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- W2324961504 abstract "Purpose: For young patients (<65 years), knee joint distraction (KJD) may be a joint-saving treatment option for end stage knee osteoarthritis. Distracting femur from tibia 5 mm for 6–8 weeks using an external fixation frame results in addition to prolonged clinical benefit also in cartilaginous tissue repair. However, cartilaginous tissue repair by use of joint distraction is still controversial, and it not clear which patients favor the most of this treatment regarding this cartilage tissue repair. This study is a first attempt to predict the degree of cartilaginous tissue repair upon KJD by use of baseline variables. Methods: Fifty-seven consecutive patients received KJD. Twenty patients were included in an open prospective study and had end-stage knee OA, initially considered for total knee arhtroplasty (TKA) and received eight weeks distraction. The remaining thirty-seven patients were included in ongoing randomized controlled trials. These RCTs compare KJD with presently applied surgical alternatives (TKA or high tibial osteotomy; HTO). At baseline and at one-year mean and minimum joint space width (JSW) of the most affected compartment was determined on standardized weight-bearing, semi-flexed posterior-anterior radiographs. KIDA software was used to determine mean and min JSW. Baseline (pre-treatment) patient characteristics were gender, distraction time (six or eight weeks of distraction performed), HTO or TKA indication, age, BMI, min JSW, mean JSW of the MAC, and Kellgren & Lawrence grade (KLG). To evaluate the predictive ability of baseline characteristics for JSW at one-year multivariable linear regression analysis was performed. Results: For a larger mean JSW at one-year follow-up only KLG at baseline was predictive (β = 0.474, 95% CI = 0.180–0.768, p = 0.002). For a larger min JSW, KLG (β = 0.462, 95% CI = 0.193–0.731, p = 0.001) and male gender (β = 0.524, 95% CI = 0.058–0.991, p = 0.028) were significantly predictive. Eight weeks of distraction time neared significance (β = 0.439, 95% CI = −0.054–0.931, p = 0.080). Conclusions: This study is the first to demonstrate that KLG, male gender, and distraction time of osteoarthritis patients treated with KJD predict radiographic determined cartilaginous thickness one-year after treatment." @default.
- W2324961504 created "2016-06-24" @default.
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- W2324961504 date "2016-04-01" @default.
- W2324961504 modified "2023-09-28" @default.
- W2324961504 title "Prediction of degree of cartilaginous tissue repair as observed by knee joint distraction" @default.
- W2324961504 doi "https://doi.org/10.1016/j.joca.2016.01.770" @default.
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