Joint Unloading Implant Modifies Subchondral Bone Trabecular Structure in Medial Knee Osteoarthritis: 2-year Outcomes of a Pilot Study Using Fractal Signature Analysis

Overview

Journal Clin Interv Aging

Publisher Dove Medical Press

Specialty Geriatrics

Date 2015 Feb 12

PMID 25670891

Citations 9

Authors

Larry E Miller

Miki Sode

Thomas Fuerst

Jon E Block

Affiliations

Soon will be listed here.

Abstract

Background: Knee osteoarthritis (OA) is largely attributable to chronic excessive and aberrant joint loading. The purpose of this pilot study was to quantify radiographic changes in subchondral bone after treatment with a minimally invasive joint unloading implant (KineSpring(®) Knee Implant System).

Methods: Nine patients with unilateral medial knee OA resistant to nonsurgical therapy were treated with the KineSpring System and followed for 2 years. Main outcomes included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, function, and stiffness subscores and independent core laboratory determinations of joint space width and fractal signature of the tibial cortex.

Results: WOMAC scores, on average, improved by 92% for pain, 91% for function, and 79% for stiffness over the 2-year follow-up period. Joint space width in the medial compartment of the treated knee significantly increased from 0.9 mm at baseline to 3.1 mm at 2 years; joint space width in the medial compartment of the untreated knee was unchanged. Fractal signatures of the vertically oriented trabeculae in the medial compartment decreased by 2.8% in the treated knee and increased by 2.1% in the untreated knee over 2 years. No statistically significant fractal signature changes were observed in the horizontally oriented trabeculae in the medial compartment or in the horizontal or vertical trabeculae of the lateral compartment in the treated knee.

Conclusion: Preliminary evidence suggests that the KineSpring System may modify knee OA disease progression by increasing joint space width and improving subchondral bone trabecular integrity, thereby reducing pain and improving joint function.

Citing Articles

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Trabecular bone texture analysis of conventional radiographs in the assessment of knee osteoarthritis: review and viewpoint.

Almhdie-Imjabbar A, Podsiadlo P, Ljuhar R, Jennane R, Nguyen K, Toumi H Arthritis Res Ther. 2021; 23(1):208.

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Quantitative imaging of bone remodeling in patients with a unicompartmental joint unloading knee implant (ATLAS Knee System)-effect of metal artifacts on a SPECT-CT-based quantification.

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Two-Year Results of the PHANTOM High Flex Trial: A Single-Arm Study on the Atlas Unicompartmental Knee System Load Absorber in Patients With Medial Compartment Osteoarthritis of the Knee.

Slynarski K, Walawski J, Smigielski R, van der Merwe W Clin Med Insights Arthritis Musculoskelet Disord. 2019; 12:1179544119877170.

PMID: 31579106 PMC: 6757501. DOI: 10.1177/1179544119877170.

Can UKA after KineSpring system failure be a viable option? A case report.

Niccoli G, Di Benedetto P, Salviato D, Beltrame A, Gisonni R, Cainero V Acta Biomed. 2019; 90(1-S):192-197.

PMID: 30715024 PMC: 6503415. DOI: 10.23750/abm.v90i1-S.8075.

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