[Progress on knee cartilage repair by knee joint distraction]

Area of Science:

• Orthopedics and Regenerative Medicine
• Biomechanical Engineering
• Molecular Biology

Context:

• Knee osteoarthritis (OA) is a prevalent degenerative joint disease.
• Current treatments focus on pain management and function, with limited cartilage repair options.
• Knee joint distraction (KJD) has emerged as a novel therapeutic approach.

Purpose:

• To review the mechanisms and influencing factors of KJD in cartilage repair.
• To synthesize current literature on KJD's effects on knee joint biomechanics and cellular processes.
• To identify factors impacting KJD efficacy for knee OA treatment.

Summary:

• KJD reduces knee joint load, creating a favorable mechanical environment for cartilage.
• Hydrostatic pressure fluctuations from KJD enhance nutrient uptake and modulate gene expression for cartilage formation and degradation.
• KJD promotes synovial mesenchymal stem cell recruitment and chondrogenic differentiation, while reducing inflammation.

Impact:

• KJD demonstrates potential for significant cartilage repair in knee OA.
• Factors such as increased weight-bearing activity, distraction height/duration, male sex, and higher OA severity correlate with better repair outcomes.
• Further research is needed to optimize KJD clinical application and long-term efficacy.