Abstract
BackgroundOsteoarthritis is a degenerative joint disease that is highly prevalent worldwide. Knee osteoarthritis is the most common form of osteoarthritis and is a major cause of pain and disability. However, there remains a lack of treatments available that have demonstrated effectiveness in stopping or reversing the degenerative process. Joint distraction has emerged as a viable alternative in the treatment of knee osteoarthritis to delay the need for knee arthroplasty.MethodsAn electronic search will be conducted on MEDLINE, EMBASE, Web of Science, CINAHL, Cochrane and EBSCO databases. Clinical studies investigating joint distraction for knee osteoarthritis, which reported clinical or structural outcomes including ∆WOMAC index, ∆VAS pain score and ∆joint space width will be included. Risk of bias will be assessed using the Newcastle-Ottawa Scale for observational studies and Cochrane Collaboration tool for randomised controlled trials. Quality of studies will be assessed using the modified Coleman methodology score.DiscussionThis systematic review will summarise the short- and long-term clinical and structural outcomes following joint distraction for knee osteoarthritis. The findings from this review will establish the quality of currently available evidence, which will determine the need for further studies to establish the true effect size of this procedure.Systematic review registrationPROSPERO CRD42018087032
Highlights
Osteoarthritis is a degenerative joint disease that is highly prevalent worldwide
Knee osteoarthritis comprises of the largest proportion of all cases and is a major cause of pain and disability, which have a significant impact on quality of life [3]
Knee arthroplasty has been shown to be effective in treating osteoarthritis in patients who have impaired quality of life despite optimal conservative treatment [7,8,9]
Summary
Protocol development and registration This systematic review is registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD42018087032). Two reviewers (E.L.G. and S.C.) will screen all the titles, abstracts and full texts for inclusion, both of whom will be blinded to authors, journals, institutional affiliations and dates of publication Both reviewers will evaluate each selected reference independently and summarise relevant study characteristics. The following data items will be extracted: the year of publication, study design, sample size, country of study, type of patients, patient characteristics, joint distraction technique employed, outcome measures and conclusions. Standard mean difference with 95% confidence intervals will be used in the analysis Both the fixed-effects and random-effects model will be considered in the analysis of the data and the most appropriate
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