ArticlePloS one2016
Knee Joint Distraction Compared to Total Knee Arthroplasty for Treatment of End Stage Osteoarthritis: Simulating Long-Term Outcomes and Cost-Effectiveness.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- Pooled it
- Pooled it
- The Knee Arthroplasty versus Joint Distraction Study for Osteoarthritis (KARDS): lessons learnt from an internal pilot trial.Health technology assessment (Winchester, England) · 2025Trial
- Trial
- Mechanotransduction and musculoskeletal regeneration: Molecular mechanisms and interdisciplinary applications.Genes & diseases · 2026Review
- Article
- Patient-specific instrumentation in shoulder arthroplasty: high tech, low yield?Clinics in shoulder and elbow · 2025Article
- Decision Analysis in the Management of Hip and Knee Osteoarthritis: A Systematic Review.Cureus · 2025Review
- Esketamine alleviated cardiomyocyte ferroptosis induced by oxygen-glucose deprivation/reoxygenation (OGD/R) via cyclic GMP-AMP synthase interactor.Cytotechnology · 2025Article
- Forecasting the value of innovation in total knee arthroplasty care: A headroom approach.Journal of experimental orthopaedics · 2024Article
- Joint distraction using a purpose-built device for knee osteoarthritis: a prospective 2-year follow-up.RMD open · 2023Article
- Harnessing joint distraction for the treatment of osteoarthritis: a bibliometric and visualized analysis.Frontiers in bioengineering and biotechnology · 2023Article
- Article
- Article
- Role of joint distraction in osteoarthritis of the knee: Basic science, principles and outcomes.Journal of clinical orthopaedics and trauma · 2022Review
- The molecular profile of synovial fluid changes upon joint distraction and is associated with clinical response in knee osteoarthritis.Osteoarthritis and cartilage · 2020Article
- Gait Analysis after Total Knee Arthroplasty Assisted by 3D-Printed Personalized Guide.BioMed research international · 2020Article
- Knee joint distraction in regular care for treatment of knee osteoarthritis: A comparison with clinical trial data.PloS one · 2020Article
- Managing rheumatic and musculoskeletal diseases - past, present and future.Nature reviews. Rheumatology · 2017Review
- Modelling the cost-effectiveness of total knee arthroplasty: A systematic review.Journal of orthopaedicsReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn end-stage knee osteoarthritis the treatment of choice is total knee arthroplasty (TKA). An alternative treatment is knee joint distraction (KJD), suggested to postpone TKA. Several studies reported significant and prolonged clinical improvement of KJD. To make an appropriate decision regarding the position of this treatment, a cost-effectiveness and cost-utility analysis from healthcare perspective for different age and gender categories was performed.
methodsA treatment strategy starting with TKA and a strategy starting with KJD for patients of different age and gender was simulated. To extrapolate outcomes to long-term health and economic outcomes a Markov (Health state) model was used. The number of surgeries, QALYs, and treatment costs per strategy were calculated. Costs-effectiveness is expressed using the cost-effectiveness plane and cost-effectiveness acceptability curves.
resultsStarting with KJD the number of knee replacing procedures could be reduced, most clearly in the younger age categories; especially revision surgery. This resulted in the KJD strategy being dominant (more effective with cost-savings) in about 80% of simulations (with only inferiority in about 1%) in these age categories when compared to TKA. At a willingness to pay of 20.000 Euro per QALY gained, the probability of starting with KJD to be cost-effective compared to starting with a TKA was already found to be over 75% for all age categories and over 90-95% for the younger age categories.
conclusionA treatment strategy starting with knee joint distraction for knee osteoarthritis has a large potential for being a cost-effective intervention, especially for the relatively young patient.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.