However, both the minimum and mean joint space width showed a steeper increase in patients randomized to the knee joint distraction group, suggesting that cartilaginous tissue repair might be better with the latter method.
Sara Freeman/Frontline Medical News
Dr. Natalia Kuchuk
The potential clinical benefit of knee joint distraction was further highlighted in another poster from the team, presented by Dr. Natalia Kuchuk, which showed the effects of the procedure were maintained at 5-year follow-up. Importantly, 80% of the 20 patients studied in this open study still had their own knee joint. The mean age of patients at the time of distraction was 48.5 years. “In young patients, knee joint distraction effectively postpones total knee arthroplasty and is the only treatment which allows regeneration of cartilage,” she said in an interview.
Dr. Lafeber also commented in an interview on the practicalities of the procedure, which is still in its experimental phases. “It’s a rather an invasive procedure but if you compare it to a total knee replacement or high tibial osteotomy it’s less invasive,” he said.
“The surgical procedure takes about half an hour, we place a few pins through soft tissue and bone and the distraction tubes are placed mediolaterally to these pins, so in fact it’s less invasive than many of the other surgical techniques.” The distraction itself is not painful, he added, and actually alleviates OA pain but patients may need painkillers and perhaps antibiotics for short periods during the method.Next steps for the team are to follow up patients in the randomized trials for a longer period of time and refine the distraction device. “This is an off-the-shelf, ‘proof-of-concept’ device, and we are now developing a more patient-friendly, smaller, lighter frame device which is also easier to place by orthopedic surgeons,” Dr. Lafeber said. “Then we will do a comparison with the proof-of-concept device.”
Reumafonds (the Dutch Arthritis Foundation), ZonMw (The Netherlands Organization for Health Research and Development), UMC Utrecht, and Sint Maartinskliniek funded the research. Dr. Mastbergen, Dr. Lafeber, and Dr. Kuchuk had no disclosures to report.