Joint distraction promotes structural repair in patients with severe knee oste...( Paris France Friday 13 June 2008: Jo...),Health

Paris, France, Friday 13 June 2008: Joint distraction (the use of a surgical frame around a degenerated joint to strengthen and promote repair) promotes cartilage repair in severe end stage osteoarthritis (OA) of the knee, as demonstrated for the first time by data presented today at EULAR 2008, the Annual Congress of the European League Against Rheumatism in Paris, France.

In the study, an external fixation frame, with springs, was used to bridge the knee joint in 19 relatively young osteoarthritis patients (<60 years). The frame was then distracted by 5mm over a period of two months with the aim of promoting knee repair by removing mechanical stress on the knee. The functional ability and pain scores of the patients were poor before treatment (40% and 30% of the maximum WOMAC score), however, following joint distraction, both scores increased to more than 80%, equivalent to almost complete normalisation in terms of symptoms experienced.

MRI and digital x-ray evaluation carried out at baseline and at one year follow up showed evidence of cartilage repair. Cartilage volume and subchondral bone covered with cartilage increased by 50% and 40% respectively and mean cartilage thickness increased from baseline to one year follow up. Biomarkers of cartilage and bone (breakdown and synthesis), measured in serum and urine, demonstrated an increased level of turnover of cartilage and bone during distraction that returned to normal in the months after treatment, with a gradual increase for cartilage synthesis markers over time indicative of structural repair due to distraction.

Professor Floris Lafeber of the University Medical Center Utrecht, The Netherlands, who led the study, said, "We are delighted to report such an impressive outcome in the use of joint distraction for severe osteoarthritis of the knee. Positive results have been sustained over the two year follow up period, suggesting the potential for joint distraction to delay the nee
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