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Synopsis: Five randomized controlled trials were included in this meta-analysis which sought to investigate the efficacy of mesenchymal stem cell injections in patients with knee osteoarthritis.Included studies featured various control groups, including placebo injection, hyaluronic acid injection, and no injection, as well as various concomitant treatments, including high tibial osteotomy, microfracture, platelet rich plasma injection and hyaluronic acid injection.Accordingly, clinical heterogeneity was assumed.Data was pooled from 12-24 month time points. Analyses on visual... Read More »
Level 2 Meta Analysis
15%
Synopsis: 29 studies were included in this meta-analysis comparing operative and non-operative treatment for acute Achilles tendon ruptures.The primary outcome of interest was the rate of re-rupture.Secondary outcomes included the rate of complications, functional outcomes, time to return to sports and time to return to work.The results revealed a significantly lower rate of re-rupture, but a higher rate of complications, in the operative group compared to the non-operative group.Similar findings to the primary analyses were observed in the sensitivity analyses based on early and late weight bearing status, high quality studies and studies conducted after the year 2000.There were no significant differences in re-rupture rate in studies utilizing accelerated functional rehabilitation. There was no... Read More »
Level 1 Meta Analysis
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Synopsis: Two hundred and seven studies with 32959 participants were analyzed in this network meta-analysis.The aim of this study was to compare outpatient treatments for managing acute pain from non-low back musculoskeletal injuries.Results revealed that the treatment with the greatest benefit was using topical nonsteroidal anti-inflammatory agents (NSAIDs).Afterwards, oral NSAIDs were beneficial which was followed by acetiminophen with or without diclofenac.The benefits included relieving pain 1-7 days, as well physical functioning , and symptom relief. Moreover, topical NSAIDs demonstrated increase in treatment satisfaction. Fentanyl and acetaminophen... Read More »
Meta Analysis
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Synopsis: 100 patients with chronic lateral epicondylitis were randomized to receive either leukocyte-enriched platelet-rich plasma (PRP) or a corticosteroid treatment, as a control.This was performed in order to determine the efficacy of PRP treatment in the recovery of postoperative function and pain relief.Patients were followed-up at two years to determine the effect on pain and function. Both pain and... Read More »
Author verified Level 1 RCT
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Synopsis: 381 patients with knee osteoarthritis (OA) were randomized to receive intra-articular injections with either Synovail (highly purified intra-articular hyaluronic acid) or Synvisc (hylan G-F20) once a week for three weeks.This double blinded randomized trial examined the efficacy and non-inferiority of Synovial treatment in patients with OA of the knee.The results from this study indicate that both treatments provide significant reductions in the WOMAC Index pain sub-scores at 6 months. Comparisons of mean... Read More »
Author verified Level 1 RCT
2%
Synopsis: 40 patients presenting with non-insertional Achilles tendinopathy were randomized to receive standard physical therapy with or without topical glyceryl trinitrate (GTN) treatment.Follow-up at 6 months indicated both groups made significant improvements; however, there were no differences between groups for ankle osteoarthritis scale (AOS) scores. There were also... Read More »
Level 2 RCT
2%
Synopsis: 8 ACE Reports (all randomized controlled trials) from the OrthoEvidence database were included in this review/meta-analysis examining the effect of arthroscopic surgery and physical therapy in the treatment of degenerative tears of the meniscus and knee osteoarthritis.The purpose of this review was to determine if any differences in outcome were demonstrated between arthroscopy followed by physical therapy versus physical therapy alone, regarding pain, function, satisfaction, adverse events, or osteoarthritis progression.Pain results were pooled at 3 different time point: 2-3 months, 6 months, and 12-24 months postintervention.At short-term (2-3 months) and long-term (12-24 months) follow-up, pain was similar between groups, with no significant difference observed.There tended to be less pain experienced at 6 months following arthroscopy, however this only reached significance in the KOOS pain outcome and the clinical importance of this observation is unknown.Assessments of functional outcome, either pooled or qualitative, suggested no significant difference between groups as well. The rate of... Read More »
ACE Review
2%
Synopsis: This systematic review identified 25 studies which assessed the effects of intra-articular corticosteroid injections, as well as the effects of image-guided corticosteroid injections, for the treatment of adhesive capsulitis.A total of 1,429 patients were identified from the 25 studies, and were followed up between 1 to 44 months.Results from the review indicated that corticosteroid injections offer rapid pain relief in the short term, as well as increased range of motion, however long-term effects are similar to other treatments, including placebo. No conclusions could... Read More »
Level 3 Meta Analysis
2%
Synopsis: 5 randomized controlled trials (170 patients) analyzing the effects of ultrasound-guided platelet-rich plasma (PRP) injections in patients with tendinopathy were included.The purpose of this meta-analysis was to quantitatively compare PRP injections to placebo injections or dry needling in terms of pain and function outcomes up to 6 months after treatment.The results displayed that PRP injections statistically improved pain intensity 6 months after treatment (but not at 2 or 3 months) and improved functional disability 3 months after treatment, in comparison to the control groups.Subgroup analyses indicated that PRP displayed the greatest effect sizes in rotator cuff tendinopathy, and had no significant effects in lateral epicondylitis patients in either outcome. The results of... Read More »
Author verified Level 1 Meta Analysis
2%
Synopsis: 193 patients with grade II-III acute lateral ankle injury were randomized to treatment with either a semi-rigid ankle brace, a lace-up ankle brace, or tape.The purpose of this study was to compare functional outcome measures between groups over the 6-month follow-up.The results demonstrated no significant differences between groups overall in the Foot and Ankle Outcome Score and Karlsson assessment. Return to pre-injury... Read More »
Conference Report