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Author Topic: Interesting article  (Read 1098 times)

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Offline mayme

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Interesting article
« on: June 17, 2008, 03:30:19 AM »
Joint distraction promotes structural repair in patients with severe knee osteoarthritis


1st on the web (June 16, 2008)
June 2008

Researchers used knee distraction for the first time to strengthen and promote cartilage repair in severe end-stage knee osteoarthritis, according to a report at the European League Against Rheumatism (EULAR) 2008 Annual Congress in Paris.

In the study, a group of Dutch investigators used an external fixation frame with springs to bridge the knee joint in 19 patients younger than 60 years with osteoarthritis. The frame was distracted by 5 mm over a period of 2 months with the goal of promoting cartilage repair by removing mechanical stress on the knee.

The functional ability and pain scores of the patients were poor prior to treatment (40% and 30% of the maximum WOMAC score, respectively). However, both scores increased to more than 80% following joint distraction, which is equivalent to almost complete normalization in terms of symptoms experienced, said presenter Floris Lafeber, PhD, of the University Medical Center Utrecht.

MRI and digital X-ray evaluation carried out at baseline and at 1-year follow-up showed evidence of cartilage repair. Cartilage volume and subchondral bone covered with cartilage increased by 50% and 40%, respectively, and mean cartilage thickness increased from baseline to 1-year follow-up, according to a EULAR news release.

Biomarkers of cartilage and bone breakdown and synthesis, measured in serum and urine, also demonstrated an increased level of cartilage and bone turnover during distraction that returned to normal in the months after treatment, with a gradual increase in cartilage synthesis markers over time. This is indicative of structural repair due to distraction, he said.

"We are delighted to report such an impressive outcome in the use of joint distraction for severe osteoarthritis of the knee. Positive results have been sustained over the 2-year follow-up period, suggesting the potential for joint distraction to delay the need for a joint prosthesis in these relatively young patients," Lafeber said in the news release.

"Our data are very promising, demonstrating the clinical efficacy and potential for structural repair. The logical next step should be the implementation of a prolonged prospective multicenter study on the procedure."

For more information:

Intema F, Marijnissen ACA, Beekhuizen M, et al. Joint distraction in the treatment of severe knee osteoarthritis; the first results on clinical efficacy and structural repair. Paper OP-0151. Presented at the European League Against Rheumatism 2008 Annual Congress. June 11-14, 2008. Paris.


Offline msmcfad

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Re: Interesting article
« Reply #1 on: June 25, 2008, 09:32:36 PM »
I agree.  I have a Google alert set up for stuff like this and when I read the article I knew it was something I wanted to try before yet another surgery.  Of course I can't seem to figure out where I could try something like this!  I would rather have an external fixation device for a couple of months and see how things go vs. having a surgery that will put me out of commission for 6-12 months.

Anyone have any ideas where this procedure could be/is performed outside of a clinical trial?  I hardly know where to start.
8/2005-LK subtotal meniscectomy & patellar shaving
10/2005-unable to bear weight on LK, MRI shows OCD
1/26/2006-left knee microfracture for OCD,  biopsy for ACI
7/06&07 Supartz injections, minimal improvement
2014-MRI/films show bone on bone w/cysts,
PKR 6/2/14

Offline amy1

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Re: Interesting article
« Reply #2 on: June 25, 2008, 10:06:37 PM »
Wow!  How could we find out if there are any clinical trials scheduled for the USA?  I am facing a TKR but would much rather wear a brace for awhile than do a tkr.
6/2004 partial lateral meniscus removal and microfracture left knee
7/13/05  open lateral release, medial plication, spur removal right knee
12/06  re do proximal realignment right knee (scar tissue formed ) 5 days post op - fell and fractured elbow
08/2009 - feeling good so far work 50 hrs a week

Offline JustMeInNC

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Re: Interesting article
« Reply #3 on: June 25, 2008, 10:15:16 PM »
Iwould love to find out more about this and when it could be in the US to. I am tired of CONSTANT pain and i have been told that i am too young for the TKR
I'm so busy that I'm not sure if I lost my horse or just found my lead rope.

1989 - Right Knee - don't rember what they did
1997 - Right Knee - Orthoscopic clean up again
2000 - LR on left knee
2001 - LR on right knee
2008 -LR on right knee (again)
9-18-2009 - Maquet osteotomy right knee

Offline msmcfad

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Tried contacting
« Reply #4 on: July 09, 2008, 03:13:41 AM »
I tried contacting the email they give in the EULAR article  but they told me they are only the PR folks and therefore couldn't advise me on where to find this procedure in the U.S.   :'(

I've tried all sorts of searches with no luck.  I don't even need it to be a research study - I'd try it just to try it.
8/2005-LK subtotal meniscectomy & patellar shaving
10/2005-unable to bear weight on LK, MRI shows OCD
1/26/2006-left knee microfracture for OCD,  biopsy for ACI
7/06&07 Supartz injections, minimal improvement
2014-MRI/films show bone on bone w/cysts,
PKR 6/2/14

Offline lady

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Re: Interesting article
« Reply #5 on: July 10, 2008, 01:44:10 AM »
All I can say is OMG!!! and sign me up.

OH and thanks for the article.
dislocated patella and chopped off most of chondal 1985
chondroplasty/medial meniscus repair 1996
ACI  quater size defect-surgery failure
lateral meniscus repair2002
chondroplasty, lateral Meniscectomy2006
synvisc & orthovisc injections 2008/2009
drained and cortizone injection 2008

Offline villafup

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Re: Interesting article
« Reply #6 on: September 30, 2010, 04:28:33 PM »
I just heard about this recently and thought it might be a good option instead of an osteotomy.  I found a doctor who will do at HSS in New York.  Seems relatively painless -- two months in a Taylor Spatial Frame.  Better than that year-long rehab from an osteotomy.  I'm tired of all the pt I had to go through for my ACL an meniscectomy.