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Synopsis: One hundred and fifty-one patients with knee osteoarthritis (OA) who received either cooled radiofrequency ablation (CRFA; n=76) therapy or intra-articular corticosteroid (IAS; n=4/75) injections were included in this 12 month follow-up study.After 6 months, patients in the IAS group were offered the opportunity to cross over to CRFA therapy (n=58/75).The primary outcomes of interest included the proportion of patients with at least a 50% reduction in numeric rating scale (NRS) pain score at 12 months.Secondary outcomes of interest included the change in Oxford Knee Score (OKS), the global perceived effect of improvement, opioid consumption, and the incidence of adverse and serious adverse events.Follow-up was performed at 12 months from the point of randomization; patients who crossed-over to CRFA at 6 months were therefore monitored for another 6 months.Results demonstrated that 65% of patients in the CRFA group and 49% of patients in the cross-over group experienced a minimum 50% reduction in NRS pain score from baseline.Moreover, NRS pain scores and OKS scores were significantly improved from baseline in the CRFA and cross-over group.The mean opioid consumption was not significantly different from baseline in the CRFA group.Also, 75% of patients in the CRFA group and 57% of patients in the cross-over group perceived an improvement in health at final follow-up. A total of... Read More »
Level 2 RCT
16%
Synopsis: Five randomized controlled trials were included in this meta-analysis which sought to investigate the efficacy of mesenchymal stem cell injections in patients with knee osteoarthritis.Included studies featured various control groups, including placebo injection, hyaluronic acid injection, and no injection, as well as various concomitant treatments, including high tibial osteotomy, microfracture, platelet rich plasma injection and hyaluronic acid injection.Accordingly, clinical heterogeneity was assumed.Data was pooled from 12-24 month time points. Analyses on visual... Read More »
Level 2 Meta Analysis
5%
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
5%
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
5%
Synopsis: 118 patients who have unilateral hip pain due to osteoarthritis participated in this study to determine the efficacy of patient education and manual therapy.Patients were randomized into one of 3 groups: (1) a patient education group, (2) a manual therapy + patient education group, or (3) a minimal control group wherein patients were advised to complete stretches at home.Assessments were completed immediately following treatment at 6 weeks and at 3 and 12 months.Patients who underwent patient education as well as manual therapy experienced the greatest benefits in pain relief, enhanced function and perceived improvement. Read More »
Author verified Level 2 RCT
5%
Synopsis: 92 patients with symptomatic and radiographic patellofemoral joint (PFJ) osteoarthritis were randomized to receive osteoarthritis education with or without patellofemoral joint targeted exercise and therapy.The purpose of the study was to determine the efficacy of a patellofemoral joint specific program (which included exercise, education, manual therapy, and taping) in improving patient rated outcomes after 3 months of treatment.Patients receiving the PFJ targeted treatment reported a greater global rating of change and significantly lower pain after 3 months compared to patients receiving education alone. No differences were... Read More »
Level 2 RCT
5%
Synopsis: 67 patients with femoroacetabular impingement and complete labral tear scheduled for arthroscopic surgery were randomized to undergo the procedure either with or without an intraarticular injection of platelet-rich-plasma (PRP) at the end of surgery.The purpose of this study was to compare clinical outcomes (modified Harris Hip Score and visual analog scale [VAS] pain) over 24 months postoperatively, and MRI results at 6 months postoperatively.Significant differences were observed in favor of the PRP group in terms of VAS pain 2 days following surgery, and the rate of effusion at the 6 month follow-up. However, no other... Read More »
Author verified Level 2 RCT
5%
Synopsis: 73 patients with rotator cuff tendinopathy were randomized to one of three study treatment groups: (1) hypertonic dextrose prolotherapy injection directly to affected entheses, (2) saline injection directly to affected entheses, or (3) saline injection superficial to affected entheses.The purpose of this study was to investigate the clinical benefits of dextrose prolotherapy when compared to control groups by observing improved patient-reported pain scores, patient satisfaction scores, and ultrasound grading of regenerative effect. Results demonstrated that... Read More »
Author verified Level 2 RCT
5%
Synopsis: 182 patients with knee osteoarthritis (OA) were randomized to one of four groups: PRP-3 (3 injections), PRP-1 (single injection), hyaluronic acid (HA), or saline injections.All active treatment groups (PRP-3, PRP-1, HA) demonstrated significantly more favourable EQ-VAS pain scores and IKDC scores compared to saline injections.The patients treated with three injections of platelet-rich plasma (PRP) achieved significantly more favourable scores on the EQ-VAS for pain and IKDC subjective scores compared to those treated with a single injection of PRP and HA injections. Subgroup evaluations indicated... Read More »
Level 1 RCT
5%
Synopsis: 111 patients with either unilateral or bilateral hip osteoarthritis were randomized to be treated with one of three injection protocols; platelet rich plasma, hyaluronic acid, or combined platelet rich plasma and hyaluronic acid.Patients were administered three weekly intra-articular injections of the allocated treatment, were followed-up for 12 months post-injection and assessed clinically using a visual analog scale for pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Harris Hip Score (HHS). Results demonstrated significantly... Read More »
Level 2 RCT