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Synopsis: 36 randomized controlled trials were included in his meta-analysis which examined the use of platelet rich plasma (PRP) versus varying control interventions for various soft-tissue orthopaedic injuries and conditions, predominantly elbow tendinopathy and plantar fasciitis.Pooled results among patients with elbow tendinopathy demonstrated a lack of significant difference in pain or functional measures between PRP and control groups at 3 months, but significant differences in favour of PRP groups at 6 months.In patients with plantar fasciitis, pooled results demonstrated a lack of significant difference in pain scores between PRP and control at 3 months, while 6-month results significantly favoured PRP groups.When outcome on the AOFAS functional score were considered, pooled results significantly favoured PRP groups at 3 and 6 months. When effects were... Read More »
Level 1 Meta Analysis
6%
Synopsis: 108 patients with knee osteoarthritis were randomized to application of either a neoprene knee brace with a patellar hole, or a neoprene knee brace without a patellar hole.Participants were first assessed for pain and functional performance measures prior to application of the brace.Then, following application of the brace, the participants were assessed on the outcome measures again.Results reported significant within-group improvement in each VAS pain scores, TUG test times, and 8-meter walk test times in both groups. Statistical analyses on... Read More »
Level 2 RCT
5%
Synopsis: 321 patients with a nonobstructive mensical tear were randomized to either an 8-week physical therapy program or to arthroscopic partial meniscectomy.The primary purpose of this study was to determine if the PT group was noninferior to the APM for outcome on the International Knee Documentation Committee (IKDC) subjective score at a noninferiority margin of 8pts. When analyzed in... Read More »
Author verified Level 2 RCT
5%
Synopsis: 40 patients with plantar heel pain and previously failed response to conservative treatment were randomized to a proximal medial gastrocnemius recession procedure followed by stretching exercise or to stretching exercise only.The primary outcome of interest was the American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot score at 12 months.Secondary outcomes included the AOFAS score at 3 months, Visual Analog Scale (VAS) pain score, Short Form 36 (SF-36) health survey, and Achilles performance test.Results demonstrated significantly better AOFAS ankle-hindfoot score and VAS pain score at 3 and 12 month, as well as SF-36 scores at 12 months, among the group who underwent proximal medial gastrocnemius recession procedure when compared patients allocated to stretching alone. Achilles performance test... Read More »
Level 2 RCT
2%
Synopsis: 50 patients with chronic, nonspecific neck pain were randomized to an 8-week exercise program of either craniocervical flexion exercises or isometric neck exercises.Patients were assessed at 4 and 8 weeks after enrollment for outcomes of pain on a visual analog scale (VAS), the Neck Disability Index, and cervical range of motion in flexion-extension, lateral flexion, and rotation.Results demonstrated significant within-group improvement after 4 and 8 weeks in both groups for all of the above measures. The group treated... Read More »
Level 2 RCT
2%
Synopsis: 9 randomized controlled trials were included in this meta-analysis, comparing arthroscopic surgery to conservative management for the treatment of degenerative meniscal tears in patients over the age of 40 years.Outcomes of interest included knee pain and knee function. The results from... Read More »
Level 1 Meta Analysis
1%
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
1%
Synopsis: 42 patients with Kellgren-Lawrence grade II-III knee osteoarthritis were randomized to an 8 week protocol of either traditional Chinese acupuncture or sham acupuncture.Patients attended 20-minute treatment sessions, three times per week for the 8 weeks.Patients were primarily assessed for rate of treatment response, based on a reduction of at least 36 points in the sum of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain and Function scales.Secondary outcomes included mean scores for pain, function, and quality-of-life measures after 8 weeks, 16 weeks, and 26 weeks. Results demonstrated no... Read More »
Level 1 RCT
1%
Synopsis: Ten ACE Reports (all randomized controlled trials) were identified from the OrthoEvidence database assessing the efficacy of platelet-rich plasma (PRP) versus control in the treatment of rotator cuff tears.Result are presented for Constant scores, University of California (UCLA) scores, American Shoulder and Elbow Surgeons (ASES) scores, Simple Shoulder Test (SST) scores, Shoulder Pain and Disability Index (SPADI), Sugaya classification, and the incidence of retear.Qualitative descriptions were provided for Visual Analog Scale (VAS) pain scores and range of motion (ROM).The results indicated that PRP treatment provided favourable Constant scores and Simple Shoulder test at 12 months.Otherwise, the remaining poolable outcomes displayed similar results amongst treatment and control groups.Evaluations of ROM proposed a potential benefit of PRP in the short-term, although effects were primarily lost at longer follow-up (6-12 months).Tendon integrity and retear risk also did not appear to be improved with PRP. This review exhibited... Read More »
ACE Review
1%
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