Joint distraction in the treatment of degenerative articular cartilage damage
Laar, A.M. van
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Joint distraction is a technique that has been used to treat a variety of joint diseases, including degenerative arthropathies such as osteoarthritis (OA) and chondrolysis. It has been suggested that joint distraction could promote cartilage regeneration. However, treatment outcomes and study features have not been compared yet to allow a thorough evaluation, and actual cartilage repair has not been reported in clinical studies before. Therefore, we performed a systematic literature review on clinical and preclinical publications about joint distraction in subjects with degenerative cartilage damage. After a well defined literature screening, 30 publications were included, which showed the clinical methods and results of joint distraction of the hip, ankle, knee, hand or foot, or were preclinical animal studies concerning distraction of the knee or spine. In general, joint distraction has been found to reduce pain and to improve joint mobility, function and joint space width (JSW). Joint distraction is especially effective in younger, active subjects without serious synovial inflammation. Joint motion and weight bearing during or shortly after distraction optimises treatment outcome. From preclinical studies, there is evidence for repair of cartilage damage during joint distraction. Further studies may lead to improved therapies as well as to a better understanding of the regeneration capacity of cartilage.