Knee Joint Distraction in a Dog as Treatment for Severe Osteoarthritis

Abstract

Osteoarthritis (OA) is the most common joint disease diagnosed in veterinary practice. There is no cure; where conservative treatment fails, a joint prosthesis is the last resort. In human OA patients, temporary distraction is a joint-preserving treatment which provides clinical and structural benefits, and postpones the need for total knee replacement for up to 9 years. In this single case, feasibility of knee joint distraction (KJD) was assessed in a 9-year-old female Dobermann with severe OA. Osteoarthritis of the left stifle joint was diagnosed clinically and radiographically. Knee joint distraction was applied for 7 weeks using a custom-made, hinged, external fixator. Follow-up of 1 year included owner questionnaires, orthopaedic examination, radiography, and force plate analysis. Additionally, synovial fluid biomarkers were assessed. Application and removal of the KJD frame were successfully accomplished without surgical complications. During KJD, the dog tolerated the frame well and maintained the use of the left hindlimb. Mild pin tract infection developed during the distraction period, which responded well to oral antibiotic medications. Owners reported clinical improvement during KJD and the follow-up period. This was confirmed by force plate analysis, demonstrating improvement from 3 months and onward. KJD proved to be a feasible strategy to treat end-stage OA in this single case; clinical efficacy remains to be determined in a larger cohort.

Knee Joint Osteoarthritis in Overweight Cats: The Clinical and Radiographic Findings

“…However, in the recent study, the authors did not consider non-specific symptoms, such as apathy, which seems to be the most common clinical symptom. Therefore, one may conclude that when the owner reports any unusual behavior of the cat, the veterinarian should take a detailed history driven to identify non-specific clinical symptoms of OA, especially as dogs suffering from knee joint OA most frequently show discomfort followed by other more specific clinical symptoms such as pain, limited joint range of motion, loss of muscle mass, reduced activity level, and lameness [53,67,68]. Similarly, in humans suffering from knee joint OA, joint pain and tenderness, short-term morning stiffness, and restricted movement may occur early in the disease.…”

The catabolic-to-anabolic shift seen in the canine osteoarthritic cartilage treated with knee joint distraction occurs after the distraction period

“…Finally, as the dog is not only a suitable animal model for OA but also a species that suffers from spontaneous OA [ 10 ], the techniques optimized for this animal model could be applied to treat dogs with OA. KJD has been shown to be a feasible treatment strategy for dogs with severe end-stage OA, although efficacy has to be proven in larger clinical studies [ 15 ].…”

“…Limb loading was assessed using gait analysis ( Fig. 1 A) as described previously [ 15 ]. Briefly, vertical (Fz) and craniocaudal (Fy) forces at walking speed were measured using a force plate mounted flush with the surface of an 11-meter walkway with 100 ​Hz sampling frequency.…”

Harnessing joint distraction for the treatment of osteoarthritis: a bibliometric and visualized analysis

“…In addition to regenerative therapies, joint distraction, a minimally invasive surgical procedure, entails delicately separating the two osseous extremities of a joint and maintaining them at a specific distance for a designated period through the use of an external fixation frame (Teunissen et al, 2022). First elucidated in the 1990 s, it has subsequently emerged as a pivotal joint-preserving modality for individuals afflicted with end-stage OA, who are candidates for joint replacement surgery (Aldegheri et al, 1994;Lafeber et al, 2006).…”