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Synopsis:
61 patients with idiopathic frozen shoulder were randomized to receive either watchful waiting (WW; n=31) or physical therapy (PT; n=30).The primary outcome of interest was the American Shoulder and Elbow Surgeons score (ASES) questionnaire.Secondary outcomes of interest included pain scores on a Visual Analog Scale (VAS), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, direct patient healthcare costs, and patient value (defined as the 12-month ASES score divided by healthcare costs).Outcomes were assessed at baseline, 6 weeks, and 3, 6, and 12 months.Both cohorts improved at each time point for all primary outcomes, but no significant differences in patient-reported outcomes (PROMs) between treatment modalities were found at any time point.WW patients incurred significantly lower direct costs than PT patients, with a normalized mean difference was of 1,635.67.Patients in the WW group also achieved greater patient value, with a normalized mean difference of -146.97. Both of these...
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Conference Report
①
Synopsis:
64 patients with primary frozen shoulder (adhesive capsulitis) were randomized to receive either a multisite (rotator interval, intraarticular, and subacromial bursa) triamcinolone injection (MCI; n=32) or a single-site triamcinolone injection (SRI; n=32).The primary outcomes of interest include range of motion in shoulder flexion, abduction, external and internal rotation and pain on a Visual Analog Scale (VAS).Secondary outcomes included patient satisfaction, American Shoudler and Elbow Surgeons (ASES) scores, Contant-Murley Score (CMS), and the incidence of palpitations.Range of motion in flexion, abduction, internal rotation at 8 weeks, ASES scores, CMS scores, and VAS pain at 4 & 8 weeks were all significantly better in the MCI group compared to the SRI group. All other outcomes...
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Level 1 RCT
①
Synopsis:
This meta-analysis and systematic review included 193 studies (84 randomized controlled trials were assessed in the meta-analysis) comparing physical therapy to a control group in patients with knee osteoarthritis (OA).The most effective interventions were ultrasonography, and aerobic, aquatic, strengthening, and proprioception exercise.Education, orthotics, taping, tai chi, and pulsed electromagnetic fields had no clinically significant effect on any of the patient-centered or functional outcomes of interest. Few adverse events...
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Author verified Level 1 Meta Analysis
②
Synopsis:
110 patients (ages of 17-70 years) after undergoing a surgical repair for Achilles tendon rupture were kept non-weight-bearing for the first two weeks after surgery.Subsequently, they were randomized to be kept either weight-bearing or non-weight-bearing for an additional four weeks. Early weight-bearing at...
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Author verified Level 2 RCT
①
Synopsis:
12 randomized controlled trials (788 patients) comparing the use of a minimally invasive medial midvastus approach (MMV-TKA) versus the standard medial parapatellar total knee arthroplasty (MP-TKA) were included in this systematic review and meta-analysis.Outcomes of interest included the Knee Society Score (KSS), knee pain on a Visual Analog Scale (VAS), knee function on a Normalized Function Scale, knee range of motion (ROM), time to straight leg activity, incidence of loose outboard support belt use, operative time, length of stay, blood loss, and incidence of postoperative complications.KSS scores, VAS pain scores, and knee joint flexural activity at 3 months, and days of straight leg raises were significantly better in the MMV-TKA group.Operative time was significantly shorter in the MP-TKA group. All other outcomes...
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Level 1 Meta Analysis
①
Synopsis:
38 patients over the age of 18 with chronic lower back pain who were non-traumatic and unresponsive to at least 1 month of physical therapy were included in this blinded trial.Patients were randomized to receive either prolotherapy with hypertonic glucose solution (n=19) or conservative therapy (n=19).The outcomes of interest included pain intensity, measured with a visual analog scale (VAS), and functional disability, measured with the Rolland-Morris Disability Questionnaire (RMDQ), assessed at baseline and 1, 3 and 6 months. The results of...
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Author verified Level 1 RCT
②
Synopsis:
17 patients were randomized to investigate the effects of a single bout of anterior to posterior (AP) talocrural joint mobilization for acute lateral ankle sprains.Patients received either a single 30-second bout of grade III AP talocrural joint mobilization or no intervention and were assessed after the first 24 hours.A single bout of AP talocrural joint mobilizations was revealed to have no immediate effect on ankle dorsiflexion range of motion (ROM), posterior talar translation, or self-reported function; however, an immediate effect on pain perception was observed.
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Author verified Level 2 RCT
②
Synopsis:
38 patients patients scheduled for ankle fusion and/or subtalar fusion under continuous popliteal sciatic nerve block were randomized to receive 30 mL ropivacaine (0.75%) with or without the addition of epinephrine (5 ug/mL).The purpose of the study was to determine how the duration of postoperative analgesia was affected by the addition of epinephrine, as measured by the time elapsed from poplitear catheter placement until the time of first request for postoperative analgesia via patient controlled analgesia. Results indicated that...
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Author verified Level 2 RCT
①
Synopsis:
Forty-seven patients with single-level cervical radiculopathy were randomized to receive either BRYAN CDA (cervical disk arthroplasty; n=22) or ACDF (anterior cervical discectomy and fusion; n=25) in a prospective, randomized, controlled trial conducted as a Food and Drug Administration Investigational Device Exemption trial.The primary outcomes of interest included visual analog scales (VAS) for neck and arm pain, neck disability index (NDI), and reoperation rates.The follow-up rate was 91.3%.Both groups demonstrated significantly improved NDI, VAS arm pain, and VAS neck pain scores at 20 years compared to preoperative scores.However, there were no significant differences between CDA and ACDF groups at 20 years for NDI, VAS arm pain, and VAS neck pain scores.Reoperations were reported in 41.7% of ACDF patients and 10.0% of CDA patients. Both CDA and...
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Level 1 RCT
②
Synopsis:
41 women with carpal tunnel syndrome were randomized to 8 weeks of nightly splinting with or without the addition of a single injection of platelet-rich plasma.Patients were followed up after 10 weeks from the beginning of treatment for results related to pain, outcome on the Boston Carpal Tunnel Questionnaire, and electrophysiological measures of peak latency of sensory nerve action potential (PL-SNAP) and onset latency of the compound muscle action potential (OL-CMAP). Results demonstrated no...
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Level 2 RCT