Joint distraction in treatment of osteoarthritis: a two-year follow-up of the ankle

Valburg, A. A. Van; Roermund, P.M. van; Marijnissen, A.C.; Melkebeek, J. Van; Lammens, Johan; Verbout, Abraham J.; Lafeber, Floris P. J. G.; Bijlsma, J. W. J.

doi:10.1053/joca.1998.0242

Cited by 136 publications

(101 citation statements)

References 9 publications

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“…In a prospective, uncontrolled study of 15 patients, we showed that joint distraction for the treatment of severe ankle OA resulted in significant relief of pain after 1 year, with further improvement during the following year. Function and clinical status also improved after 1 year and further improved during the following year (19).…”

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confidence: 80%

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Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study

Marijnissen¹,

Roermund²,

Melkebeek³

et al. 2002

Arthritis & Rheumatism

136

125

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Objective. Osteoarthritis (OA) is a degenerative, disabling joint disease that affects >10% of the adult population. No effective disease-modifying treatment is available. In the present study, we used joint distraction, a relatively new treatment in which mechanical contact between the articular surfaces is avoided while intraarticular intermittent fluid pressure is maintained, to treat patients with severe OA of the ankle.Methods. Patients with severe ankle OA (n ‫؍‬ 57) who were being considered for joint fusion (arthrodesis) were treated with joint distraction in an open prospective study. In addition, a randomized trial was performed in 17 patients to determine whether joint distraction had a better outcome than debridement. A standardized evaluation protocol (physical examination, assessment of pain, mobility, and functional ability) was used, and changes in radiographic joint space width and subchondral sclerosis were measured. Thirtyeight patients in the open study have been followed up for >1 year, with up to 5 years of followup in 7 of them (mean ؎ SD followup 2.8 ؎ 0.3 years). Patients in the randomized study have been followed up for 1 year.Results. Significant clinical benefit was found in three-fourths of the 57 patients in the open prospective study. Most interestingly, the improvement increased over time. Radiographic evaluation showed increased joint space width and decreased subchondral sclerosis. Moreover, joint distraction showed significantly better results than debridement.Conclusion. The clinical benefit of joint distraction in the treatment of severe OA is proof of the concept. Although the followup remains relatively short and effects over time remain unpredictable, our study creates possibilities for the treatment of severe OA in general. Considering the high prevalence of OA and the lack of a cure for it, joint distraction as a treatment of severe OA may have great medical, social, and economic impact.

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confidence: 80%

“…Loss of function was measured using a slight modification of the score described by Van Valburg et al (19), based on the functional index for hip and knee OA (21); the maximum score for this measure is 30 ( Table 1). The clinical condition of the patients was measured by assessment of 4 features (maximum score 8) ( Table 1).…”

Section: Treatmentmentioning

confidence: 99%

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study

Marijnissen¹,

Roermund²,

Melkebeek³

et al. 2002

Arthritis & Rheumatism

136

125

View full text Add to dashboard Cite

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“…Those investigators then performed a prospective series and found that more than two-thirds of patients demonstrated significant improvement at two years 36 . When that cohort was followed to an average of ten years (minimum, seven years), 73% of the patients reported good results 37 .…”

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confidence: 99%

Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

Saltzman

Hillis

Stolley

et al. 2012

Journal of Bone and Joint Surgery

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“…13 Contraindications to this surgery include significant bone loss, active infection, significant boney deformity, and severe arthrosis. 13,34 Early clinical studies appear promising in decreasing pain and improving function, 55,68,90,91 especially in individuals younger than 45 years of age. 5 Complications such as painful toe flexion contractures and joint stiffness can result if the joint is excessively distracted.…”

Section: Distraction Arthroplastymentioning

confidence: 99%

Posttraumatic Ankle Arthritis: An Update on Conservative and Surgical Management

Martin¹,

Stewart²,

Conti³

2007

J Orthop Sports Phys Ther

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T he purpose of this manuscript is to provide current information regarding the examination, conservative treatment, and surgical treatment for individuals with posttraumatic arthritis. The 3 major categories of arthritis are inflammatory, osteoarthritis, and posttraumatic arthritis. Rheumatoid arthritis is the most common form of inflammatory arthritis; however, it does not always affect the ankle.35 It has been reported that 10% to 50% of individuals with rheumatoid arthritis have ankle involvement. 8,16,48,60,83 The mechanical properties of the tibiotalar articular cartilage make it durable and efficient at equalizing stress. These properties may reduce the risk of osteoarthritis at the ankle. 7,37,75,77,80,86 Posttraumatic arthritis is more common than osteoarthritis at the ankle. Saltzman et al 71 reported that osteoarthritis and posttraumatic arthritis accounted for 12% and 70% of ankle arthritis cases, respectively.

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Joint distraction in treatment of osteoarthritis: a two-year follow-up of the ankle

Cited by 136 publications

References 9 publications

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study

Clinical benefit of joint distraction in the treatment of severe osteoarthritis of the ankle: Proof of concept in an open prospective study and in a randomized controlled study

Motion Versus Fixed Distraction of the Joint in the Treatment of Ankle Osteoarthritis

Posttraumatic Ankle Arthritis: An Update on Conservative and Surgical Management

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