{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:15:23Z","timestamp":1791821723903,"version":"4.3.4"},"reference-count":23,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100018286","name":"Dutch Arthritis Society","doi-asserted-by":"publisher","award":["LLP-9"],"award-info":[{"award-number":["LLP-9"]}],"id":[{"id":"10.13039\/100018286","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Vrienden UMC Utrecht","award":["1814144"],"award-info":[{"award-number":["1814144"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["CARTILAGE"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Distraction treatment for severe osteoarthritis below the age of 65 successfully postpones arthroplasty. Most patients have been treated with a general external fixator or a device specifically intended for knee distraction. This study compares clinical efficacy of both devices in retrospect and their mechanical characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Clinical efficacy 2 years posttreatment was compared using retrospective data from patients with severe knee osteoarthritis treated with knee distraction; 63 with the Dynamic Monotube (Stryker GmbH, Switzerland) and 65 with the KneeReviver (ArthroSave BV, the Netherlands). Changes in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, stiffness, and function, general well-being (SF-36), cartilage thickness by radiographic joint space widening, and adverse events during treatment were assessed. Axial stiffness of clinically feasible configurations was assessed by bench testing for the Dynamic Monotube triax system and the KneeReviver.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>No differences were observed in clinical efficacy, nor in mechanical characteristics and adverse events between the two devices. Although with large variation, both showed a clinically relevant improvement. In mechanical testing, contact between articular surfaces was observed for both devices at physiological loading. Stiffness of applied configurations strongly varied and primarily depended on bone pin length.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients treated with a general intended-use device or a distraction-specific device both experienced clinical and structural efficacy although with significant variation between patients. The latter may be the result of varying mechanical characteristics resulting from differences in clinical configurations of the devices and actual loading. The exact role of full\/partial mechanical unloading of the joint during distraction treatment remains unclear.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19476035231226418","type":"journal-article","created":{"date-parts":[[2024,3,5]],"date-time":"2024-03-05T02:04:19Z","timestamp":1709604259000},"page":"407-416","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Comparison of Clinical Efficacy and Mechanical Characteristics of Two Knee Distraction Devices With Relevance for Clinical Practice"],"prefix":"10.1177","volume":"15","author":[{"given":"T.","family":"Struik","sequence":"first","affiliation":[{"name":"Department of Rheumatology &amp; Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1929-6350","authenticated-orcid":false,"given":"M.P.","family":"Jansen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology &amp; Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.G.P.","family":"Lafeber","sequence":"additional","affiliation":[{"name":"Department of Smart Systems for Healthy Living, University of Applied Sciences Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"Distraction Study Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.P.J.G.","family":"Lafeber","sequence":"additional","affiliation":[{"name":"Department of Rheumatology &amp; Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8825-6486","authenticated-orcid":false,"given":"S.C.","family":"Mastbergen","sequence":"additional","affiliation":[{"name":"Department of Rheumatology &amp; Clinical Immunology, UMC Utrecht, Utrecht University, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30059-4."},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/19476035231164733."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/1947603520942945."},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-021-00695-y."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2018.08.004."},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab456."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/S-0038-1669447."},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/19476035231157335."},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/J.KNEE.2021.10.007."},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.5005\/JP-JOURNALS-10080-1530."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.99B1.BJJ-2016-0099.R3."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-016-4131-0."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1947603519828432."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.142364."},{"key":"e_1_3_2_16_2","article-title":"Joint distraction using an intended device for knee osteoarthritis: a prospective two-year follow-up","volume":"31","author":"Struik T","year":"2022","unstructured":"Struik T, Mastbergen SC, Brouwer RW, Custers RJ, Van Geenen RC, Heusdens CH, et al. Joint distraction using an intended device for knee osteoarthritis: a prospective two-year follow-up. Osteoarthritis Cartilage. 2022;31:S405-S406.","journal-title":"Osteoarthritis Cartilage."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjp.2021.100007."},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.knee.2016.05.001."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2013.08.006."},{"issue":"11","key":"e_1_3_2_20_2","article-title":"Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and global assessments in patients with osteoarthritis","volume":"27","author":"Ehrich EW","year":"2000","unstructured":"Ehrich EW, Davies GM, Watson DJ, Bolognese JA, Seidenberg BC, Bellamy N. Minimal perceptible clinical improvement with the Western Ontario and McMaster Universities Osteoarthritis Index questionnaire and global assessments in patients with osteoarthritis. J Rheumatol. 2000;27(11):2635-41.","journal-title":"J Rheumatol"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2021.07.013."},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0227975."},{"issue":"8","key":"e_1_3_2_23_2","article-title":"Reproducibility of the semiflexed (metatarsophalangeal) radiographic knee position and automated measurements of medial tibiofemoral joint space width in a multicenter clinical trial of knee osteoarthritis","volume":"31","author":"Buckland-Wright JC","year":"2004","unstructured":"Buckland-Wright JC, Ward RJ, Peterfy C, Mojcik CF, Leff RL. 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