Mylène Jansen

Systematic review and meta-analysis of KJD as treatment for OA 31 2 Table 3 : Changes in non-primary outcome parameters after knee joint distraction (continued) Knee joint distraction + microfracture Δ~3 years # cohorts (patients) Change P- value Knee flexion 1 (6) 14.8 (2.7 to 26.9) 0.04 JOA score 1 (6) 28.7 (23.8 to 33.5) <0.001 Knee joint distraction, microfracture + debridement Δ~5 years # cohorts (patients) Change P- value Pain (0–4) 1 (19) Median 2 (IQR 1) to 0 (1) <0.004 Walking capacity 1 (19) Range 10–15 to 32–51 <0.001 Difficulty stair climbing (y/n) 1 (19) 100% to 36% yes <0.002 Knee flexion 1 (19) Range 75–95 to 110–135 degrees <0.029 Passive flexion 1 (19) Range 85–120 to 150–170 degrees <0.193 Tibiofem- oral angle 1 (19) Range 173–189 to 171–174 degrees <0.001 ICOAP: Intermittent and Constant Osteoarthritis Pain; IQR: interquartile range; JOA: Japanese Orthopaedic Association; MCS: mental component scale; PCS: physical component scale; SF-36: Short-Form 36. Complications Complications were reported in 5 studies with 87 patients, with 57 patients developing 1 or more pin tract skin infections, resulting in a risk of pin tract infections of 63% (95%CI 45 – 81). Only 3 studies (n=62) reported treatment of complications. 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, 3 patients a pulmonary embolism and 1 patient deep vein thrombosis, all successfully treated. One patient required knee manipulation under anesthesia 17 days after frame removal, 1 patient had a broken bone pin and 1 patient experienced distraction frame failure, requiring re-fixation.