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Synopsis: Twelve studies were included in this meta-analysis and systematic review to determine the effects of exercise therapy in the management of meniscal lesions as a non-operative treatment and as a modality for rehabilitation following meniscectomy compared to other treatments.This summary focused on the results from the meta-analyses conducted in this publication.When exercise therapy alone was compared to isolated meniscectomy/meniscal repair, exercise therapy demonstrated significantly greater strength in extension at 3 months, and no significant differences in short- and long-term pain and function.When exercise therapy was assessed as a rehabilitative treatment following meniscectomy/meniscal repair, standard exercise therapy demonstrated no significant differences in short-term pain and short- and long-term function when compared to alternative exercise therapies (early range of motion, isokinetic exercise, etc). There was limited... Read More »
Level 1 Meta Analysis
7%
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
6%
Synopsis: 18 randomized controlled trials were included in this network meta-analysis to evaluate the effect of platelet-rich plasma injections in the management of tendinopathies and if outcomes are affected by the type of preparation.The results from this study indicate that platelet-rich plasma is an effective treatment for tendinopathies and that leukocyte-rich platelet-rich plasma preparations appear to have the greatest effect. However, further trials... Read More »
Level 2 Meta Analysis
5%
Synopsis: 14 randomized controlled trials were included in this systematic review and meta-analysis to evaluate the use of corticosteroid injections in the management of rotator cuff tendinosis in comparison to a placebo.The primary outcome of interest for this meta-analysis was pain assessed at 3 months (12 weeks).A subgroup analysis was also performed to compare the efficacy of single vs multiple injections.The results of this study indicated that corticosteroid injections provided greater reductions in pain at 4 and 8 weeks compared to placebo, however, these differences were small and not clinically relevant.There were no differences observed between groups at 12 weeks.Additionally, there were no differences observed between single and multiple injections of a corticosteroid. Read More »
Author verified Meta Analysis
4%
Synopsis: 160 patients with a Robinson type 2B1-2 displaced midshaft clavicle fracture were included in this multicenter randomized controlled trial to compare outcomes between operative and nonoperative treatment methods.Patients were evaluated for nonunion, constant shoulder score, disabilities of the arm, shoulder, and hand (DASH) score, pain, secondary operations, and cosmetic result.At one year the rate of nonunion was significantly higher in the nonoperative group as was the rate of secondary plate fixation to manage nonunion.However, there was no difference in the total number of secondary procedures between groups.Additionally, there were no differences in constant and DASH scores between the groups. Read More »
Level 2 RCT
3%
Synopsis: Six comparative studies (5RCT, 1 cohort) were included in this meta-analysis comparing osteochondral autograft transfer (OAT) and microfracture (MFx) in the treatment of cartilage lesions of the knee.Activity level, patient-reported outcome scores, and the incidence of failure were pooled.Results demonstrated a significant difference in Tegner score in favour of OAT groups compared to MFx groups, though subgroup analysis suggested the difference may be associated with greater lesion size.The patient reported outcome scores also favoured the OAT groups compared to MFx within a 3-year follow-up, though no significant difference was observed when pooled at 5-10 years. The incidence of... Read More »
Author verified Level 2 Meta Analysis
3%
Synopsis: 50 patients with plantar fasciitis were randomized to injection of the flexor digitorum brevis with either botulinum toxin or placebo.Patients were followed up for patient-reported function and pain at 6 and 12 months. Results demonstrated significantly... Read More »
Level 1 RCT
2%
Synopsis: 68 patients with a fifth metacarpal neck fracture were randomized to two different conservative management options: buddy taping with soft wrapping, or closed reduction and cast immobilization.The purpose of this study was to compare clinical and radiological outcomes between the two treatment options.Follow-up was conducted over 4 months post-injury.No significant differences were observed in clinical and radiological outcomes between groups. The group which... Read More »
Author verified Level 2 RCT
2%
Synopsis: 5 randomized controlled trials (RCTs), with a total of 215 patients, were included in this systematic review to determine if there are benefits to reduction and splint or cast immobilization to fractures of the fifth metacarpal neck (or more commonly known as boxer's fractures).Analysis of the included studies indicated that splint or cast immobilization yields no benefits in range of motion, strength, or any other measured outcomes when compared to soft wrap or buddy taping treatment without reduction. On the contrary,... Read More »
Level 3 Meta Analysis
1%
Synopsis: 57 patients with chronic neck pain (CNP) were randomized to undergo either a progressive neck exercise program (PNEP) or interactive behavioral modification therapy (IBMT).The purpose of this study was to determine whether the addition of cognitive-behavioral (CB) principles to a standardized exercise regimen would provide greater pain and disability reduction compared to an exercise regimen without CB.Patients were assessed 6 months after the start of treatment. Findings indicated similar... Read More »
Author verified Level 2 RCT