Joint Distraction for Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials .

A small body of randomized evidence has explored whether knee joint distraction (KJD) can serve as a joint-preserving option for patients with knee osteoarthritis, especially younger individuals hoping to delay arthroplasty. Across three trials comparing KJD with TKA, HTO, or physiotherapy, results were mixed but generally suggested non-inferiority to surgical comparators and short-term advantages when paired with physiotherapy. However, pin site infections were common after KJD surgery, and clinical benefits varied across outcomes and time points. Because sample sizes were small and protocols differed widely, the evidence is far too limited to support firm conclusions. Larger, well-designed RCTs are needed to clarify when, and for whom, KJD might be a meaningful alternative.