Knee joint distraction is more efficient in rebuilding cartilage thickness in the more affected compartment than high tibial osteotomy in patients with knee osteoarthritis

Knee Joint Distraction as Treatment for Osteoarthritis Results in Clinical and Structural Benefit: A Systematic Review and Meta-Analysis of the Limited Number of Studies and Patients Available

“…Of these, 3 were excluded, since they reported on a subgroup from other included articles without reporting extra information on primary outcomes, leaving 11 articles included for analysis. [12][13][14][15][16][17][18][19][20][21][22] As multiple articles reported on different follow-up moments in the same patient cohorts, the overview of selected studies is separated per cohort of KJD-treated patients and control groups ( Table 1). 23 A total of 7 patient cohorts were treated with KJD, of which 2 in combination with another treatment: 1 cohort of 6 patients was treated with KJD and microfracture 13 and 1 cohort of 19 patients treated with KJD, microfracture, and debridement 15 that also had a control group of 42 patients treated with microfracture and debridement alone.…”

“…12 Last, a subgroup of 16 KJD patients and 17 HTO patients from the previously mentioned RCTs were evaluated and compared on an additional outcome measure (MRI cartilage thickness) after 2 years in a conference abstract. 14 The risk of bias for the included articles is shown in Figure 2. As blinding of patients and personnel was not possible in any study and blinding of outcome measures only for structural parameters, none of the included articles had a completely low risk of bias.…”

“…Only the RCTs [20][21][22] had a low selection bias and only Jansen et al same research group. Last, Jansen et al 12,14 had a lot of unclear bias since they are conference abstracts and as such did not report all information required to judge. No indication for publication bias was found.…”

“…12 Last, a subgroup of 16 KJD patients and 17 HTO patients from the previously mentioned RCTs were evaluated and compared on an additional outcome measure (MRI cartilage thickness) after 2 years in a conference abstract. 14 The risk of bias for the included articles is shown in same research group. Last, Jansen et al 12,14 had a lot of unclear bias since they are conference abstracts and as such did not report all information required to judge.…”

“…The majority of infections could be treated with oral antibiotics, resulting in a 57% (95% CI 33-82) risk of an infection requiring oral antibiotics and a 10% (95% CI 1-18) risk of an infection (including osteomyelitis, n = 1) requiring intravenous antibiotics. Also, 1 patient experienced postoperative foot drop, 20 54.9 (SeM 1.8) 11:9 27.4 (SeM 0.9) 0:1:8:11 6 Van der Woude 2017 22 51.2 (SeM 1.1) 6:16 27.5 (SeM 0.7) 6:4:11:1 6.1 (range 5.6-7.1) Jansen 2019 12 54.3 (SD 6.8) 17:23 27.7 (SD 3.9) 0:7:23:10 6.5 (SD 0.6) Jansen 2019 14 Median 3 (iQr 1)…”