Mylène Jansen

Systematic review and meta-analysis of KJD as treatment for OA 29 2 The minimum (Figure 5) and mean (Figure S3) JSWof the most affected compartment (MAC) are reported in 3 cohorts, after 1 (n=59), 2 (n=59), 5 (n=20) and 7 (n=8) years. Both JSW measures were statistically significantly increased after 1 and 2 years (MD between 0.68 – 0.87; all p< 0.01), but after 5 and 7 years the JSW increase was no longer statistically significant (MD between 0.30 – 1.00; all p> 0.2). Figure 5 : Change in minimum joint space width (JSW) 1, 2, 5 and 7 years after treatment with knee joint distraction. References can be used multiple times because of division in patient cohort and years of follow-up. CI: confidence interval; SD: standard deviation. The MRI cartilage thickness is reported in 1 cohort after 1, 2 and 5 years (all n=20; Figure S4). After 1 (MD=0.70; p< 0.001) and 2 years (MD=0.50; p= 0.002) there was a statistically significant increase compared to pre-treatment, but after 5 years the increase was no longer significant (MD=0.20; p= 0.21). For patients treated in regular care (n=41) an increase in total WOMAC and subscales is shown, all with >20 points and p< 0.001. The MRI subgroup of RCT patients (n=16) show a cartilage thickness increase of around 0.25mm with p= 0.009. Patients treated with KJD and microfracture (n=6) showed a significant increase in VAS pain (MD=56.7; 95%CI 26.3 – 87.1; p< 0.001) and minimum JSW (MD=1.09; 95%CI 0.19 – 1.99; p= 0.02) after an average of 3 years. Patients treated with KJD, microfracture and debridement (n=19) showed a significant increase in mean JSW from 2.5 to 4.3 mm with p< 0.001 after an average of 5 years.