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

Area of Science:

• Orthopedics
• Biomedical Engineering
• Rheumatology

Background:

• Knee joint distraction (KJD) is an emerging knee-preserving procedure.
• It aims to delay total knee arthroplasty (TKA) in younger patients with end-stage knee osteoarthritis.

Purpose of the Study:

• To compare the efficacy and outcomes of KJD versus TKA in patients under 65 with end-stage knee osteoarthritis.
• To evaluate patient-reported outcomes and radiological markers.

Main Methods:

• A randomized controlled trial involving 60 patients (≤65 years) with end-stage knee osteoarthritis.
• Patients were randomized to KJD (n=20) or TKA (n=40).
• Outcomes were assessed at multiple time points up to 12 months, including joint space width (JSW) as a surrogate for cartilage thickness.

Main Results:

• Both KJD and TKA groups showed significant improvements in patient-reported outcomes over one year.
• TKA demonstrated a statistically greater improvement in only one of 16 assessed outcome measures.
• The KJD group experienced a high incidence of pin track infections (60%), while JSW significantly increased in this group.

Conclusions:

• Knee joint distraction (KJD) is not inferior to total knee arthroplasty (TKA) in terms of outcomes at one year for younger patients with end-stage knee osteoarthritis.
• A significant drawback of KJD is its high rate of pin track infections.
• Further investigation is warranted to mitigate infection risks associated with KJD.