No beneficial effects of joint distraction on early microscopical changes in osteoarthrotic knees

Karadam, Bahattin; Karatosun, Vasfi; Murat, Nergis; Özkal, Şermin; Günal, İzge

doi:10.1080/00016470510030391

Cited by 15 publications

(16 citation statements)

References 9 publications

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“…Karadam et al reported no beneficial effects of distraction on a study using rabbits. 11 On this research, the anatomical and histopathological results show worsening as evaluated by the respective grading and scoring (p < 0.05). Therefore, a significant difference exists between the control and intervention groups though the result was the other way around.…”

Section: Med J Indonesmentioning

confidence: 58%

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Effect of distraction arthroplasty on osteoarthritic goat models of the articular cartilage

Putro¹,

Priyamurti²,

Lubis³

2013

Med J Indones

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AbstrakLatar belakang: Osteoartritis (OA) adalah kelainan sendi lutut degeneratif tersering, jumlah pasien OA semakin bertambah dengan bertambahnya harapan hidup. Artroplasti distraksi adalah sebuah alternatif yang relatif lebih tidak invasif untuk tatalaksana OA dengan menghilangkan stres mekanis dan mempertahankan tekanan intermiten cairan sendi, sehingga menghentikan siklus kerusakan pada OA. Penelitian ini bertujuan mempelajari perubahan anatomi dan histopatologi setelah artroplasti distraksi pada model hewan osteoartritis.Metode: Penelitian dilakukan pada 32 lutut kambing (16 kambing) yang terlebih dahulu diinduksi secara mekanis menjadi OA dengan menisektomi lateral. Selama masa penelitian, 6 kambing mati. Artroplasti distraksi dilaksanakan menggunakan fiksasi eksterna pada 10 lutut selama 4 minggu, dan 10 lutut kontralateral dibiarkan, kemudian diperiksa secara anatomis dan histopatologis untuk diperbandingkan mengunakan staging International Cartilage Repair Society (ICRS) dan skoring Osteoarthritis Research Society International (OARSI). Perbedaan anatomis dan histopatologis diuji kemaknaannya menggunakan uji Wilcoxon.Hasil: Terdapat perburukan secara anatomi dan histopatologi pada lutut yang diberikan perlakuan. Nilai median perbandingan secara makroskopis dengan staging ICRS berbeda bermakna (1,5 vs 2,5; p < 0,002). Perbandingan secara histopatologi dengan skoring OARSI berbeda bermakna (6 vs 10; p < 0,002).Kesimpulan: Arthroplasti distraksi pada model OA kambing dalam penelitian ini, tidak memberikan perbaikan, melainkan memperburuk OA. Penelitian lebih lanjut diperlukan untuk memberikan dasar biologis yang kuat dari artroplasti distraksi sebagai terapi alternatif untuk OA. AbstractBackground: Osteoarthritis (OA) is the most common knee degenerative disease, the number of OA patients increases along with the increase of life expectancy. Distraction arthroplasty is a less invasive alternatif for OA management by releaving mechanical stress while maintaining intermitten joint fluid pressure changes, thus halting the OA destructive cycle and inducing repair. This study aims to evaluate the anatomical and histopathological changes after distraction arthroplasty on osteoarthritic animal models. Methods:The study was performed on 32 goat stiffle joint (16 goats) with mechanically induced OA by lateral meniscectomy. During the study 6 goats were decreased. Distraction arthroplasty was performed using external fixation on 10 knees for 4 weeks, and the contralateral knees left untreated. The knees were anatomically and histopathologically examined using International Cartilage Repair Society (ICRS) staging and Osteoarthritis Research Society International (OARSI) scoring. The differences of the anatomical and histopathological changes are tested for significance using the Wilcoxon test.Results: There was anatomical and histopathological worsening of the OA on treated knees. The anatomical difference assessed using ICRS stage gave median values of 1.5 and 2.5 respectively (p < 0.002). The histopathological diff...

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Section: Med J Indonesmentioning

confidence: 58%

“…Several animal studies show different results. [11][12][13][14] It has only been performed on a pilot study on humans. 15 Some authors also doubt the efficacy of this method.…”

mentioning

confidence: 99%

Effect of distraction arthroplasty on osteoarthritic goat models of the articular cartilage

Putro¹,

Priyamurti²,

Lubis³

2013

Med J Indones

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“…In our study (Karadam et al 2005), non-articulated distraction worsened the results (p = 0.001) whereas articulated distraction had no significant effect (p = 0.1), although the results were worse than the control group. With these data, it is impossible to reach any conclusion other than "there is no beneficial effect of joint distraction on early microscopical changes in osteoarthrotic knees in rabbits, but non-articulated distraction worsens the results".…”

mentioning

confidence: 54%

“…Sir-In the recent publication of Karadam et al (2005) entitled "No beneficial effects of joint distraction on early microscopical changes in osteoarthritic knees; a study in rabbits." the crucial statement is made in the last sentence: "Studies with longer follow-up are necessary because distraction treatment requires up to a year before substantial clinical benefit may be achieved.…”

mentioning

confidence: 99%

No beneficial effects of joint distraction on early microscopical changes in osteoarthrotic knees

2005

Acta Orthopaedica

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“…In a canine study [53] we found beneficial changes in chondrocyte activity immediately after ending the distraction, but no cartilage repair. Karadam and colleagues [54] reported 'no beneficial effects of joint distraction on early microscopical changes in osteoarthritic knees' in a rabbit study. Osteoarthritis was induced by papain injection in 24 rabbits which were divided into four groups.…”

Section: Unloading In Cases Of Severe Osteoarthritis: Joint Distractionmentioning

confidence: 98%

Unloading joints to treat osteoarthritis, including joint distraction

Lafeber

Intema

Roermund

et al. 2006

Current Opinion in Rheumatology

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To improve patient function and possibly reduce disease progression, a biomechanical approach should be considered in treating patients with osteoarthritis. Further research (appropriate high-quality clinical trials) and analysis (clinical as well as preclinical and fundamental) are still necessary, however, to understand, validate, and refine the different approaches of unloading to treat osteoarthritis.

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No beneficial effects of joint distraction on early microscopical changes in osteoarthrotic knees

Abstract: We conclude that joint distraction has no beneficial effect on the osteoarthrotic cartilage in papain-induced osteoarthrosis, and nonarticulated distraction worsens the results.

Cited by 15 publications

References 9 publications

Effect of distraction arthroplasty on osteoarthritic goat models of the articular cartilage

Effect of distraction arthroplasty on osteoarthritic goat models of the articular cartilage

No beneficial effects of joint distraction on early microscopical changes in osteoarthrotic knees

Unloading joints to treat osteoarthritis, including joint distraction

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