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Clinical outcomes of knee joint distraction combined with marrow stimulation procedures for patients with advanced knee osteoarthritis.
Adachi, Nobuo; Hayashi, Seiju; Nakamae, Atsuo; Ishikawa, Masakazu; Kamei, Goki; Ikuta, Yasunari; Deie, Masataka; Ochi, Mitsuo.
Afiliación
  • Adachi N; Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan. Electronic address: nadachi@hiroshima-u.ac.jp.
  • Hayashi S; Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
  • Nakamae A; Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
  • Ishikawa M; Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
  • Kamei G; Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
  • Ikuta Y; Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
  • Deie M; Department of Orthopedic Surgery, Aichi Medical University, Yazakokarimata, Nagakute, Aichi 480-1195, Japan.
  • Ochi M; Department of Orthopedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan.
Knee ; 33: 342-350, 2021 Dec.
Article en En | MEDLINE | ID: mdl-34749126
ABSTRACT

BACKGROUND:

Knee joint distraction (KJD) has received much attention as a joint preserving surgery, especially in young patients with advanced knee osteoarthritis (OA).

METHODS:

This study included 16 patients with advanced knee OA who underwent KJD combined with marrow stimulating techniques and were followed up for more than 2 years. The patients' clinical scores, including the Japanese Orthopaedic Association (JOA) score, Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales, ROM, joint space width, and semiquantitative MRI were evaluated. The factors affecting clinical outcomes were analyzed.

RESULTS:

Postoperatively, the JOA score and the individual scores of the KOOS subscales improved significantly (JOA score P = 0.0028, KOOS-symptoms P = 0.0016, -pain P = 0.0011, -ADL P = 0.0009, -sports/recreation P = 0.0144, and -QOL P = 0.0034). Although the extension of the knee joint did not change throughout the follow-up period, flexion of the joint deteriorated at the time of device removal but recovered to the preoperative level at the final follow-up. Preoperative joint space width was 2.4 ± 2.0 mm and at the final follow-up, it increased to 3.3 ± 1.5 mm, showing statistically significant improvement (P = 0.034). The postoperative semiquantitative MRI score also improved significantly (from 6.0 ± 3.0 to 42.1 ± 28.7, P = 0.0001). A high BMI was associated with a poor clinical outcome.

CONCLUSION:

Although the effect of marrow stimulating techniques for cartilage repair was not well clarified and the complication rate was high, the clinical and radiographic outcomes showed significant improvement after KJD combined with marrow stimulating techniques in patients with advanced knee OA. However, we should be careful about suggesting this procedure in obese patients.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoartritis de la Rodilla Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Knee Asunto de la revista: ORTOPEDIA Año: 2021 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Osteoartritis de la Rodilla Aspecto: Patient_preference Límite: Humans Idioma: En Revista: Knee Asunto de la revista: ORTOPEDIA Año: 2021 Tipo del documento: Article