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15%
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
6%
Synopsis: 30 blinded randomized controlled trials evaluating the use of hyaluronic acid injections in comparison to a placebo injection in patients with knee osteoarthritis were included in this systematic review and meta-analysis.The objective of this systematic review and meta-analysis was to compare the efficacy and safety of hyaluronic acid injections across different dosing regimens.At 3 months, data were available for 2-4 injection and 5+ injection groups.The 2-4 injection groups demonstrated significantly lower pain scores compared placebo (SMD -0.76 p<0.00001), while the 5+ injection groups did not demonstrate significantly lower pain compared to placebo (SMD -0.20; p=0.09).At 6 months, both the 2-4 injection group (SMD -0.36; p=0.008) and 5+ injection group demonstrated significantly lower pain compared to placebo (SMD -0.18; p=0.04).The single injection groups did not significantly reduce pain compared to placebo at 6 months (SMD -0.04; p=0.67).When looking at the incidence of adverse events, only the 5+ injection group demonstrated a significantly greater incidence compared to placebo (RR 1.67; p=0.02). Read More »
Meta Analysis
6%
Synopsis: 60 patients with an isolated, full-thickness supraspinatus tear were randomized to either receive two postoperative ultrasound-guided injections of platelet-rich plasma or to no adjunct postoperative intervention.Patients were evaluated over a mean of 3.5 years for MRI (Sugaya classification) and clinical outcomes (QuickDASH, Oxford Shoulder Score, and Constant Score).At a mean of 3.5 years, there were no significant differences in clinical scores between groups, with the exception of a greater score on the abduction subscale of the Constant score in the PRP group. MRI outcomes were... Read More »
Level 2 RCT
6%
Synopsis: 41 patients with multidirectional instability of the shoulder were randomized to rehabilitation with either 12 weeks of the Watson program, which included scapular retraining exercises prior to strengthening exercises, or the Rockwood program.Patients were assessed at 6, 12, and 24 weeks after study initiation for outcome on functional scores, satisfaction, strength, dislocation rate, and adverse event rate.Results on the Western Ontario Shoulder Index significantly favoured the Watson program group after 12 and 24 weeks, and results on the Melbourne Instability Shoulder Score significantly favoured the Watson program group after 24 weeks. Dislocation was recorded... Read More »
RCT
4%
Synopsis: 151 patients with shoulder stiffness were randomized to an intraarticular injection of either 40mg or 20mg triamcinolone acetonide (TA).The purpose of this study was to evaluate if high-dose TA demonstrated a significantly greater post-injection range of motion compared to low-dose TA.Average follow-up length was 17.6 months in the 40mg group and 18.1 months in the 20mg group.Results demonstrated significant within-group increases in forward flexion, external rotation, and internal rotation in both groups, with no significant between-group differences. In patients with... Read More »
Level 1 RCT
3%
Synopsis: 36 patients diagnosed with rotator cuff tendinopathy were included in this trial to compare the efficacy of 12-week eccentric and conventional exercise programs.Outcomes were evaluated over a 26-week follow-up period and included shoulder function evaluated using the Constant-Murley score, pain, range of motion, and shoulder strength.Both groups demonstrated significant improvements in shoulder function and pain from baseline over the 26-week follow-up.There were no significant differences between the two exercise programs over the 26-week follow-up, indicating that eccentric exercises are an effective form of exercise therapy for rotator cuff tendinopathy.Larger randomized controlled trials are needed to corroborate the findings of this trial. Read More »
Level 2 RCT
3%
Synopsis: 68 patients with recurrent patellar instability and/or dislocation were randomized to one of three combinations of surgical interventions: medial patellofemoral ligament (MPFL) reconstruction plus lateral patellar retinaculum (LPR) release, MPFL reconstruction plus medial patellar retinaculum (MPR) plication, or LPR release plus MPR plication.Patients were followed up over 24 months postoperative for congruence angle, the patellar tilt angle, and the lateral patellofemoral angle on radiograph, patellofemoral joint congruence on CT, and clinical score on the Lysholm score, the Kujala patellorfemoral score, and the International Knee Documentation Committee (IKDC) score. While radiographic results... Read More »
Level 2 RCT
3%
Synopsis: 132 patients with mild-to-moderate, symptomatic knee osteoarthritis were randomized to a single injection of either HYA-JOINT Plus (SciVision Biotech) or Synvisc-One (Sanofi-Aventis).Patients were assessed over a 6-month follow-up for patient-reported outcome measures, functional performance measures, patient satisfaction, and rate of adverse events.Pain assessed using a visual analog scale was significantly lower in the HYA-JOINT Plus group compared to the Synvisc-One group at 1, 3, and 6 months, but pain assessed on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) did not significantly differ between groups at any point.WOMAC Stiffness score at 6 months was also significantly lower in the HYA-JOINT Plus group compared to the Synvisc-One group. All other outcomes... Read More »
Level 1 RCT
3%
Synopsis: 50 patients scheduled for total knee arthroplasty were randomized to postoperative cryotherapy through either a continuous cold flow device or bags of crushed ice.Patients were assessed for knee edema, pain, and range of motion over the first 7 days after surgery, as well as blood loss on postoperative day 1. Results demonstrated no... Read More »
Level 2 RCT
3%
Synopsis: Fourteen studies were included in this meta-analysis evaluating the efficacy of combined hip and knee strengthening exercises programs to either knee strengthening exercises alone or no training in management of patellofemoral pain. Pooled analyses demonstrated larger pain reduction and change in activity among groups managed with the combined strengthening protocols compared to both knee strengthening alone groups and no training groups. Read More »
Level 1 Meta Analysis