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3%
Synopsis: 40 patients with plantar heel pain and previously failed response to conservative treatment were randomized to a proximal medial gastrocnemius recession procedure followed by stretching exercise or to stretching exercise only.The primary outcome of interest was the American Orthopedic Foot and Ankle Society (AOFAS) ankle hindfoot score at 12 months.Secondary outcomes included the AOFAS score at 3 months, Visual Analog Scale (VAS) pain score, Short Form 36 (SF-36) health survey, and Achilles performance test.Results demonstrated significantly better AOFAS ankle-hindfoot score and VAS pain score at 3 and 12 month, as well as SF-36 scores at 12 months, among the group who underwent proximal medial gastrocnemius recession procedure when compared patients allocated to stretching alone. Achilles performance test... Read More »
Level 2 RCT
3%
Synopsis: 108 patients with knee osteoarthritis were randomized to application of either a neoprene knee brace with a patellar hole, or a neoprene knee brace without a patellar hole.Participants were first assessed for pain and functional performance measures prior to application of the brace.Then, following application of the brace, the participants were assessed on the outcome measures again.Results reported significant within-group improvement in each VAS pain scores, TUG test times, and 8-meter walk test times in both groups. Statistical analyses on... Read More »
Level 2 RCT
2%
Synopsis: 321 patients with a nonobstructive mensical tear were randomized to either an 8-week physical therapy program or to arthroscopic partial meniscectomy.The primary purpose of this study was to determine if the PT group was noninferior to the APM for outcome on the International Knee Documentation Committee (IKDC) subjective score at a noninferiority margin of 8pts. When analyzed in... Read More »
Author verified Level 2 RCT
2%
Synopsis: 222 patients with femoroacetabular impingement were randomized to either arthroscopic surgery or to a tailored physiotherapy program.The purpose of this study was to compare functional scores, quality-of-life scores, and incidence of complications between the two groups at 8-month follow-up.Results for the primary outcome measure, the Hip Outcome Score Activities of Daily Living (HOS ADL), demonstrated significantly higher scores in the arthroscopy group compared to the PT group at 8 months.Most secondary outcomes of changes in function and QoL scores significantly favoured the arthroscopy group as well.Crossover from the PT group to arthroscopy was recorded in 6 patients. Three complications, including... Read More »
Level 2 RCT
1%
Synopsis: 9 studies (599 patients) were included in this meta-analysis comparing opening wedge high tibial osteotomy (OWHTO) to closing wedge high tibial osteotomy (CWHTO) for the treatment of unicompartmental knee osteoarthritis.Outcomes of interest included Visual Analog Scale (VAS) pain score, Hospital for Special Surgery (HSS) knee score, walking distance, Hip-Knee-Ankle (HKA) angle on radiograph, tibial slope on radiograph, complication rate and survival rate.The results from this study demonstrated no significant differences in the pooled VAS pain score, HSS knee score, walking distance, HKA angle, complications or survival rates. Results of pooled... Read More »
Level 1 Meta Analysis
1%
Synopsis: 100 patients scheduled for total knee arthroplasty and had the knee placed in 60 degrees flexion for the first 24 hours after surgery were randomized to surgery with or without intraoperative use of a tourniquet.Patients were assessed for outcomes related to blood loss, pain scores on a visual analog scale, knee range of motion, knee circumference, and incidence of complications.For blood loss outcomes, intraoperative blood loss was significantly lower in the tourniquet group, while postoperative blood loss to drainage and hidden blood loss were significantly lower in the non-tourniquet group.Total blood loss and transfusion rate did not significantly differ between groups. Pain scores and... Read More »
Level 2 RCT
1%
Synopsis: 7 randomized controlled trials were selected for inclusion in this meta-analysis which sought to compare outcomes of anterior cruciate ligament remnant preservation and resection in ACL reconstruction.Outcomes included clinical scores, knee stability measures, and incidence of complications.For clinical measures, no significant difference in IKDC subjective score was observed between techniques, though Lysholm scores significantly favoured remnant preservation.For knee stability, no significant differences between techniques were noted in the rates of negative pivot-shift and Lachman tests, while KT-1000/2000 arthrometer results significantly favoured remnant preservation. No significant difference... Read More »
Level 1 Meta Analysis
1%
Synopsis: 36 randomized controlled trials were included in his meta-analysis which examined the use of platelet rich plasma (PRP) versus varying control interventions for various soft-tissue orthopaedic injuries and conditions, predominantly elbow tendinopathy and plantar fasciitis.Pooled results among patients with elbow tendinopathy demonstrated a lack of significant difference in pain or functional measures between PRP and control groups at 3 months, but significant differences in favour of PRP groups at 6 months.In patients with plantar fasciitis, pooled results demonstrated a lack of significant difference in pain scores between PRP and control at 3 months, while 6-month results significantly favoured PRP groups.When outcome on the AOFAS functional score were considered, pooled results significantly favoured PRP groups at 3 and 6 months. When effects were... Read More »
Level 1 Meta Analysis
1%
Synopsis: 313 patients with subacromial impingement were randomized to either arthroscopic subacromial decompression, arthroscopic irrigation alone, or no treatment.The purpose of this study was to explore cost-effectiveness of arthroscopic subacromial decompression compared to no treatment and arthroscopic irrigation alone, assessed after 6- and 12-month follow-up.Quality-adjusted life-years gained significantly favoured decompression compared to no treatment, and demonstrated no significant difference between decompression and arthroscopic irrigation alone.Total operative cost was significantly higher in the decompression group compared to the two other groups, while follow-up health service use cost was significantly higher with decompression versus no treatment and not significantly different between decompression and arthroscopic irrigation.Resulting incremental cost-effectiveness ratios demonstrated 0% probability and 50% probability of decompression being considered cost-effective compared to no treatment after 6 and 12 months, respectively, at a willingness-to-pay threshold of £20,000. Relative to arthroscopic... Read More »
Level 2 RCT
1%
Synopsis: 120 patients with full thickness rotator cuff tears were randomized to receive either 3 weeks of post-surgery immobilization in a sling, or 6 weeks of immobilization in a brace (with an abduction pillow placing the arm in a neutral position).Follow-up was performed at the 6 week time-point, as well as at 3, 6 and 12 months post-surgery.Outcomes reported included the Western Ontario Rotator Cuff (WORC) index, Constant Murley (CM) score, range of movement (ROM), as well as MRI results and patient-reported satisfaction.Sling immobilization for a period of 3 weeks was found to be a non-inferior treatment compared to brace immobilization for a period of 6 weeks, according to primary outcome of WORC index at 12 months. Additionally, patient reported... Read More »
Level 1 RCT