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Synopsis: Previous studies have established the success of non-operative treatment following Achilles tendon rupture.37/60 patients were analyzed in this follow-up study comparing an early weight-bearing protocol to standard weight-bearing protocol during dynamic rehabilitative treatment of acute Achilles tendon ruptures.The primary outcome of interest was the Achilles Tendon Rupture Score (ATRS).Secondary outcomes of interest included heel raise height and work, as well as the return to level (heavy, light but active, sedentary) of work and sporting, and the incidence of re-rupture.Follow up was performed at 4.5 years post-operation.At 4.5 years, there were no significant differences between the early weight-bearing and usual care groups in ATRS score, heel raise height or heel raise work.All 37 patients had return to some level of work by the 4.5 year follow up, and 33/37 patients had returned to some level of sporting activity. Three cases of... Read More »
Level 2 RCT
2%
Synopsis: 83 patients with plantar fasciitis were randomized to one of the three following physiotherapy interventions for the purpose of comparing pain, disability, and balance outcomes after 8 weeks: (1) stretching and exercise of hip and foot muscles, (2) stretching and exercises of foot muscles only, and (3) stretching of foot muscles only.Outcomes of interest included a VAS scale for pain, the Foot and Ankle Outcome Score (FAOS), the Star Excursion Balance test (SEBT).Results demonstrated that patients in all study groups significantly improved in all outcomes of interest after completion of eight weeks of allocated therapy. However, no significant... Read More »
Author verified Level 2 RCT
2%
Synopsis: A non-inferiority trial including 356 patients presenting to a general practitioner with traumatic knee complaints were randomized to receive immediate referral for magnetic resonance imaging (MRI) or usual protocol directed by the guidelines provided by the Dutch college of general practitioners.The primary outcome of interest was the Lysholm knee score.Secondary outcomes of interest included the EQ-5D quality of life questionnaire, the Knee Injury and Osteoarthritis Outcome Scale (KOOS), pain on a numeric rating scale (NRS), as well as patient perceived recovery and satisfaction.Follow up was performed at 6 weeks, 3, 6, 9 and 12 months. Results found no... Read More »
Level 2 RCT
2%
Synopsis: 48 single or double blinded, prospective, randomized control trails that used human subjects and compared the therapeutic effects of intra-articular hyaluronic acid with intra-articular injection of a placebo to treat osteoarthritis of the knee were analyzed to determine if the qualitative conclusions by authors about the therapeutic effects of hyaluronic acid was affected by industry sponsorship or financial conflicts of interest. Results of the systematic review indicated that industry funding may have an effect on the conclusions provided within the study and that clinicians should be aware of potential financial conflicts of interest in authors reporting on the topic of intra-articular injection of hyaluronic acid for treatment of knee OA. Read More »
Level 2 Meta Analysis
2%
Synopsis: 54 patients with chronic midportion Achilles tendinopathy undergoing an eccentric exercise programme were randomized to receive either a platelet-rich plasma (PRP) injection or a saline injection (placebo), in order to determine whether PRP injections would result in enhanced tendon structure and neovascularisation that could be observed through ultrasonographic methods. Following evaluations over a 24 week period, the results indicated that no significant differences existed in neovascularisation scores between groups and that PRP injections did not contribute to improved tendon structure. Read More »
Author verified Level 1 RCT
2%
Synopsis: 442 patients suffering from unilateral knee pain were randomized to evaluate the safety and efficacy of 26 weeks of a single-injection of intra-articular non-animal stabilized hyaluronic acid (NASHA) compared to methylprednisolone acetate (MPA).Following 26 weeks of blinded evaluation, patients were offered a second injection with NASHA and were followed for an additional 26 weeks.The evidence presented in this study demonstrated that NASHA gel produced a non-inferior response rate in comparison to MPA.WOMAC pain, physical function, and stiffness evaluations favored NASHA over MPA during the blinded phase from 12 to 26 weeks.Sustained improvements were apparent in WOMAC outcomes irrespective of initial treatment in response to open-labeled extension with NASHA. No serious device-related... Read More »
Author verified Level 1 RCT
1%
Synopsis: 40 patients presenting with non-insertional Achilles tendinopathy were randomized to receive standard physical therapy with or without topical glyceryl trinitrate (GTN) treatment.Follow-up at 6 months indicated both groups made significant improvements; however, there were no differences between groups for ankle osteoarthritis scale (AOS) scores. There were also... Read More »
Level 2 RCT
1%
Synopsis: 246 patients age 60 or older with knee osteoarthritis were randomized to 1 of 3 groups: one group received three intra-articular injections of Artzal hyaluronan, one group received three intra-articular injections of Synvisc hyaluronan, and one group received three intra-articular injections of placebo.The primary outcomes of interest were weight-bearing pain 26 weeks after treatment, and the percentage of patients reporting positive outcomes 1 year after treatment.Other outcomes of interest included change to resting pain, maximum pain, algofunctional score, quality of life, and number of adverse events.While results indicated a significant reduction in weight-bearing pain from baseline for all groups starting at 4 weeks and continuing to 26 weeks, no significant between-group differences were reported at any time point.No significant difference in duration of treatment was found for either hyaluronan treatment when independently compared to placebo, but pooled analysis of the hyaluronan groups revealed a significant effect on Kaplan-Meier curve analysis regarding treatment failure (ie. need to additional... Read More »
Level 2 RCT
1%
Synopsis: This systematic review identified 25 studies which assessed the effects of intra-articular corticosteroid injections, as well as the effects of image-guided corticosteroid injections, for the treatment of adhesive capsulitis.A total of 1,429 patients were identified from the 25 studies, and were followed up between 1 to 44 months.Results from the review indicated that corticosteroid injections offer rapid pain relief in the short term, as well as increased range of motion, however long-term effects are similar to other treatments, including placebo. No conclusions could... Read More »
Level 3 Meta Analysis
1%
Synopsis: 21 patients diagnosed with chronic recalcitrant plantar fasciitis were randomized to receive either dextrose prolotherapy (DP) or autologous platelet-rich plasma (PRP) injection therapy.The purpose was to evaluate the efficacies of these treatments and additionally, to assess whether one is more effective.Results at 28 weeks indicated that both treatments significantly improved total Foot Function Index scores versus baseline but no between-group differences were found. Nevertheless, PRP provided... Read More »
Author verified Level 2 RCT