Knee distraction is a temporary surgical treatment that preserves your joint and can delay the placement of a knee prosthesis (artificial knee). Here you can find an explanation of what the treatment involves.

Knee distraction is suitable for patients with painful knee osteoarthritis who no longer respond well to conservative treatment such as pain relief and/or physiotherapy. Here you can find more information about which patients are suitable for this treatment. Your doctor will determine together with you whether you are suitable for this treatment.

Distraction of a painful (osteoarthritis) knee with the ArthroSave KneeReviver aims to delay the placement of a knee prosthesis (artificial knee) for as long as possible. The majority of patients whose painful knee is treated with distraction experience significantly less pain and better function. This results in the postponement of knee prosthesis placement. Additionally, treatment with the ArthroSave KneeReviver can result in tissue regeneration.

Scientific research (Jansen 2022 Jansen 2018) shows that 81% of patients still have their own knee after 5 years of knee distraction, and 48% even after 9 years.

Delaying a knee prosthesis (artificial knee) in patients aged 65 or younger is important because a knee prosthesis, made of metal and plastic, also wears out. The lifespan of a knee prosthesis ranges from 10 to 20 years. A knee prosthesis lasts shorter in younger and more active patients, necessitating replacement through so-called revision surgery over time. Since the results after a revision are less favorable, it is beneficial to try to avoid this by postponing the placement of a first knee prosthesis by several years, preferably until the age of 65 or older.

Before the surgery, you can already learn to walk with crutches, possibly under the guidance of a physiotherapist. This physiotherapist will also treat you during and after the treatment. It is important to keep the knee moving to try to prevent swelling and pain as much as possible.

Placing the KneeReviver takes 30 to 45 minutes.

After consulting with the anesthesiologist, you will receive general anesthesia or an epidural.

You may bear weight on your knee during the treatment. Support with crutches while walking is recommended. Additionally, the physiotherapist can help you with specific exercises to keep the muscle strength in the muscle groups around the knee as much as possible. During the treatment, your leg is fixed in the frame, preventing you from bending your knee. This means you cannot drive a car yourself.

Six to seven weeks after the surgery, the KneeReviver along with the bone pins will be removed in a day treatment. After consultation with the anesthetist, you will receive either general anesthesia or an epidural. Since you have not been able to bend your knee for six weeks, the orthopedic surgeon will mobilize the ‘stiff’ knee while you are under anesthesia. This mobilization facilitates the performance of mobility exercises after distraction. The holes in the skin where the bone pins were will be covered with gauze or bandages and will close up within a week. You can also shower again. Always ensure that the wounds remain clean. You will receive specific instructions for this.

You may fully bear weight on your knee and try to bend it as long as it does not cause pain. However, we advise gradually increasing the weight-bearing and bending. A physiotherapist can provide advice in this regard. It is important to note that it may take several months before you notice a reduction in pain in your arthritic knee.

This varies for each patient, so discuss your personal recovery plan with your treating physician. For a group of patients who have had the KneeReviver treatment in the past, 91% could return to work within six months, and 73% could play sports again within six months.

Be aware that the knee may swell slightly due to the distraction. This is a normal reaction. During the knee distraction treatment, the following side effects may occur:

• There may be wound fluid coming from the pin sites in your skin. This can sometimes lead to a pin site infection. You may feel pain at one of the bone pins. The skin around this pin may become red, and cloudy fluid may come out. You may also develop a fever.
• If you start the prescribed antibiotic course immediately upon experiencing any of these symptoms, the pain usually subsides and disappears within one to two days.
• Sometimes an antibiotic course is not necessary. In case of doubt, you can always consult the orthopedic surgeon or your general practitioner.
• If a pin site infection is not properly treated, the bone may become infected.
• There is a small risk of a blood clot (thrombosis or pulmonary embolism). To reduce this risk, you must give yourself a small injection of anticoagulant medication daily into a skin fold of the abdomen. This will be taught to you in the hospital.
• In rare cases, nerve damage can occur due to the surgery.
• In rare cases, a severe bleeding (compartment syndrome) requiring urgent surgery can occur.

ArthroSave continuously collects experiences from patients who have undergone the knee distraction treatment. Here you can read these experiences.

Treatment centers in the Netherlands: Here you can find all the information about the distraction study and the hospitals participating in it. Treatment centers outside the Netherlands: Fill out this form and ArthroSave will contact you.