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①
Synopsis:
64 patients with primary frozen shoulder (adhesive capsulitis) were randomized to receive either a multisite (rotator interval, intraarticular, and subacromial bursa) triamcinolone injection (MCI; n=32) or a single-site triamcinolone injection (SRI; n=32).The primary outcomes of interest include range of motion in shoulder flexion, abduction, external and internal rotation and pain on a Visual Analog Scale (VAS).Secondary outcomes included patient satisfaction, American Shoudler and Elbow Surgeons (ASES) scores, Contant-Murley Score (CMS), and the incidence of palpitations.Range of motion in flexion, abduction, internal rotation at 8 weeks, ASES scores, CMS scores, and VAS pain at 4 & 8 weeks were all significantly better in the MCI group compared to the SRI group. All other outcomes...
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Level 1 RCT
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Synopsis:
One hundred and seventy-seven patients with chronic knee pain from knee osteoarthritis (OA) were randomized to receive cooled radiofrequency ablation (CRFA; n=89) of the genicular nerves or a single intra-articular hyaluronic acid (HA; n=88).The primary outcome of interest was the number of patients who reported a =>50% reduction in pain scores from baseline after 6 months.Additional outcomes of interest included pain scores on a Numeric Rating Scale (NRS), the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, WOMAC pain scores, WOMAC physical function scores, WOMAC stiffness scores, patient perception of treatment effect as reflected by the Global Perceived Effect (GPE) score, the Euro-Qol-5 Dimensions-5 Level (EQ-5D-5L) quality of life questionnaire, and the incidence of treatment-related and non-treatment related adverse events.Outcomes were assessed at 1, 3, and 6 months post-treatment.Results revealed a statistically significantly higher proportion of patients in the CRFA group who reported =>50% improvement in pain scores from baseline compared to the HA group (71% vs.38%, p<0.0001).NRS pain scores, WOMAC total scores, WOMAC pain scores WOMAC physical function scores, GPE scores, and EQ-5D-5L scores were statistically significantly in favour of the CRFA group at all time points compared to the HA group (p<0.05 for all).WOMAC stiffness scores were statistically significantly in favour of the CRFA group at 3 months (p=0.0022) and 6 months (p<0.0001) post-treatment. The incidence of...
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Author verified Level 1 RCT
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Synopsis:
Fifteen studies involving a total of 353,169 patients undergoing knee or hip arthroplasty were included in this meta-analysis.Among them, 156,405 patients received Spinal Anaesthesia (SA), while 196,764 patients underwent General Anaesthesia (GA).The primary outcome assessed was the incidence of Postoperative Surgical Site Infections (SSIs).Outcomes were evaluated up to 30 days post-surgery. This meta-analysis reveals...
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Level 1 Meta Analysis
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Synopsis:
47 patients with combined anterior cruciate ligament (ACL) and medial collateral ligament (MCL) injuries were randomized to receive either operative treatment on both ACL and MCL or operative treatment just on ACL. It was observed that the non-operative treatment of the MCL led to a greater range of motion and recovery of quadriceps power generation during early follow-ups.
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Author verified Level 2 RCT
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Synopsis:
351 patients with a meniscus tear and knee osteoarthritis (OA) were randomized to either undergo arthroscopic partial meniscectomy (APM) followed by a physical therapy program or physical therapy alone, in order to compare clinical and functional outcomes. Following treatment over a 12 month period, all patients improved similarly in WOMAC physical-function score, KOOS pain score, and SF-36 physical-activity score.
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Author verified Level 2 RCT
Greater Quality of Life But Longer Operative Time With THA vs HA for Displaced Femoral Neck Fracture
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Synopsis:
Sixteen randomized controlled studies containing a total of 3084 patients were included in this meta-analysis including patients with displaced femoral neck fractures undergoing total hip arthroplasty (THA; n=1521) or hemiarthroplasty (HA; n=1563).Pooled outcomes of interest included the following: incidence of revision, functional outcomes (evaluated using the Harris hip score), incidence of mortality, health-related quality of life (QoL; evaluated using the EuroQol-5 Dimensions [EQ-5D] Index), incidence of periprosthetic fracture, incidence of dislocation, and operative time.Subgroup analyses was conducted by level of risk of bias.Revision surgery, incidence of mortality and dislocation were all analyzed at 12-60 months follow-up, where as the rest of the outcomes were assessed at 12-36 months.Pooled results revealed that health-related quality of life, evaluated using EQ-5D Index, was statistically significantly in favour of the THA group vs.HA (p=0.001).However, pooled operative time was statistically significantly shorter in the HA group vs THA (p=0.001). All other pooled...
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Author verified Level 1 Meta Analysis
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Synopsis:
101 patients undergoing an arthroscopic rotator cuff repair were randomized to receive 14 days of buccally absorbed cannabidiol (CBD; n=54; 25mg dose to those ≤80kg, 50mg dose to those >80 kgs) or placebo (n=47) for the control of postoperative pain.The primary outcome of interest was pain intensity measured with a Visual Analog Scale (VAS).Secondary outcomes of interest included patient satisfaction, opioid consumption, nausea, liver enzyme levels, and adverse events.Outcomes were assessed up to 14 days post-operation.Results revealed significantly less pain in the CBD group vs.placebo on Day 1 post-operation only.However, in the subgroup analysis by dose, the superiority in pain scores was only observed in the 50mg group vs.placebo.Patient satisfaction on day 1 and 2 post-operation were also significantly in favour of the CBD group; in the subgroup analysis by dose, this superiority was observed in the 50mg group vs.both the 25mg and placebo groups on day 1, and vs.the placebo group only on day 2.Severity of nausea was significantly greater in the 50mg group vs.
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Level 1 RCT
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Synopsis:
Twenty-eight patients recovering from anterior cruciate ligament (ACL) surgery were randomized to receive 12 weeks of low-intensity, blood flow restriction quadriceps-hamstring exercise training (n=14) or high-intensity, unrestricted exercise training (n=14).The primary outcome of interest was knee muscle strength in flexion and extension.Secondary outcomes of interest included the Lysholm score, International Knee Documentation Committee (IKDC) score, and the Knee Injury and Osteoarthritis Outcomes Score (KOOS), measured on the 4th, 8th and 12th week.Results revealed significantly greater muscle strength in extension in the intervention group vs.control at week 12, and in flexion at weeks 8 and 12. IKDC scores, Lysholm...
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Level 1 RCT
①
Synopsis:
Eight hundred and twenty-three (n=823) overweight/obese knee osteoarthritis patients ≥50 years or older were randomized to receive an 18-month diet & exercise program (n=414) or an attention control (n=409), delivered in a community-based setting.The primary outcome of interest was the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) pain score.Secondary outcomes of interest included body weight, waist circumference, WOMAC function, 6-minute walk test, pain medication use, and Short-Form 36 (SF-36) physical and mental subscores.All outcomes were assessed upon completion of the 18-month study.Results of this study found diet & exercise to result in a higher rate of clinically meaningful WOMAC pain score reduction vs.control. Body weight, waist...
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Level 1 RCT
①
Synopsis:
94 patients between the ages of 50-75 years with knee osteoarthritis were included in this non inferiority trial in which patients were randomly allotted to undergo either traditional moxibustion (TM; n=44) or jade moxibustion (JM; n=45).The primary outcome of interest was quality of life, measured by the 8 dimensions of the 36-item short-form health survey (SF-36) at 8,12 and 24 weeks.Secondary outcomes of interest included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) knee stiffness scores at 2, 4, 8, 12, and 24 weeks, serum levels of osteoarthritis-related cytokines.Adverse events were also recorded.The results of the study indicate that JM significantly improved role-physical and physical functioning SF-36 scores at long-term follow-up compared to TM.WOMAC stiffness scores showed significant improvement from baseline for both groups, however no significant differences were found between groups.Serum COMP, MMP-13 and MCP-1 levels in the JM group and serum IL-1β, IL-2, IL-6, MMP-3 and IL-8 levels in the TM group fell significantly, although no significant differences were observed between groups. Rates of adverse...
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Author verified Level 1 RCT