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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
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Synopsis: 50 patients between the ages of 18 and 65 undergoing hip arthroscopy were randomized to receive a femoral nerve block (FNB) or placebo prior to surgery.The purpose of the study was to determine the efficacy and safety of a preoperative femoral nerve block, in terms of postoperative pain reduction and morphine consumption.Patients receiving the femoral nerve block had a significantly lower intake of morphine equivalents at 48 hours postoperative compared to the control group, but this difference was insignificant at the 24 hour and 7 day assessments.VAS pain was significantly lower in the FNB group for most assessments up to 6 hours postoperative, but was similar between groups by 24 hours postoperatively.No differences in patient satisfaction, recovery quality, or time spent in the hospital were noted between groups. However, a significantly... Read More »
Author verified Level 1 RCT
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Synopsis: 80 patients with grade 2-3 gluteal tendinopathy were randomized to an intratendinous injection of either leukocyte-rich platelet rich plasma or corticosteroid.Patients were initially followed-up over the first 24 weeks after injection, after which they were given the option of secondary injection with LR-PRP if they had an unsatisfactory response to the first injection.Modified Harris Hip Score were significantly greater in the LR-PRP group compared to the CS group at 12 and 24 weeks, and at 52 and 104 weeks among patients who remained in their originally allocated group.A total of 27 patients of the CS group requested secondary injection with LR-PRP. After 104 weeks,... Read More »
Level 2 RCT
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Synopsis: Jumping athletes in sports, such as volleyball and basketball, are at risk of overuse injuries with a common injury being patellar tendinopathy.62 eligible jumping athletes with patellar tendinopathy for 3-12 months were randomized to receive either extracorporeal shockwave therapy (ESWT) or placebo, to determine the efficacy of EWST in the treatment of this injury. Pain and function... Read More »
Author verified Level 2 RCT
1%
Synopsis: 300 patients with one to three vertebral fractures were randomized to receive balloon kyphoplasty or non-surgical treatment to assess the efficacy and safety of kyphoplasty.There were significant improvements in quality of life, pain, and function measures at one month follow-up in the kyphoplasty group when compared to the non-surgical group. However, these differences... Read More »
Level 2 RCT
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Synopsis: 116 patients diagnosed with a single segmental cervical disc herniation, presenting with neck and radiating upper extremity pain, were randomized to receive cervical transforaminal steroid injection using either computer tomography (CT) fluoroscopy guidance or traditional C-arm fluoroscopy guidance.The outcomes were measured using pain reported through a numeric ranking scale (NRS), and assesed using the neck disability index (NDI). CT fluoroscopy guidance... Read More »
Author verified Level 2 RCT
1%
Synopsis: 10 patients were randomized to evaluate the efficacy of Platelet-Rich Plasma (PRP) for the treatment of patellar tendinopathy.In this double-blinded trial, patients received either dry needling and eccentric exercise (control) or dry needling with PRP and eccentric exercise. When assessed after... Read More »
Conference Report
1%
Synopsis: 16 patients with patellar tendinopathy were randomized to received dry needling with platelet rich plasma (PRP) injections or dry needling alone.were. Results at 6... Read More »
Conference Report
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
1%
Synopsis: Seven studies were included in this meta-analysis which aimed to determine the effect of the application of platelet-rich products (PRP) in arthroscopic rotator cuff repair.Pooled analyses of functional outcome measurements indicated no beneficial effect of PRP at a minimum of 12 months postoperatively, and overall no decrease in retear rate. However, an analysis... Read More »
Level 1 Meta Analysis