ArticleCartilage2026
Knee Joint Distraction and Implantable Shock Absorbers for Knee Osteoarthritis: A Systematic Review of Joint-Preserving Outcomes, Structural Changes, and Complications.
Article in Cartilage, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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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
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
ObjectiveTo systematically synthesize clinical, structural, biomarker, and safety outcomes of knee joint distraction (KJD) and implantable medial compartment shock absorbers (ISA) for tibiofemoral knee osteoarthritis (KOA), and to summarize comparative evidence versus arthroplasty, high tibial osteotomy (HTO), orthoses, and non-operative care.DesignA PRISMA-based systematic review of PubMed, EMBASE, Scopus, and Cochrane Library from inception to 1 October 2025 identified peer-reviewed clinical studies of KJD or ISA for tibiofemoral KOA. Two reviewers independently screened records, extracted data, and assessed risk of bias. Owing to substantial clinical and methodological heterogeneity and overlapping cohorts, a narrative synthesis was prespecified and no quantitative meta-analysis was performed.ResultsSeventeen studies (13 KJD, 4 ISA) reporting on approximately 400 patients met the inclusion criteria. KJD yielded clinically important 1- to 2-year improvements in WOMAC/KOOS and VAS pain, with arthroplasty-free survival of roughly 75% to 85% at 5 to 9 years in selected series, accompanied by increases in radiographic joint-space width and MRI-derived cartilage thickness in the most affected compartment. ISA consistently improved WOMAC pain and function and showed higher 2-year arthroplasty-free survival than HTO or non-operative comparators.ConclusionsCurrent evidence, based on small heterogeneous cohorts at low-to-moderate certainty, suggests that KJD and ISA can provide meaningful short- to mid-term symptom relief and delay arthroplasty in carefully selected patients. KJD and ISA address different indications and mechanisms and should be considered complementary rather than interchangeable joint-preserving strategies. Larger, independently replicated randomized trials with standardized structural and clinical endpoints are needed before widespread adoption.
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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.