Joint distraction, the prolonged mechanical separation of the bones at a joint, has emerged as a joint-preserving treatment for end-stage osteoarthritis, with the gradually growing promise of implementation in regular clinical practice. Joint distraction of the knee has been most extensively studied, with these studies showing prolonged symptomatic improvement in combination with repair of cartilage tissue in degenerated knee joints, supporting the concept that cartilage repair can translate into real clinical benefit. The reversal of tissue degeneration observed with joint distraction could be the result of one or a combination of various proposed mechanisms, including partial unloading, synovial fluid pressure oscillation, mechanical and biochemical changes in subchondral bone, adhesion and chondrogenic commitment of joint-derived mesenchymal stem cells or a change in the molecular milieu of the joint. The overall picture that emerges from the combined evidence is relevant for future research and treatment-related improvements of joint distraction and for translation of the insights gained about tissue repair to other joint-preserving techniques. It remains to be elucidated whether optimizing the biomechanical conditions during joint distraction can actually cure osteoarthritis rather than only providing temporary symptomatic relief, but even temporary relief might be relevant for society and patients, as it will delay joint replacement with a prosthesis at an early age and thereby avert revision surgery later in life. Most importantly, improved insights into the underlying mechanisms of joint repair might provide new leads for more targeted treatment options.

关节牵引，即关节处骨骼的长时间机械分离，已成为终末期骨关节炎的关节保护治疗方法，在常规临床实践中的实施前景逐渐看好。膝关节牵张已得到最广泛的研究，这些研究表明，在退化的膝关节中，结合软骨组织的修复，症状会得到长期改善，支持软骨修复可以转化为实际临床益处的概念。关节牵引观察到的组织退化逆转可能是多种机制之一或组合的结果，包括部分卸载、滑液压力振荡、软骨下骨的机械和生化变化，关节来源的间充质干细胞的粘附和软骨形成承诺或关节分子环境的变化。从综合证据中得出的总体情况与未来的研究和与治疗相关的关节牵引改进相关，以及将获得的关于组织修复的见解转化为其他关节保护技术。在关节牵引过程中优化生物力学条件是否真的可以治愈骨关节炎，而不仅仅是提供暂时的症状缓解，这还有待阐明，但即使是暂时的缓解也可能与社会和患者相关，因为它会延迟在早期使用假体进行关节置换从而避免在以后的生活中进行翻修手术。最重要的是，