minimum joint space width (min JSW) was significantly increased from 0.01 to 1.98 mm. The mean maximal affected compartment joint space width increased from 0.65 to 2.7 mm. Cartilage thickness observed by MRI (1.6 mm) at BL was still significantly greater at 5-year follow-up (2.34 mm). The percentage denuded area of subchondral bone visualized by MRI (44.7 %) was still significantly decreased at 5-year follow-up (15.3 %).