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100%
7%
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
5%
Synopsis: The success of non-operative knee osteoarthritis treatments is of great interest to patients and surgeons.The authors in this article randomized 63 patients with knee osteoarthritis to receive extracorporeal shockwave therapy (ESWT) or sham ESWT, and followed their pain, function, and MRI T2 measurements at 5 and 12 weeks.Primary outcome was pain on a 0-10 VAS, and secondary outcomes were the Wester Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Lequesne Index, and T2 relaxation time on MRI.ESWT, compared to placebo, resulted in significantly improved pain and function at 5 and 12 weeks. There was no... Read More »
Level 1 RCT
3%
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
3%
Synopsis: Six studies (626 patients) were included in this meta-analysis comparing surgical repair to conservative management and subacromial decompression for the treatment of rotator cuff tears in elderly patients.The primary outcome of interest was the Constant-Murley score. Results revealed significantly... Read More »
Level 1 Meta Analysis
3%
Synopsis: Recovery from ankle fracture surgery can be difficult, with 20% of patients having ongoing restrictions 6 months after the injury.In this study, the authors randomized 157 patients with fixed Weber B ankle fractures.Patients were randomized to an early motion and directed exercise (EMADE) physiotherapy program versus usual care in a plaster cast.Outcomes were measured at 12 weeks, and were as follows: Olerud-Molander ankle score (OMAS) and EuroQol 5 Dimensions 5 Levels (EQ-5D-5L).Of 130 patients analyzed, mean OMAS score significantly favoured EMADE group.There were no adverse events. Overall, EMADE may... Read More »
Conference Report
2%
Synopsis: Ten studies were included in this meta-analysis comparing varying routes of administration of ketamine to placebo in patients undergoing total joint arthroplasty (TJA).The primary outcome of interest was pain intensity.Secondary outcomes of interest included cumulative morphine consumption and the incidence of adverse events.Results of the meta-analysis found significantly lower early post-operative pain intensity, cumulative morphine consumption (0-24hr; 0-48hr) and incidence of gastrointestinal events with intravenous ketamine vs.placebo.Late post-operative pain intensity and cumulative morphine consumption (0-48hr) were significantly lower in the intraarticular ketamine group vs.placebo. Data on the... Read More »
Level 1 Meta Analysis
2%
Synopsis: Acute syndesmotic injures are commonly associated with ankle fractures, and can have long-term implications on patient function and stability.Suture buttons and syndesmotic screws are the two most commonly used techniques to treat these injuries.The authors randomized 97 patients to suture button versus syndesmotic screw fixation.Outcomes included the American Orthoapedic Foot & Ankle Society Ankle-Hindfoot Scale (AOFAS), Olerud-Molander Ankle score (OMA), pain on walking on a visual analogue scale (VAS), and the EuroQol-5-D (EQ-5D).Follow-up time was five years post-operatively.The suture button had significantly higher AOFAS and OMA scores, significantly less frequent ankle osteoarthritis and better maintenance of reduction.There was no difference in terms of VAS or EQ-5D. Overall, suture button... Read More »
Conference Report
1%
Synopsis: 34 patients with lateral epicondylitis were randomized to receive either saline and lidocaine, corticosteroid and lidocaine, or autologous blood and lidocaine injections. The results of the study indicated that there were no significant differences in regards to the Disabilities of the Arm, Shoulder, and Hand (DASH), pain and function scores among the three groups. Read More »
Author verified Level 2 RCT
1%
Synopsis: 23 patients diagnosed with patellar tendinopathy were randomized to treatment with eccentric exercise and either ultrasound-guided leukocyte-rich platelet-rich plasma (PRP) injection with dry needling (DN) or dry needling without PRP injection.The purpose of this trial was to compare patient-reported outcomes between to the interventions.Results at 12 weeks revealed statistically and clinically significant improvements in Victorian Institute of Sports Assessment (VISA), Lysholm, and VAS scores versus baseline with PRP whereas only Lysholm scores improved with DN.At 26 weeks, VISA, Tegner, Lysholm and VAS scores improved significantly versus baseline with DN whereas this occurred with only VISA and VAS scores in PRP patients. Nevertheless, overall outcome... Read More »
Author verified Level 1 RCT
1%
Synopsis: 90 patients with adhesive capsulitis were randomized to one of three different injection therapies: hydrodilation, intra-articular steroid injection, or subacromial sterioid injection.The purpose of this study was to determine if hydrodilation offered significantly better pain outcome, function outcome, or range of motion when compared to intra-articular and subacromial steroid injection.Follow-up was performed at 1, 3, and 6 months post-injection.Results demonstrated significantly lower pain and significant greater range of motion at 1 month in the hydrodilation group compared to the other two groups.Additionally, functional outcome, either through the Simple Shoulder Test or Constant score, was significantly greater in the hydrodilation group up to 3 months post-injection. Nonetheless, differences between... Read More »
Author verified Level 2 RCT