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Operative versus nonoperative treatment for full-thickness rotator cuff tears
①
Synopsis: Three randomized controlled trials were included in this meta-analysis comparing pain and functional improvement between operative and nonoperative treatment for full-thickness rotator cuff tears.Follow-up was 12 months in each study. Results demonstrated that... Read More »
Author verified Level 1 Meta Analysis
4%
PRP injection more effective than corticosteroid injection after 12 weeks for gluteal tendinopathy
①
Synopsis: 80 patients with grade 2-3 gluteal tendinopathy were randomized to intratendinous injection of either platelet-rich plasma or corticosteroid (betamethasone).Patients were assessed over a 12-week follow-up for results on the modified Harris Hip Score.Results at 12 weeks demonstrated significantly higher scores on the mHHS in the PRP group compared to the CS group. Additionally, the rate... Read More »
Author verified Level 1 RCT
3%
Steroid injection into rotator interval favoured over IA & subacromial injection for frozen shoulder
Synopsis: 97 patients with symptomatic primary adhesive capsulitis for less than 9 months were included in this trial to compare the efficacy of three sites for corticosteroid injections.Patients were randomized to receive an injection of 1mL 40mg/mL triamcinolone acetonide with 2mL 2% lidocaine within the rotator interval along the coracohumeral ligament, in the intraarticular space, or in the subacromial space.All injections were performed under ultrasound guidance. At 12 weeks,... Read More »
Author verified RCT
2%
Network meta-analysis evaluating injection treatments for plantar fasciopathy
①
Synopsis: 22 randomized controlled trials were included in this network meta-analysis, that included over 10 injectable treatments, to evaluate comparative efficacy for the management of plantar faciopathy.The primary outcome of this study was pain relief.At 0-2 month follow-up, micronized dehydrated human amniotic/chorionic membrane was the most likely treatment to be effective for pain relief.At 2-6 months, botulinum toxin A was the treatment most likely to be effective for pain relief, while a treatment most likely to be effective beyond 12 months could not be identified from the limited amount of evidence available at this time point.The lack of trials available was a limiting factor of this network meta-analysis, exemplified by the lack of studies reporting data on micronized dehydrated human amniotic/chorionic membrane beyond 2 months. Further trials are... Read More »
Level 1 Meta Analysis
2%
Pain reduction greater with 5 injections of high-dose HA vs control for plantar fasciopathy
②
Synopsis: 168 patients with plantar fasciopathy were randomized to weekly injections of high-dose hyaluronic acid (25mg), low-dose hyaluronic acid (8mg), or control, very low-dose hyaluronic acid (0.25mg), for 5 weeks.Patients were assessed for reduction in visual analog scale pain (VAS pain) from baseline to 5 weeks, as well as incidence of improvement in function, local symptoms, and activities of daily living after 5 weeks.Results demonstrated a significantly greater reduction in VAS pain from baseline to 5 weeks in the high-dose HA group compared to the control group, but not the low-dose HA group compared to the control group. The incidences of... Read More »
Level 2 RCT
2%
AAOS2018: TissueGene-C demonstrates 52-week efficacy versus placebo in treatment of moderate knee OA
Synopsis: 163 patients with Kellgren-Lawrence grade III knee osteoarthritis were randomized to intraarticular treatment with either TissueGene-C or placebo.Patients were assessed for outcome on clinical scores, including the International Knee Documentation Committee (IKDC) score, a visual analog scale, and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), over 52-week follow-up. Results for all... Read More »
Conference Report
1%
Nonopioid analgesia demonstrates better 12-month efficacy versus opioids for chronic OA pain and LBP
②
Synopsis: 240 patients with moderate-to-severe chronic low back pain, knee osteoarthritis pain, or hip osteoarthritis pain were randomized to analgesia through either an opioid or nonopioid medication regimen.Patients were assessed over 12-month follow-up for efficacy outcomes related to pain-related function, pain severity, quality-of-life and disability, and safety outcomes related to adverse events and potential opioid misuse.Despite no significant difference in pain-related function scores over 12 months, significantly worse results for pain severity over 12-month follow-up were observed in the opioid group compared to the nonopioid group. Checklist scores for... Read More »
Level 2 RCT
1%
AAOS2018: Two-year results favour ECRB release versus PRP injection for lateral epicondylitis
Synopsis: 101 patients with lateral epicondylitis were randomized to either arthroscopic release of the extensor carpi radialis brevis or to platelet-rich plasma injections.Patients were assessed for pain, function, and grip strength over 104-week follow-up. While 8-week results... Read More »
Conference Report
1%
AAOS2018: Tourniquet versus tourniquetless total knee arthroplasty
Synopsis: 19 trials were included in this meta-analysis comparing blood loss measures and complication rate between tourniquet use and no tourniquet use in total knee arthroplasty.For blood loss, intraoperative blood loss volume was significantly lower among tourniquet groups, though no significant differences between tourniquet and no tourniquet groups were observed in analyses of total blood loss and calculated blood loss. The incidence of... Read More »
Conference Report
1%
Efficacy of platelet-rich plasma in the treatment of degenerative knee pathology
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