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. 2022 Oct 20;38:44–55. doi: 10.1016/j.jot.2022.09.003

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© 2022 The Authors

This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Fig. 1 — Study design of the experimental animal study (A). Force plate analysis (FPA) and Synovial Fluid (SF) biopsy was performed at baseline in all dogs (N = amount of dogs used). After 2 weeks, osteoarthritis (OA) was induced bilateral according to the groove model in all dogs (N = 12). At the end of the OA induction (at 9 weeks), FPA was performed. After 10 weeks of OA induction, knee joint distraction (KJD) was applied to the right hindlimb for 8 weeks. At the start and end of KJD, SF was collected. Directly after KJD (at week 18 of the experimental study), 4 dogs were euthanized. Of the other 8 dogs, the frame was removed. After 2 weeks, the bone pins were removed and FPA was performed. After 8 more weeks (at week 28 of the experimental study), FPA and SF biopsies were performed and the dogs were euthanized. Fluoroscopic images of application of distraction (B) were taken during surgery just before distraction and directly after the application of distraction to determine the sufficiency of the amount of distraction. Schematic image of the distraction frame (C) showing the placement of the bone pins and their connection with the external frame. The tibial and femoral part of the frame are connected by hinges, allowing for the ability to flex and extend the knee joint. The peak vertical force (PVF) (D), also known as the maximal vertical force (Fz max) (in newton (N) corrected for body weight), was determined in both hindlimbs at baseline (before the induction of OA), at 9 weeks (after 9 weeks of OA induction), at 20 weeks (after the bone pins were removed), and at 28 weeks (after 10 weeks of follow-up). The round dots represent the left hindlimb, which, after week 10, represents the OA control limb (OA). The squared dots represent the right hindlimb, which, after week 10, represents the distracted hindlimb (OA + KJD). The individual colours represent individual donors. ∗∗p < 0.01. The bars represent the different phases of the experimental study; green = baseline (healthy), red = OA induction (10 weeks), blue = KJD treatment (8 weeks), yellow = Follow-up (10 weeks). (For interpretation of the references to colour in this figure legend, the reader is referred to the Web version of this article.)