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Case Study of Continuous Knee Joint Traction Treatment on the Pain and Quality of Life of Patients with Degenerative Gonarthritis

Case Study of Continuous Knee Joint Traction Treatment on the Pain and Quality of Life of Patients with Degenerative Gonarthritis Case Study of Continuous Knee Joint Traction Treatment on the Pain and Quality of Life of Patients with Degenerative Gonarthritis
Case Study of Continuous Knee Joint Traction Treatment on the Pain and Quality of Life of Patients with Degenerative Gonarthritis Case Study of Continuous Knee Joint Traction Treatment on the Pain and Quality of Life of Patients with Degenerative Gonarthritis

A 62-year-old woman and 59-year-old man presented with the signs of degenerative gonarthritis. They had no issues of breathing, pulse and blood pressure. They had no consciousness and also did not report any sensory disorder.



Which of the following methods could be the suitable management option for this case?

  • Knee Joint
  • Traction
  • Lateral knee injections


Degenerative gonarthritis is a disorder caused by damage in the joint cartilage and the surrounding ligaments and muscles, responsible for joint movement. It is characterized by weakness of joints and severe abrasion in cartilage resulting in stiffness, reduced range of work, pain and functional dependency. Sociopsychological issues may also result because of prolonged pain and functional disorder. Research evidence depicts that mechanical joint traction of knee using external fixing device is useful in patients with degenerative gonarhthritis. It increases joint space and cartilage thickness along with improvement in overall function. However, joint traction is difficult to apply as it used surgical methods disturbing daily life activities. 

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Key take away

Among 2 cases of degenerative gonarthritis, the pain decreased after applying the continuous traction treatment in them. It increases the gap between joints, offers muscle relaxation and inhibits protective muscle reflection thus the ability to perform physical functions and working range of joints improved.

Examination & lab investigations

The participants' pain intensity was evaluated by Visual analogue scale (VAS) scores. The pain scores were 8 and 7 points for male and female patient respectively. The short form 36-item health survey (SF-36) was used to measure the QoL. The survey contained eight sections and 36 questions related to public health. The eight different sections are pain, vigour, physical function, general and mental health, mental health, social function, limitations of physical roles and constraints of emotional roles. The male participant indicated an SF-36 score of 81 points whereas female participant indicated an SF-36 score of 78 points.   

Management

The patients were requested to bend their joints of hip and knee at 60 degrees in the supine position. To tow the tibia in cephalocaudal direction, application of the continuous knee joint traction was done and strap was used to secure it. For continuous 20 minutes, traction and force equivalent to 6% of the patient's weight was applied. The treatment was administered 20 min once a day and five times a week for at least 4 weeks. After the treatment, VAS scores decreased from point 8 to point 1 and point 9 to point two whereas SF-36 scores increased from point 81 to point 93 and point 78 to point 96 in both male and female patients respectively.  

Discussion

The present study reported the 2 cases of individuals who received continuous knee joint traction for degenerative gonarthritis of the knee. The results of the study showed a significant decrease in pain after applying the treatment. Positive effects of external fixing device were observed on reducing pain. The present study results were consistent with results of the previous surveys. Continuous traction decreases pain by relaxing muscles, inhibiting protective muscle reflection and by stimulating dynamic muscle contractions. Furthermore, the increase in the joint space is also one of the reasons behind the pain reduction.  

Learning

The results of the present case report suggested that continuous knee joint traction is useful for the treatment of patients with degenerative gonarthritis of the knee. Continuous knee joint traction considerably improves QoL and gait.  

References

    1. Aspden RM: Osteoarthritis: a problem of growth not decay? Rheumatology (Oxford), 2008, 47: 1452–1460.
    2. Turner JA, Ersek M, Kemp C: Self-efficacy for managing pain is associated with disability, depression, and pain coping among retirement community residents with chronic pain. J Pain, 2005, 6: 471–479.
    3. Intema F, Van Roermund PM, Marijnissen AC, et al. : Tissue structure modification in knee osteoarthritis by use of joint distraction: an open 1-year pilot study. Ann Rheum Dis, 2011, 70: 1441–1446.
    4. Alpayci M, Ozkan Y, Yazmalar L, et al. : A randomized controlled trial on the efficacy of intermittent and continuous traction for patients with knee osteoarthritis. Clin Rehabil, 2013, 27: 347–354.
    5. Kisner C, Colby LA: Therapeutic exercise: Foundations and techniques, 3rd ed. Philadelphia: F.A. Davis Co., 1996.
    6. Khademi-Kalantari K, Mahmoodi Aghdam S, Akbarzadeh Baghban A, et al. : Effects of non-surgical joint distraction in the treatment of severe knee osteoarthritis. J Bodyw Mov Ther, 2014, 18: 533–539.

Source:

J Phys Ther Sci. 2018 Jun; 30(6): 848–849.

Article:

Case study of the continuous knee joint traction treatment on the pain and quality of life of patients with degenerative gonarthritis

Authors:

Dong-Kyu Lee et al.

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