A line in which our expertise on cartilage and (un)loading is combined with the clinical expertise of the department of orthopedics (see collaborations). Joint distraction is an approach, based on the hypothesis that osteoarthritic cartilage has reparative activity. The hypothesis is that this reparative activity is the most effective when the cartilage surfaces are mechanically unloaded, preventing further wear and tear, while the intermittent fluid pressure in the joint is maintained, required for nutrition of the cartilage cells (cartilage tissue is not vascularised). Additionally, as a result of distraction, subchondral sclerosis is normalized (decreased stiffness), resulting in less mechanical stress on the cartilage. Proof of concept has been provided for severe ankle osteoarthritis. We demonstrated almost complete normalisation of pain, and functional ability in 75% of the treated patients for a period of 10 yrs. In addition, cartilage repair was suggested by clear signs on radiographs.
At present we focus on the effects of joint distraction in treatment of severe knee osteoarthritis. In addition to evaluation of clinical benefit there is a focus on the evaluation of structural changes in cartilage and bone by use of state of the art imaging techniques and biomarker analysis.
For more information contact Dr Peter van Roermund (email: P.M.vanRoermund@umcutrecht.nl) or Dr Anne Karien Marijnissen (email: A.C.A.Marijnissen@umcutrecht.nl)