Osteoarthritis (OA) of the knee is the leading cause of disability in the adult population. Although a number of treatments for knee OA are available, none effectively prevent OA progression. Currently, a wide therapeutic gap exists for patients who have unsuccessfully exhausted conservative OA treatments but who are hesitant or ineligible to undergo invasive surgery. The KineSpring device is a novel, joint preserving, minimally invasive implant that reduces medial compartment loading without significantly impacting the loading of the lateral compartment. This article describes the rationale for and the design of the KineSpring device and summarizes results of initial biomechanical testing in an OA cadaver model.
The vascular response to balloon-expandable stenting in the coronary and peripheral circulations is different. After 6 months, neointimal hyperplasia and stent-induced stenosis were increased in peripheral porcine arteries compared with coronary arteries.
Medial knee osteoarthritis (OA) is a common disorder often associated with pathologic joint loading. Insoles, braces, and high tibial osteotomy are OA treatments aimed at reducing medial joint loads, but their use and effectiveness are limited. The KineSpring System implant also intends to reduce knee loads in OA patients while overcoming those limitations. The current study was undertaken to test the implant's effect on loads at the knee. Six cadaver knees with Outerbridge Grade I-II medial OA were subjected to simulated gait using a kinematic test system. Knees were tested with and without the medial knee implant while thin film sensors measured medial and lateral femorotibial contact pressures. Significant medial compartment load reductions (134 ± 53 N [P = .002]) were found throughout the stance phase of gait in the treated knee. Significant total joint load decreases (91 ± 40 N [P = .002]) were also observed without substantial changes in lateral compartment loads. These significant reductions of medial and total intra-articular loads are also within clinically effective ranges of other unloading systems. This suggests that the KineSpring System could be a viable treatment for medial knee OA.
Symptomatic medial compartment knee osteoarthritis (OA) is the leading cause of musculoskeletal pain and disability in adults. Therapies intended to unload the medial knee compartment have yielded unsatisfactory results due to low patient compliance with conservative treatments and high complication rates with surgical options. There is no widely available joint-unloading treatment for medial knee OA that offers clinically important symptom alleviation, low complication risk, and high patient acceptance. The KineSpring® Knee Implant System (Moximed, Inc, Hayward, CA, USA) is a first-of-its-kind, implantable, extra-articular, extra-capsular prosthesis intended to alleviate knee OA-related symptoms by reducing medial knee compartment loading while overcoming the limitations of traditional joint-unloading therapies. Preclinical and clinical studies have demonstrated excellent prosthesis durability, substantial reductions in medial compartment and total joint loads, and clinically important improvements in OA-related pain and function. The purpose of this report is to describe the KineSpring System, including implant characteristics, principles of operation, indications for use, patient selection criteria, surgical technique, postoperative care, preclinical testing, and clinical experience. The KineSpring System has potential to bridge the gap between ineffective conservative treatments and irreversible surgical interventions for medial compartment knee OA.
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