Mylène Jansen

SF biomarker changes upon KJD 327 16 Clinical outcomes Knee injury and Osteoarthritis Outcome Score (KOOS) was collected as part of usual hospital care electronically at baseline, 3, 6 and 12 months (Figure 1A). From this, KOOS 4 , a single composite score which has been validated as a single outcome in other clinical studies was calculated (the mean of 4 of 5 KOOS subscales: Pain, Symptoms, Sports/Recreation and Quality of Life). 32,33 Usual care intervention A non-hinged, external proof-of-concept fixation joint distraction frame (Monotube Triax with pin clamps, Stryker) (Figure 1B) was fitted to the index knee by an orthopedic surgeon (RC) whilst the patient was under spinal or general anesthesia (GA) and the joint surfaces distracted by 5 mm. The frame was then worn for 6–7 weeks. Figure 1 : Design and outcome measures of a proof-of-concept study to investigate synovial fluid analytes at time of knee joint distraction. (A) Flow chart indicating timings of study visits, collection of synovial fluid samples and collection of KOOS from 20 participants, including completeness of sampling/data over the 12 month study period. A further 2 participants gave consent but no baseline SF could be aspirated so they were excluded from further analysis as per protocol. (B) Illustration of distraction frame which is surgically placed on the knee joint for a 6 week period. (C) KOOS 4 measurements in participants at baseline (predistraction), 3 months, 6 months and 12 months after surgical knee joint distraction. Medians and inter-quartile ranges are shown (bar and line). KOOS: Knee Injury and Osteoarthritis Outcome Score (KOOS 4 is composite measure of 4 domains); SF: synovial fluid.