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4%
Synopsis: 96 randomized controlled trials were included in this meta-analysis and systematic review which sought to evaluate the efficacy and safety of opioid analgesia for chronic, noncancer pain compared to placebo and active comparator treatment.When compared to placebo, opioid therapy was associated with statistically significant effects with respect to pain relief, increase in physical function, and improvement in sleep quality, though the effect estimates all fell below preset minimally important differences (MIDs) for each outcome.In contrast, opioid therapy was associated with significantly higher incidences of vomiting, nausea, constipation, dizziness, drowsiness, pruritus, and dry mouth when compared to placebo. When compared to... Read More »
Author verified Level 1 Meta Analysis
4%
Synopsis: 38 patients with sub-acute non-specific low back pain (NSLBP) were randomized to receive 7 weeks of either Core Stabilization Exercise (CSE) therapy or 7 weeks of standard therapy (ultrasound and thermal treatment).Outcomes measured included lumbar joint repositioning error, pain intensity, and functional disability.The results demonstrated that CSE therapy was associated with significantly less lumbar joint repositioning error compared to the control group after 7 weeks of intervention, and 4 weeks after the cessation of treatment. Moreover, pain intensity... Read More »
Level 2 RCT
4%
Synopsis: Seven randomized controlled trials were included in this meta-analysis evaluating the efficacy of corticosteroid injections in the treatment of enthesopathy of the extensor carpi radialis brevis origin.Included RCTs featured local anesthetic or placebo saline injections as a control.Results demonstrated significantly lower pain at 1 month with corticosteroid versus control injections, but no significant difference at 3 and 6 months. Functional scores and... Read More »
Author verified Level 1 Meta Analysis
3%
Synopsis: 1583 patients with symptomatic knee osteoarthritis were randomized to either glucosamine monotherapy, chondroitin monotherapy, combined glucosamine and chondroitin therapy, celecoxib 200mg daily, or placebo.Patients were assessed over 24 weeks of treatment.In the primary analysis, only the celecoxib group demonstrated a significantly higher rate of patients attaining the primary efficacy endpoint - a reduction of WOMAC pain by a minimum of 20% relative to baseline - compared to placebo. However, when only... Read More »
RCT
3%
Synopsis: Three randomized controlled trials were included in this meta-analysis comparing pain and functional improvement between operative and nonoperative treatment for full-thickness rotator cuff tears.Follow-up was 12 months in each study. Results demonstrated that... Read More »
Author verified Level 1 Meta Analysis
3%
Synopsis: 150 patients with an acute displaced midshaft clavicle fracture were randomized to treatment through either open reduction and internal fixation with a plate or nonoperative management with sling immobilization.Patients were followed-up at 6 weeks, 3 months, 6 months, and 12 months for outcome related to the Disabilities of the Arm, Shoulder, and Hand score, the Constant score, and the incidence of nonunion.Outcome on both the DASH score and the Constant score significantly favoured the plate group compared to the sling group at 6-week and 3-month follow-up, but no significant between-group differences were observed in the measures at 6 months or 12 months. The incidence of... Read More »
Level 2 RCT
3%
Synopsis: 93 patients with chronic low back pain were randomized to an exercise therapy program administered via a mobile application (app group) or though standard written instructions (control group).Patients were assessed for change in pain severity on a numeric rating scale and disability on the Oswestry Disability Index after 12 weeks. Results demonstrated no... Read More »
Level 2 RCT
2%
Synopsis: 18 patients with a displaced (>2mm) base of the 5th metatarsal fracture were randomized to be treated with either open reduction and internal fixation (ORIF) or nonoperative management with a short leg cast.The purpose of this study was to compare clinical measures of pain and function, time to union, and restoration of injured metatarsal length between groups.Follow-up was performed for an average of 8.5 weeks.Results demonstrated no significant differences in pain or functional scores, despite a significantly shorter time to union in the operative group. Read More »
Level 2 RCT
2%
Synopsis: 60 patients with bilateral secondary knee osteoarthritis to corticosteroid-induced osteonecrosis were randomized to have one knee treated with subchondral injection of mesenchymal stem cells, and one knee treated with total knee arthroplasty.Patients were assessed over a minimum of 8 years after treatment.Results demonstrated no significant difference between groups in outcome on the Knee Society Score at final follow-up. Rate of secondary... Read More »
Level 2 RCT
2%
Synopsis: 208 patients with knee osteoarthritis were randomized to a combined intervention which consisted of three sessions of patellar mobilization and daily home-based nonloaded vastus medialis oblique exercise over 6 months, or to wait-list control for 6 months.Patients were assessed for outcome related to change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, VAS pain score, functional performance tests, and pain-free knee range of motion. Results after 6... Read More »
Level 2 RCT