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Synopsis: 10 randomized or quasi-randomized controlled trials were included in this direct meta-analysis and indirect network meta-analysis comparing the results of corticosteroid injection, autologous whole blood injection (AB), and platelet-rich plasma injection (PRP) in the treatment of patients with lateral epicondylitis.The results fo this study indicated that by final follow-up, which ranged from 2-12 months post-injection, both direct and indirect analyses favoured pain and disability results with platelet-rich plasma versus corticosteroid, while only indirect analyses favoured autologous whole blood over corticosteroid. No significant differences... Read More »
Level 2 Meta Analysis
2%
Synopsis: Patients were randomized to investigate the most suitable treatment for lateral epicondylitis; patients received physiotherapy, Extracorpeal Shockwave Therapy (ESWT), prolotherapy, or Platelet-Rich-Plasma (PRP) treatment. The results of the treatments at the mean 22 month follow-up indicated that prolotherapy and PRP produced better clinical outcomes than the other two groups, where PRP displayed significantly better DASH scores than the prolotherapy treatment. Read More »
Conference Report
2%
Synopsis: 4 studies (228 patients) were included in this meta-analysis which compared the outcome of anatomic Bankart repair with both arthroscopic lavage and sling immobilization for the treatment of first time anterior shoulder dislocations at a minimum of 2 years.The results indicated that recurrent instability of the shoulder was significantly reduced through the use of anatomic Bankart repair, and quality of life was improved as measured by the Western Ontario Shoulder Instability questionnaire. Patient satisfaction was... Read More »
Level 1 Meta Analysis
2%
Synopsis: Six ACE Reports (5 randomized controlled trials and 1 systematic review/meta-analysis) were identified from the OrthoEvidence database which evaluated the efficacy of platelet-rich plasma in the treatment of knee osteoarthritis.All included studies were randomized controlled trials, and reported clinical and functional assessment at various time points between 1 and 6 months following treatment.Pooled analysis of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Total scores suggested a possible beneficial effect with PRP injection in comparison to saline and a lower effect versus hyaluronic acid.Beneficial effects were also noted for individual subscales of the WOMAC assessment (pain, stiffness, and physical function).However, pooling of OMERACT-OARSI responders and a review of the literature indicated that there was no significant difference between PRP and comparison groups in other functional outcome measures, such as the International Knee Documentation Committee (IKDC) assessment and Knee Injury and Osteoarthritis Outcome Score (KOOS).Furthermore, contrasting results were obtained between two studies reporting function on the Lequesne Index. The discrepancy in... Read More »
ACE Review
2%
Synopsis: Ten ACE Reports (all randomized controlled trials) were identified from the OrthoEvidence database assessing the efficacy of platelet-rich plasma (PRP) versus control in the treatment of rotator cuff tears.Result are presented for Constant scores, University of California (UCLA) scores, American Shoulder and Elbow Surgeons (ASES) scores, Simple Shoulder Test (SST) scores, Shoulder Pain and Disability Index (SPADI), Sugaya classification, and the incidence of retear.Qualitative descriptions were provided for Visual Analog Scale (VAS) pain scores and range of motion (ROM).The results indicated that PRP treatment provided favourable Constant scores and Simple Shoulder test at 12 months.Otherwise, the remaining poolable outcomes displayed similar results amongst treatment and control groups.Evaluations of ROM proposed a potential benefit of PRP in the short-term, although effects were primarily lost at longer follow-up (6-12 months).Tendon integrity and retear risk also did not appear to be improved with PRP. This review exhibited... Read More »
ACE Review
2%
Synopsis: 109 patients with traumatic shoulder dislocation were randomized to determine the effect of a shoulder motion restriction band on recurrence rates.Following reduction and immobilization in external rotation for 3 weeks, participants received either 6- or 3-week use of the restriction band, or no band use. Assessments were conducted... Read More »
Author verified Level 2 RCT
2%
Synopsis: 8 ACE Reports (7 randomized controlled trials and 1 systematic review and meta-analysis, n=694) from the OrthoEvidence database assessing the effectiveness of corticosteroid injections in comparison to control injections (either saline or local anesthesia) for the treatment of lateral epicondylitis were included in this review.The purpose of this review was to determine the impact of corticosteroid injections on pain and physical function in comparison to these control treatments.As such, information and data on platelet-rich plasma (PRP) injection efficacy as a treatment was not included from reports.Statistical pooling of VAS pain scores and Quick DASH scores exhibited that corticosteroid injections provided significant pain relief, compared to control injections only in the short-term (6-12 weeks), while having no functional benefits over control injections at any time point within a 6 month period. Similar results were... Read More »
ACE Review
2%
Synopsis: 17 randomized controlled trials (RCTs) consisting of 1381 patients with tennis elbow were evaluated to compare 8 types of injection therapies with the goal of determining the efficacy and safety of each.Results indicated that patients treated with autologous blood, platelet-rich plasma, prolotherapy, hyaluronic acid, and botulinum toxin injections experienced significant improvements in pain intensity compared to placebo.There were no significant differences between any of the glucocorticoid, polidocanol, or glycosaminoglycan polysulfate injection therapy groups against a respective placebo, where changes in pain intensity were concerned.Additionally, no serious adverse events were reported in any of the patients, but the most common minor adverse event observed was temporary pain following administration of injections. This meta-analysis strongly... Read More »
Author verified Level 1 Meta Analysis
2%
Synopsis: Six ACE Reports were identified from the OrthoEvidence database which compared intra-articular injection(s) of hyaluronic acid to corticosteroid in the treatment of osteoarthritis of the knee.All of the included studies were randomized controlled trials which reported pain and/or functional outcomes within 6 months of intervention.Pooled analysis of pain on a visual analog scale indicated that pain relief was significantly better with hyaluronic acid injections at both 3 and 6 months follow-up; however, this finding was strongly influenced by two studies of lower methodological quality. No significant differences between hyaluronic acid and corticosteroid injections were observed in any functional outcome measurement.Due to incomplete or lack of reporting adverse events, an assessment of safety could not be performed along with this review. Furthermore, these findings... Read More »
ACE Review
2%
Synopsis: Seven studies were included in this meta-analysis which aimed to determine the effect of the application of platelet-rich products (PRP) in arthroscopic rotator cuff repair.Pooled analyses of functional outcome measurements indicated no beneficial effect of PRP at a minimum of 12 months postoperatively, and overall no decrease in retear rate. However, an analysis... Read More »
Level 1 Meta Analysis