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Synopsis: Eight randomized trials containing a total of 2096 patients with osteoarthritis were included in this systematic review and meta-analysis comparing topical and oral non-steroidal anti-inflammatory drugs (NSAIDs).Pooled outcomes of interest included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and stiffness sub-scores, pain on a Visual Analog Scale (VAS), and the odds of skin adverse reactions, gastrointestinal adverse reactions, and any adverse event.The results of the meta-analysis found no differences in pooled WOMAC pain, WOMAC stiffness, VAS pain scores, and odds of any adverse event between the two formulations. The pooled odds... Read More »
Level 1 Meta Analysis
22%
Synopsis: Five randomized controlled trials were included in this meta-analysis comparing single-site and multi-site corticosteroid injections for the treatment of frozen shoulder.Pooled outcomes of interest included pain on a Visual Analog Scale (VAS), range of motion, American Shoulder and Elbow Surgeons (ASES) scores, and complications.Results revealed significantly better pooled range of motion in abduction in the first 3-4 weeks, as well as superior ASES functional scores and range of motion in internal rotation in the multisite group up to 26 weeks follow-up. However, there was... Read More »
Level 1 Meta Analysis
11%
Synopsis: 111 patients with idiopathic carpal tunnel syndrome were randomized to receive an 80mg local steroid injection (methylprednisolone), 40mg local steroid injection, or placebo injection.Outcomes of interest included time to and rate of subsequent surgical intervention, Short-Form 36 (SF-36) bodily pain scores, treatment satisfaction, symptom severity score, and Quick Disability of the Arm, Shoulder and Hand (QuickDASH) scores.Outcomes were assessed at 5 years follow up.Local steroid injection was found to significantly reduce the rate of surgical intervention and delay time to surgery compared to placebo. No significant differences... Read More »
Level 1 RCT
11%
Synopsis: 6 studies including 239 patients with lumbar disc herniation were included in this meta-analysis comparing mechanical traction plus conventional physical therapy (n=123) vs.conventional physical therapy alone (n=116).Pooled outcomes of interest included pain on a Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), and the Schober test. Results revealed significantly... Read More »
Level 1 Meta Analysis
11%
Synopsis: 316 patients with non-acute anterior cruciate ligament (ACL) injuries and persistent instability were randomized to receive immediate surgery (n=156) or rehabilitation (n=160).The primary outcome of interest was the Knee Injury and Osteoarthritis Outcome Score - 4 domain (KOOS4).Secondary outcomes of interest included quality of life measures, the Tegner activity score, resource use, complications and patient satisfaction.Primary follow-up occurred at 18 months.The results of this study found that, whilst both groups showed improvement, patients who received immediate surgery had significantly better knee function, pain, patient satisfaction, and Tegner activity scores compared to the rehabilitation group.Surgery was found to have a 72% chance of being cost-effective vs. Read More »
Author verified Level 1 RCT
11%
Synopsis: Two hundred and thirty patients with a BMI >35m/kg^2 undergoing either total hip or knee arthroplasty were randomized to receive either negative pressure wound therapy (NPWT; n=115) or silver-embedded occlusive dressing (n=115).Complication rates, number of readmissions, and reoperations were assessed at 90 days. No significant differences... Read More »
Level 1 RCT
11%
Synopsis: Fifty-six female patients with nonspecific low back pain were randomized to receive high-force massage therapy (n=28) or low-force massage therapy (n=28).The primary outcome of interest was pain intensity at 4 weeks, measured using the Visual Analog Scale (VAS).Secondary outcomes such as pain pressure threshold (PPT) and trunk mobility were measured at 4 weeks and Oswestry Disability Index (ODI), Roland-Morris Low Back Pain Disability Questionnaire (RMQ), and the World Health Organization Quality of Life (WHOQOL) were measured at 4 and 8 weeks.A between-group subgroup analyses of pain scores was also conducted at 8 weeks. The high-force massage... Read More »
Level 1 RCT
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