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100%
7%
Synopsis: 192 patients with unilateral, symptomatic knee osteoarthritis were randomized to receive 3 weekly intra-articular injections of leukocyte-rich platelet-rich plasma (n=96) or leukocyte-poor platelet-rich plasma (n=96).The primary outcome of interest was the International Knee Documentation Committee (IKDC) score at 12 months.Secondary outcomes of interest included the Knee Injury and Osteoarthritis Outcomes Score (KOOS) sub-scales, the Tegner scale for activity/sporting level, and Euro-QoL Visual Analog Scale (EQ-VAS) for quality of life. No significant differences... Read More »
Level 1 RCT
6%
Synopsis: Twenty-seven randomized controlled trials that compared the safety and efficacy of platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and hyaluronic acid (HA) were included in this meta-analysis.Outcomes of interest included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain on a Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lequesne Index Score (LEQ).WOMAC, IKDC, and VAS scores favored PRP against HA.Similarly, in the network meta-analyses comparing BMAC and HA, WOMAC, IKDC, and VAS scores favored BMAC. No differences were... Read More »
Author verified Level 1 Meta Analysis
5%
Synopsis: Three hundred thirty patients undergoing primary unilateral total knee arthroplasty for osteoarthritis were randomized to receive diosmin (n=167) or no diosmin (n=163).The diosmin group received 0.9 g twice daily for 14 days postoperatively, while the control group received no treatment or placebo.The primary outcome of interest was lower-extremity swelling measured at 24, 48, and 72 hours, and 14 days postoperatively.Secondary outcomes included pain during motion, pain at rest, Hospital for Special Surgery (HSS) scores, range of motion, levels of inflammatory biomarkers (C-reactive protein and interleukin-6), and the incidence of complications.Outcomes were assessed up to 14 days postoperatively.Overall, the results of the study revealed that diosmin significantly reduced lower-extremity swelling and pain during motion compared to the control group. The study suggests... Read More »
Level 1 RCT
5%
Synopsis: Sixty patients with knee osteoarthritis were randomized to receive intra-articular prolotherapy (IG, n=20), peri-articular perineural injection (PG, n=20), or a combination of the two treatments (I + PG, n=20).The primary outcome of interest was pain intensity measured using the Visual Analogue Scale (VAS).Secondary outcomes included knee function measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and pressure pain threshold (PPT).Outcomes were assessed at baseline, 2, 4, and 8 weeks.Overall, the results revealed that the I + PG group showed significantly greater improvements in pain and function compared to the single therapy groups, with a significant decrease in VAS and WOMAC scores at 4 and 8 weeks. This suggests that... Read More »
Level 1 RCT
4%
Synopsis: 85 patients with isolated acute Rockwood type 3 acromioclavicular joint injury (ACJI) were randomized to receive either sling immobilization (n=42) or acromioclavicular joint stabilization (ACJS; n=43).Outcomes of interest included the Constant Shoulder Score, range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) score, Taft score, Acromioclavicular Joint Instability (ACJI) score, pain on a Numeric Rating Scale (NRS), coracoclavicular (CC) distance, and the incidence of adverse events, measured up to 24 months.Constant scores were similar between the two groups at all time points.ROM, ACJI at 6 and 12 months, and CC distance at all time points were significantly better in the ACJS group compared to the sling immobilization group. NRS pain scores... Read More »
Level 1 RCT
3%
Synopsis: One hundred and forty-six patients 35–65 years of age with knee symptoms consistent with a degenerative medial meniscus tear were randomized into receiving arthroscopic partial meniscectomy (APM) or a sham surgery (diagnostic knee arthroscopy).Primary outcomes of interest included radiographic knee osteoarthritis through using the Kellgren and Lawrence knee osteoarthritis grading and the Osteoarthritis Research Society International (OARSI) instrument, as well as patient-related outcomes via the Western Ontario Meniscal Evaluation Tool (WOMET), the Lysholm knee score, and knee pain after exercise.Outcomes of interest were assessed 5 years post-operation.No significant differences between the APM and placebo groups were observed in all three patient-relevant outcomes, 5 years post-operation.A slight increase in the risk of radiographic knee osteoarthritis progression was observed in the APM group, however this was not significantly different.A significantly higher risk of mechanical symptoms was observed in the APM group. Otherwise, outcome comparisons... Read More »
Author verified Level 1 RCT
3%
Synopsis: Forty-seven children with non-reduced diaphyseal both-bones forearm fractures were randomized to receive either above-elbow cast (AEC) (n=23) or early conversion to below-elbow cast (BEC) (n=24).The primary outcome of interest was the limitation of forearm rotation.Secondary outcomes of interest included loss of flexion and extension of the elbow and wrist, patient-reported outcomes measures, grip strength ratio, and radiographic assessment.Outcomes were assessed up to 7.5 years.Overall, the results of the study revealed that forearm rotation improved over time in both groups without significant differences between them. The long-term follow-up... Read More »
Level 1 RCT
3%
Synopsis: 23 randomized controlled trials (2284 patients) comparing open versus endoscopic techniques for carpal tunnel release in patients with carpal tunnel syndrome were included in this systematic review and meta-analysis.A subgroup analysis was also conducted on single- versus dual-portal endoscopic treatment.The primary outcomes of interest included complication and reoperation rates.Secondary outcomes included operative time, the incidence of scar tenderness and pillar pain, normalized satisfaction scale, the incidence of complete or near complete symptom relief, Boston Carpal Tunnel Questionnaire (BCTQ) symptom and function, and time to return to work.All outcomes were similar between the two groups except for time to return to work and incidence of scar tenderness (dual-portal vs open) which all favored the endoscopic group.The incidence of nerve injury was significantly lower in the open-technique group. Overall, the endoscopic... Read More »
Level 1 Meta Analysis
3%
Synopsis: Ninety patients with acceptably reduced intra-articular distal radius fractures were randomized to receive surgical fixation with a volar plate (n=44) or nonoperative cast immobilization (n=46).The primary outcome was patient reported function at 12 month follow-up utilizing the Patient-Rated Wrist Evaluation (PRWE) score.Secondary outcome measures included the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Short Form-36 (SF-36) questionnaire, pain scores, range of motion, grip strength, radiographic parameters and complications.The operative group had significantly better PRWE and DASH scores at 12 month follow-up.No differences in ROM, grip strength or pain scores existed at 12 month follow-up.No differences existed in overall complications. However, 13 (28%)... Read More »
Level 1 RCT
3%
Synopsis: Nine studies including 1,405 patients with primary knee osteoarthritis were included in this systematic review and meta-analysis comparing all-polyethylene (AP) versus metal-backed (MB) tibial components in total knee arthroplasty (TKA).Pooled outcomes of interest included radiolucent lines, component positioning, knee scores, knee range of motion (ROM), quality of life, and postoperative complications.The frequency of radiolucent lines was significantly higher in the MB group than in the AP group, while no differences were found in clinical outcomes, quality of life, or complications. The main finding... Read More »
Level 1 Meta Analysis