Unloading joints to treat osteoarthritis, including joint distraction

Lafeber, Floris P. J. G.; Intema, F.; Roermund, P.M. van; Marijnissen, A.C.

doi:10.1097/01.bor.0000240366.54960.a1

Cited by 86 publications

(62 citation statements)

References 51 publications

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“…Despite previous reviews that are generally supportive of valgus bracing and highlight their relatively low cost and associated risks (11,(52)(53)(54), the rates of valgus brace prescription are very low (23)(24)(25). The personal costs, complications, and poor long-term compliance associated with valgus bracing are previously noted concerns that may influence patient decisions and clinical practices (11,23,55,56). The present meta-analysis suggests that minor complications, such as constraining fit, slipping, swelling, blisters, and skin irritation are indeed relatively common (Figure 3).…”

Section: Discussionmentioning

confidence: 99%

Valgus Bracing for Knee Osteoarthritis: A Meta‐Analysis of Randomized Trials

Moyer

Birmingham

Bryant

et al. 2015

Arthritis Care & Research

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Objective. To evaluate the effects of valgus knee bracing on pain and function, and compliance and complications, in patients with medial knee osteoarthritis (OA). Methods. A meta-analysis of randomized controlled trials that compared changes in patient-reported pain and/or function in patients with medial knee OA was performed. Seven databases were searched from their inception to January 2014. Two reviewers independently determined study eligibility, rated risk of bias, and extracted data. Pooled estimates and 95% confidence intervals (95% CIs) for standardized mean differences (SMDs) for the improvement in pain (and function) were calculated. Event rates (proportions) were calculated for studies that reported complications.

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Section: Discussionmentioning

confidence: 99%

Valgus Bracing for Knee Osteoarthritis: A Meta‐Analysis of Randomized Trials

Moyer

Birmingham

Bryant

et al. 2015

Arthritis Care & Research

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“…A secondary (mechanical) trigger is likely to be involved in the actual set off of irreversible joint damage and by that induction of OA, 2 specifically in larger weightbearing joints such as the knee. 3 A mechanical trigger can be of high impact, as in trauma, or moderate but structural overload, as in obesity or malaligned joints. 4 One of the major problems of OA is that presently available treatment options are limited, and aim at relieving symptoms instead of curing the disease.…”

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confidence: 99%

The canine bilateral groove model of osteoarthritis

Intema

DeGroot²,

Elshof

et al. 2008

Journal Orthopaedic Research

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In studies aimed at local treatment of experimental osteoarthritis (OA) it is optimal to have an internal (untreated) OA control. Such an approach excludes interanimal variation, and allows paired statistical evaluation of treatment efficacy. For this purpose, we developed and characterized a bilateral version of the canine Groove model. We hypothesized that the bilateral version of the canine Groove model would show consistent and clear development of features of OA similar to those found in the unilateral version. In six Beagle dogs, grooves were surgically made in the articular cartilage of the femoral condyles of both knee joints. Six additional dogs underwent bilateral sham surgery. The degree of OA was quantified 20 weeks after surgery and was compared in retrospect to 23 animals that undergone the same procedure in a single knee joint with the contralateral knee serving as a non-OA control. Bilateral groove surgery resulted in OA. This was based on the observed ineffective repair response in which an increase in proteoglycan synthesis, a diminished retention of these newly formed proteoglycans, and an enhanced loss of resident proteoglycans resulted in a decreased cartilage proteoglycan content. These biochemical effects were corroborated by clear histological features of OA. All these effects were found in femor as well as in the (surgically untouched) tibia. Interestingly, features of OA were slightly more severe in the bilateral model than in the unilateral variant. The bilateral canine Groove model showed consistent and clear development of features of OA, comparable to the unilateral model.

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“…25 Several factors might be involved in the role of loading/unloading in the course of OA. It might be directly related to chondrocyte activity precipitating the different loading patterns, or it might be the extra cellular matrix that is vulnerable to overload.…”

Section: Discussionmentioning

confidence: 99%

Does loading influence the severity of cartilage degeneration in the canine Groove‐model of OA?

Vos

Interma

El³

et al. 2009

Journal Orthopaedic Research

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Many animal models are used to study osteoarthritis (OA). In these models the role of joint loading in the development of OA is not fully understood. We studied the effect of loading on the development of OA in the canine Groove-model. In ten female beagle dogs OA was induced in one knee according to the Groove-model. The animals were divided in groups with and without forced-loading. Forced-loading was achieved by fixing the contra-lateral limb to the trunk 3 times a week for 4 hours. After 20 weeks joint tissues of all dogs were evaluated. Subjective evaluation revealed less movement with more loading in the forced-loading-group compared to the group without forced-loading. In both groups induction of OA resulted in macroscopical and microscopical OA changes as well as alterations in cartilage metabolism characteristics for OA. Although differences were small, for some parameters they were statistically significant for the forced-loading-group. There were no differences between the contra-lateral healthy joints of both groups. The present study demonstrates that in the Groove-model intensified loading is not a prerequisite for the development of OA, although it adds to some extent to the severity of the OA. ß

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Unloading joints to treat osteoarthritis, including joint distraction

Cited by 86 publications

References 51 publications

Valgus Bracing for Knee Osteoarthritis: A Meta‐Analysis of Randomized Trials

Valgus Bracing for Knee Osteoarthritis: A Meta‐Analysis of Randomized Trials

The canine bilateral groove model of osteoarthritis

Does loading influence the severity of cartilage degeneration in the canine Groove‐model of OA?

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