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A New Articulated Distraction Arthroplasty Device for Treatment of the Osteoarthritic Knee Joint: A Preliminary Report

      Purpose: The aim of this study was to evaluate the clinical results of a new distraction arthroplasty device when used in conjunction with a bone marrow–stimulating technique for the treatment of osteoarthritis of the knee. Methods: We developed a new distraction arthroplasty device that allows continuous joint movement. We compared preoperative and postoperative findings for 6 knees (6 patients; age range, 42 to 58 years). The fixation period for the distraction device ranged from 7 to 13 weeks, and the follow-up period ranged from 1 to 3.5 years. Results: The Japanese Orthopaedic Association knee score, range of motion, and joint space values were significantly improved in all cases at the latest follow-up (P < .05). Scores on a visual analog pain scale were also significantly improved (P < .05). Conclusions: We conclude that treatment using this new arthroplasty device in combination with a bone marrow–stimulating method was effective for osteoarthritic knees in middle-aged patients. Level of Evidence: Level IV, therapeutic case series.

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      References

        • Creamer P.
        • Hochberg M.C.
        Osteoarthritis.
        Lancet. 1997; 350: 503-508
        • Felson D.T.
        • Lawrence R.C.
        • Dieppe P.A.
        • Hirsch R.
        • Helmick C.G.
        • Jordan J.M.
        Osteoarthritis: New insights.
        Ann Intern Med. 2000; 133: 635-646
        • Michel N.
        The resurfacing of adults rabbit articular cartilage by multiple perforations through the subchondral bone.
        J Bone Joint Surg Am. 1976; 58: 230-233
        • Steadman J.R.
        • Rodkey W.G.
        • Rodrigo J.J.
        Microfracture: Surgical technique and rehabilitation to treat chondral defects.
        Clin Orthop Relat Res. 2001; : 362-369
        • O’Driscoll S.W.
        • Salter R.B.
        The repair of major osteochondral defects in joint surfaces by neochondrogenesis with autogenous osteoperiosteal grafts stimulated by continuous passive motion.
        Clin Orthop Relat Res. 1986; : 131-140
        • Ochi M.
        • Uchio Y.
        • Tobita M.
        • Kuriwaka M.
        Current concepts in tissue engineering technique for repair of cartilage defect.
        Artif Organs. 2001; 25: 172-179
        • Ochi M.
        • Uchio U.
        • Kawasaki K.
        • Iwasa J.
        Transplantation of cartilage-like tissue made by tissue engineering in the treatment of cartilage defects of the knee.
        J Bone Joint Surg Br. 2002; 84: 571-578
        • Brittberg M.
        • Lindahl A.
        • Nilsson A.
        • Ohlsson C.
        • Isaksson O.
        • Peterson L.
        Treatment of deep cartilage defects in the knee with autologous chondrocyte transplantation.
        N Engl J Med. 1994; 331: 889-895
        • Peterson L.
        • Minas T.
        • Brittberg M.
        • Nilsson A.
        • Sjogren-Jansson E.
        • Lindahl A.
        Two- to 9-year outcome after autologous chondrocyte transplantation of the knee.
        Clin Orthop Relat Res. 2000; : 212-234
        • Matsusue Y.
        • Yamamuro T.
        • Hama H.
        Arthroscopic multiple osteochondral transplantation to the chondral defect in the knee associated with anterior cruciate ligament disruption.
        Arthroscopy. 1993; 7: 318-321
        • Hangody L.
        • Fules P.
        Autologous osteochondral mosaicplasty for the treatment of full-thickness defects of weight-bearing joints: Ten years of experimental and clinical experience.
        J Bone Joint Surg Am. 2003; 85: 25-32
        • Gill G.S.
        • Joshi A.B.
        Long-term results of Kinematic Condylar knee replacement.
        J Bone Joint Surg Br. 2001; 83: 355-358
        • Stuart M.J.
        Arthroscopic management for degenerative arthritis of the knee.
        Instr Course Lect. 1999; 48: 135-141
        • Buckwalter J.A.
        • Mankin H.J.
        Articular cartilage: Degeneration and osteoarthritis, repair, regeneration, and transplantation.
        Instr Course Lect. 1998; 47: 487-504
        • Bae D.K.
        • Yoon K.H.
        • Song S.J.
        Cartilage healing after microfracture in osteoarthritic knees.
        Arthroscopy. 2006; 22: 367-374
        • Kreuz P.C.
        • Erggelet C.
        • Steinwachs M.R.
        • et al.
        Is microfracture of chondral defects in the knee associated with different results in patients aged 40 years or younger?.
        Arthroscopy. 2006; 22: 1180-1186
        • Akizuki S.
        • Yasukawa Y.
        • Takizawa T.
        Does arthroscopic abrasion arthroplasty promote cartilage regeneration in osteoarthritic knees with eburnation?.
        Arthroscopy. 1997; 13: 9-17
        • Koshino T.
        • Wada S.
        • Ara Y.
        • Saito T.
        Regeneration of degenerated articular cartilage after high tibial valgus osteotomy for medial compartmental osteoarthritis of the knee.
        Knee. 2003; 10: 229-236
        • Buckwalter J.A.
        Joint distraction for osteoarthritis.
        Lancet. 1996; 347: 279-280
        • Aldegheri R.
        • Trivella G.
        • Saleh M.
        Articulated distraction of the hip: Conservative surgery for arthritis in young patients.
        Clin Orthop Relat Res. 1994; : 94-101
        • van Valburg A.A.
        • van Roermund P.M.
        • Marijnissen A.C.
        • et al.
        Joint distraction in treatment of osteoarthritis: A two-year follow-up of the ankle.
        Osteoarthritis Cartilage. 1999; 7: 474-479
        • Karadam B.
        • Karatosun V.
        • Murat N.
        • Ozkal S.
        • Gunal I.
        No beneficial effects of joint distraction on early microscopical changes in osteoarthrotic knees.
        Acta Orthop. 2005; 76: 95-98
        • Kajiwara R.
        • Ishida O.
        • Kawasaki K.
        • Adachi N.
        • Yasunaga Y.
        • Ochi M.
        Effective repair of a fresh osteochondral defect in the rabbit knee joint by articulated joint distraction following subchondral drilling.
        J Orthop Res. 2005; 23: 909-915
        • Rosenberg T.D.
        • Paulos L.E.
        • Parker R.D.
        • Coward D.B.
        • Scott S.M.
        The forty-five-degree posteroanterior flexion weight-bearing radiograph of the knee.
        J Bone Joint Surg Am. 1988; 70: 1479-1482
        • Volkol M.V.
        • Oganesian O.V.
        Restoration of function in the knee and elbow with a hinge-distractor apparatus.
        J Bone Joint Surg Am. 1975; 57: 591-600