Background <p>Knee osteoarthritis is a&#xa0;prevalent degenerative disease with considerable impact on quality of life and function. Conservative therapies are typically symptomatic only, while total knee arthroplasty shows high revision rates in younger patients. Knee joint distraction (KJD) represents an alternative joint-preserving clinical strategy.</p> Objectives <p>Narrative assessment of current evidence on KJD regarding clinical efficacy and structural effects, and its potential role in the therapeutic spectrum of knee osteoarthritis.</p> Materials and methods <p>Structured literature search in PubMed (2010–2025) analyzing 13&#xa0;clinical studies. Inclusion criteria: clinical KJD application with outcome parameters (WOMAC, KOOS, VAS) and structural measurements. Assessment performed qualitatively.</p> Results <p>KJD leads to significant improvements in WOMAC and KOOS scores, which are sustained over several years. Structurally, an increase in cartilage thickness, an improvement in the dGEMRIC index, and an increase in joint space width have been observed for up to 10&#xa0;years after the intervention. Compared with high tibial osteotomy (HTO), similar functional outcomes are reported, while the structural improvements suggesting cartilage regeneration after KJD should be interpreted with caution. The main complications are pin tract infections, occurring in approximately 63% of cases and representing a&#xa0;key procedure-specific risk, although they can be managed with oral antibiotic therapy in the majority of patients.</p> Conclusions <p>KJD is establishing itself as a&#xa0;promising joint-preserving option for selective patient groups (40–65&#xa0;years, medial/bicompartmental osteoarthritis, no significant axis deformities), though long-term independent RCTs are required.</p>

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„Knee joint distraction“

  • Florian Springer,
  • Felix Ferner,
  • Julian Fürmetz

摘要

Background

Knee osteoarthritis is a prevalent degenerative disease with considerable impact on quality of life and function. Conservative therapies are typically symptomatic only, while total knee arthroplasty shows high revision rates in younger patients. Knee joint distraction (KJD) represents an alternative joint-preserving clinical strategy.

Objectives

Narrative assessment of current evidence on KJD regarding clinical efficacy and structural effects, and its potential role in the therapeutic spectrum of knee osteoarthritis.

Materials and methods

Structured literature search in PubMed (2010–2025) analyzing 13 clinical studies. Inclusion criteria: clinical KJD application with outcome parameters (WOMAC, KOOS, VAS) and structural measurements. Assessment performed qualitatively.

Results

KJD leads to significant improvements in WOMAC and KOOS scores, which are sustained over several years. Structurally, an increase in cartilage thickness, an improvement in the dGEMRIC index, and an increase in joint space width have been observed for up to 10 years after the intervention. Compared with high tibial osteotomy (HTO), similar functional outcomes are reported, while the structural improvements suggesting cartilage regeneration after KJD should be interpreted with caution. The main complications are pin tract infections, occurring in approximately 63% of cases and representing a key procedure-specific risk, although they can be managed with oral antibiotic therapy in the majority of patients.

Conclusions

KJD is establishing itself as a promising joint-preserving option for selective patient groups (40–65 years, medial/bicompartmental osteoarthritis, no significant axis deformities), though long-term independent RCTs are required.