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Outcomes favourable with manual and manipulative therapy for hallux abducto valgus30 patients were randomized to preliminarily investigate the effect of manual and manipulative therapy (MMT) in patients with hallux abducto valgus. Two weeks of the Brantingham protocol (MMT) was compared to nightly splinting, with follow-up for 1 month. The results indicated that patients of both group experienced significant improvement in pain, disability, and hallux valgus at posttreatment, 1-week follow-up and 1-month follow-up assessments. However, substantial regression in improvement from 1-week to 1-month follow-up in the splint group attributed to significantly better outcome with the Brantingham protocol at 1 month.
Outcomes favourable with manual and manipulative therapy for hallux abducto valgus
TKA: Significant improvement and shorter hospital stay achieved with early rehabilitation306 patients were randomized to determine the effect of the onset of physical rehabilitation following total knee arthroplasty. Patients were allocated to receive early rehabilitation (within the first 24 postoperative hours) or delayed rehabilitation (48-72h postoperatively), and were followed for outcomes in pain, range of motion (ROM), quadriceps and hamstring strength, autonomy in activities in daily living, and balance and gait characteristics up until discharge. The results indicated that early rehabilitation promoted better pain, ROM, muscle strength, and balance and gait characteristics compared to delayed therapy, and that length of hospital stay was shorter in those who underwent early rehabilitation.
TKA: Significant improvement and shorter hospital stay achieved with early rehabilitation
Microwave diathermy demonstrated to improve symptomatic knee OA compared to sham treatment63 patients were randomized to determine the effectiveness of hyperthermia induced by microwave diathermy in treating sufferers of knee osteoarthritis. Patients were allocated to receive 30-minute sessions of either microwave diathermy at a frequency of 433.92 MHz or sham treatment three times per week for four weeks. Follow-up evaluation was conducted at the end of the therapy phase (4 weeks), and also at 16 weeks for outcomes of pain, stiffness, and function. The results indicated that patient-reported WOMAC and performance-based Timed-Up and Go test outcomes were significantly improved in those who received heat therapy compared to sham treatment patients.
Microwave diathermy demonstrated to improve symptomatic knee OA compared to sham treatment
Resistance & impact training has effect on lumbar bone mass and bone degradation markers106 postmenopausal women who were breast cancer survivors were randomized to determine the effect of a resistance and impact training program on body composition and bone health. Participants were allocated to a 1-year intervention with either a training program, or a low-intensity stretching program. Outcomes were assessed after 1 year. The results indicated that women who participated in the training group preserved bone mineral density at the lumbar spine, compared to a decrease in the stretching group, and had a significantly greater decrease in deoxypyrodinoline (a bone degradation biomarker). There were no significant differences in body composition measurements, or bone mass measurements of the hip.
Resistance & impact training has effect on lumbar bone mass and bone degradation markers
Inconclusive efficacy of Chinese herbal medication in osteoarthritis treatmentResearch into effective treatments for osteoarthritis (OA) is ongoing. In this trial, 102 patients with knee or hip OA were randomized to receive specific, active or nonspecific, control herbal therapy on the basis of Traditional Chinese Medicine. The purpose was to determine whether active preparations of low-dose Chinese herbs provided a stark reduction in symptoms associated with OA. After 20 weeks of decoction therapy with the herbs, the results indicated a significant reduction in OA symptoms with the specific preparations. However, the improvement was similar to that observed with control preparations.
Inconclusive efficacy of Chinese herbal medication in osteoarthritis treatment
Exercise program may improve function and quality of life in osteoporotic women89 osteoporotic women (60 or older) were randomized to determine the effectiveness of an exercise program on functional outcome and health-related quality of life in this population. Patients were allocated to a 3-month exercise protocol group or control group, who were told to retain their current lifestyle. Follow-up assessments were conducted at the end of the program period (3 months) and at 12 months. The results indicated that functional performance and several facets of disease-specific health-related quality of life were significantly better in those of the exercise group.
Exercise program may improve function and quality of life in osteoporotic women
Additional anaesthetic not effective in reducing minimal pain from tourniquet useTourniquet use in some surgeries has been reported to cause pain and discomfort in awake patients. 56 patients undergoing forefoot surgery under regional anaesthetic were randomized to determine the effect of additional subcutaneous anaesthetic to the tourniquet area to manage any pain or discomfort that may be experienced. Intraoperative assessment observed no difference in pain between those who received the additional analgesic mixture and those who did not. Furthermore, skin condition was similar between groups.
Additional anaesthetic not effective in reducing minimal pain from tourniquet use
Dupuytren's contracture: nightly splinting after fasciectomy or dermo-fasciectomy154 patients with Dupuytren's disease were randomized to receive hand therapy either with or without nightly splinting for 6 months following fasciectomy or dermofasciectomy, in order to determine if splinting provided a beneficial effect to patients 1 year postoperatively. Patients were primarily assessed with the Disabilities of the Arm, Hand, and Shoulder questionnaire, and secondarily through total active flexion, total active extension, and patient satisfaction. The results of the study reflected no significant differences between the primary outcome or any of the secondary outcomes, and that there was no beneficial effect of nightly splinting combined with hand therapy.
Dupuytren's contracture: nightly splinting after fasciectomy or dermo-fasciectomy
Botulinum toxin injections improve pain and muscle imbalance in chronic anterior knee painImbalance in quadriceps muscle activation may give rise to anterior knee pain. 24 patients suffering from this aetiology of anterior knee pain were randomized to determine the effect of a botulinum toxin type A (BoNT-A) injection on pain management of this condition and improving quadriceps muscle balance. Results after 12 weeks indicated that BoNT-A-injected patients experienced more significant reductions in anterior knee-specific pain and functional knee pain, and had a better balance between the vastus lateralis and vastus medialis portions of the quadriceps muscle.
Botulinum toxin injections improve pain and muscle imbalance in chronic anterior knee pain
Aquatic therapy in the management of knee and hip osteoarthritis & rheumatoid arthritis10 randomized controlled trials were included in this systematic review and meta-analysis which examined the use of aquatic therapy in the treatment of hip and knee osteoarthritis and rheumatoid arthritis. The pooled results suggested that the efficacy of aquatic exercises seemed to be similar to that of land based exercise, and may represent an alternative method of management in this population of patients. In future trials a well-described, uniform treatment regimen should be examined to establish a standard protocol for aquatic exercise treatment.
Aquatic therapy in the management of knee and hip osteoarthritis & rheumatoid arthritis
Positive effect of D-003 on bone mineral density in postmenopausal women83 postmenopausal women with osteopenia or osteoporosis were randomized to determine the efficacy of D-003, an isolate from sugar cane wax, on improving bone mineral density (BMD). Participants were treated with either 10mg/day D-003 or placebo for 3 years. Results at the end of the trial indicated that lumbar spine BMD was significantly improved with D-003 compared to placebo. Women treated with D-003 also experienced an increase in femoral neck BMD, although the difference was not significantly different than that obtained by the placebo group.
Positive effect of D-003 on bone mineral density in postmenopausal women
Health-related QoL in osteoporotic women improved with zoledronic acid infusionsThis study included a subset of 1434 participants from the Health Outcomes and Reduced Incidence with Zoledronic acid ONce yearly (HORIZON) Pivotal Fracture Trial, examining the effect of zoledronic acid on health-related quality of life in postmenopausal, osteoporotic women. After 3 years of follow-up, participants treated with annual infusions of zoledronic acid displayed a significant improvement in various domains of health-related quality of life when compared to those treated with placebo infusions.
Health-related QoL in osteoporotic women improved with zoledronic acid infusions
THR: Postoperative analgesia with oxycodone or IVPCA morphine results in similar outcomes114 patients undergoing primary elective total hip replacement (THR) under spinal anaesthesia were randomized to determine the comparative efficacy of oral oxycodone with i.v patient-controlled analgesia (IVPCA) as a method of postoperative analgesia. Patients received either Oxycontin 20mg or IVPCA with morphine, and were monitored for pain and nausea in the first 72 hours postoperatively. The results demonstrated that oral oxycodone was non-inferior to IVPCA with morphine, as pain and nausea scores were observed to not significantly differ between groups.
THR: Postoperative analgesia with oxycodone or IVPCA morphine results in similar outcomes
Etidronate, alendronate, and reisendronate significantly reduce the risk of hip fractureSeven randomized controlled trials were included in this meta-analysis which investigated the use of oral bisphosphonates (etidronate, alendronate, or risendronate) in the prevention of hip fracture in the population suffering from neurological diseases, such as amylotrophic lateral sclerosis, stroke, or Parkinson's disease. Included studies were placebo controlled with the exception of one, which featured an active control group with alfacalcidol. The studies were conducted for a minimum of one year (up to two years). Pooled analyses indicated that intervention with etidronate, alendronate, or risendronate significantly reduced the relative risk of hip fracture compared to placebo or active control.
Etidronate, alendronate, and reisendronate significantly reduce the risk of hip fracture
Inconclusive effectiveness of postoperative outpatient physiotherapy following discectomy16 RCTs evaluating 1336 patients were identified for inclusion in this systematic review and meta-analysis evaluating the efficacy of outpatient physiotherapy following lumbar discectomy. The results from this study indicated that that there was no statistically significant difference in short-term disability outcome between physiotherapy and control/sham treatments, however, the pooled effect suggested a trend supporting the use of physiotherapy. Additionally, there appeared to be no statistically significant difference in short-term disability outcomes between high intensity and low intensity physiotherapy treatments. It should be noted there was significant heterogeneity in the pooled analyses and that further trials using uniform physiotherapy protocols are required to provide a more definitive assessment regarding the use of outpatient physiotherapy following lumbar discectomy and the best practice.
Inconclusive effectiveness of postoperative outpatient physiotherapy following discectomy
Local anaesthetic an efficacious method of post-operative analgesia in paediatric patients40 paediatric patients (aged 1-12) were randomized to determine the efficacy of regional anaesthetic administration for post-operative analgesia in orthopaedic extremity surgeries. Patients received local injections of either bupivacaine anaesthetic (study group) or control seurm physiologic (control group), and were followed-up for 48 hours postoperatively for outcomes of pain, opioid requirement, and incidence of postoperative complications. Results indicated that pain was significantly reduced in the study group, and that patients of the study group required less additional opioid analgesic.
Local anaesthetic an efficacious method of post-operative analgesia in paediatric patients
Shoulder pain: Pain and function significantly improved with image-guided injectionFindings of two randomized controlled trials were pooled in order to investigate if method of corticosteroid injection - either image-guided or anatomical landmark guided (blind) - impacted clinical outcome in patients suffering from shoulder pain. Clinical outcomes of pain and function were reported at 6 weeks, and the incidences of adverse events were recorded. Pooled effects illustrated that pain and function at 6 weeks were significantly improved with image-guided injections compared to blind injections. Incidence of adverse events was also lower in image-guided group; however, the difference did not reach statistical significance.
Shoulder pain: Pain and function significantly improved with image-guided injection
ACL Reconstruction: platelet-rich plasma does not significantly reduce tunnel widening50 patients undergoing ACL reconstruction with a hamstring graft were randomized to determine the effect of platelet-rich plasma on the reduction of tunnel widening 3 months following ACL reconstruction. Patients were allocated to receive surgery either with or without the application of PRP to grafts, and femoral and tibial tunnels. The results indicated that PRP patients experienced a slight reduction of tunnel widening compared to control patients, but the difference was not significant.
ACL Reconstruction: platelet-rich plasma does not significantly reduce tunnel widening
Addition of bone marrow aspirate to TCP show no benefit in radiographic outcomes55 patients were randomized to evaluate the healing of cavity defects filled with ultraporous B-tricalcium phosphate (TCP) versus TCP and bone marrow aspirate (TCP/BM). Patients with a benign bone lesion received either TCP or TCP/BM and were assessed at 24 months. Results revealed that while significant improvements in radiographic parameters were reported in both groups, the addition of BM did not provide any noticeable benefit.
Addition of bone marrow aspirate to TCP show no benefit in radiographic outcomes
Ketamine midazolam: effective sedative for urgent reductions of fractures & dislocations61 patients entering the emergency department in need of urgent reduction after experiencing a traumatic event were randomised to take either midazolam-fentanyl or ketamine-low-dose midazolam for procedural sedation to compare the efficacy of these two drug combinations. The results for this study indicated that both drug combinations were effective for procedural sedation and reduced pain, but KM reduced the risk of hypoxia and may be the better choice for use in the emergency department.
Ketamine midazolam: effective sedative for urgent reductions of fractures & dislocations
Composite-beam and sliding-taper prostheses show no difference in femoral bone loss120 patients were randomized to evaluate whether the geometry of the cemented femoral prosthesis affected the pattern of strain-adaptive bone remodelling in the proximal aspect of the femur following total hip arthroplasty (THA). Patients received either composite-beam or sliding-taper (double and triple-tapered) prostheses and were assessed at 2 years. Results indicated that the magnitude and regional distribution of proximal femoral bone loss were similar between patients who received sliding-taper or composite-beam prostheses. Furthermore, similar bone remodeling pattern was observed between double and triple-tapered prostheses.
Composite-beam and sliding-taper prostheses show no difference in femoral bone loss
Annual infusion of zoledronic acid reduces days of back pain, disability, and bed rest7736 postmenopausal women with osteoporosis were randomized to examine the effect of once-yearly zoledronic acid on improving back pain and disability. Patients received either a single 15 minute intravenous fusion of zoledronic acid (5 mg) or placebo at baseline, 12 months, and 24 months. The assessment at 36 months indicated that zoledronic acid significantly reduced the number of days with back pain when compared to placebo. Additionally, zoledronic acid reduced the number of days of limited activity due to back pain and limited activity and bed rest after a fracture.
Annual infusion of zoledronic acid reduces days of back pain, disability, and bed rest
Exercise reduces pain and improves function before hip, but not knee, replacement surgeryIn this systematic review, 18 studies examining the preoperative effects of exercise-based interventions on pain and physical function of patients waiting to undergo hip or knee replacement surgery were evaluated. Following comparisons of groups who participated in exercise and those who did not, results indicated that exercise alleviated pain and improved physical function for patients waiting to undergo hip replacement, but not knee replacement surgery.
Exercise reduces pain and improves function before hip, but not knee, replacement surgery
Anterior to posterior talocrural joint mobilizations provides no benefit for ankle sprains17 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.
Anterior to posterior talocrural joint mobilizations provides no benefit for ankle sprains
Multimodal pain management effective after bipolar hemiarthroplasty for hip fracture82 elderly patients with hip fractures scheduled to undergo bipolar hemiarthroplasty were randomized into two groups to determine the efficacy of multimodal pain management. Patients either received preemptive pain medication and intraoperative periarticular injections or did not. Following 7 days of assessment, results indicated that multimodal pain management was effective in providing additional pain relief over the first 4 days and reduced the amount of narcotics consumed for postoperative pain management.
Multimodal pain management effective after bipolar hemiarthroplasty for hip fracture
Zaltoprofen is noninferior to diclofenac for the treatment of knee OAThis study evaluated whether zaltoprofen was as a noninferior alternative (in regards to safety and efficacy) to diclofenac for the treatment of knee osteoarthritis (OA). 213 patients were randomized to either zaltoprofen (80 mg t.i.d.) or diclofenac (50 mg t.i.d.) and were assessed after 4 weeks. Results indicated that both groups experienced significant (but comparable) improvement in pain intensity, functional status, and pain relief when compared to baseline values. Moreover, no serious adverse events were observed with either medication.
Zaltoprofen is noninferior to diclofenac for the treatment of knee OA
Single and 2 PRP injections provide similar short term pain reduction in knee OA patients78 patients with bilateral knee osteoarthritis (OA) were randomized to receive 1 or 2 injections of platelet-rich plasma (PRP), or 1 injection of saline, so as to compare the effect of the injections on pain. The results displayed that 1 injection of PRP (having a concentration 10 times the normal amount) and 2 injections of PRP provided similar reductions in pain for knee OA patients and were more effective than saline injections. However, by 6 months improvements in pain from PRP injections were not noticeable, suggesting that PRP injections are only effective in the short term.
Single and 2 PRP injections provide similar short term pain reduction in knee OA patients
THR with hip resurfacing implant shows similar outcome in gait as conventional prosthesisThis trial randomized 30 patients to either a hip resurfacing system or conventional prosthesis total hip replacement (THR) to compare their gait mechanics over the short term. The 12 week assessment revealed that there were no significant differences between the techniques regarding kinetic, kinematic, or temporal-spatial gait parameter variables of the hip (except for peak abductor moments, which favoured the conventional treatment). Additional long-term assessments using larger sample sizes are required to further compare between these two treatment options.
THR with hip resurfacing implant shows similar outcome in gait as conventional prosthesis
Comparison between 0.125% and 0.25% bupivacaine ISBPB in rotator cuff repair30 patients undergoing rotator cuff repair were randomized to receive ultrasound-guided interscalene brachial plexus block with either 20 mL of 0.125% bupivacaine or 0.25% bupivacaine, to compare the diaphragm function, oxygen saturation, and pain management outcomes between groups. Following evaluations over a 48 hour period, clinically similar pain management (VAS pain scores and opioid requirements) were experienced between the two groups, although diaphragm dysfunction and oxygen saturation decrease were significantly lessened among patients treated with the dilute bupivacaine preparation (0.125%).
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Comparison between 0.125% and 0.25% bupivacaine ISBPB in rotator cuff repair
One-to-one therapy not superior to group-based or home exercise programs following TKATwo hundred and forty-nine patients undergoing unilateral or simultaneous bilateral total knee arthroplasty (TKA) were included in this study to determine whether one-to-one therapy was superior to group-based therapy or monitored home exercise programs for rehabilitation following TKA. One year postoperatively, the results from this study indicated that one-to-one therapy was not significantly superior to group- or home-based exercise programs with respect to all clinical and functional outcomes (i.e. Oxford Knee Score, WOMAC, SF-12, pain, ability to walk and climb stairs, and patient satisfaction).
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One-to-one therapy not superior to group-based or home exercise programs following TKA
Percutaneous vertebroplasty improves pain and quality of life in patients with VCF82 patients with vertebral compression fractures (VCF) were randomized to either percutaneous vertebroplasty (PV) or optimal medical therapy (OMT) to compare their efficacy in improving pain and quality of life (QOL). Percutaneous vertebroplasty led to a short-term (6 months) improvement in pain and long-term (36 months) improvement in QOL when compared to optimal medical therapy. Thus, this study considered percutaneous vertebroplasty to be more effective in patients with acute VCF than optimal medical therapy. Further research should be undertaken to compare vertebroplasty to other operative options.
Percutaneous vertebroplasty improves pain and quality of life in patients with VCF
Pulsing electromagnetic field treatment yields no effect on disuse osteopenia (bone loss)99 patients were randomized to examine whether a common pulsing electromagnetic field (PEMF) treatment could reduce the substantial osteopenia that occurs after forearm disuse. Patients wore either sham or active PEMF transducers (both for 1, 2, or 4 h/day) on the distal forearm for 8 weeks. The particular PEMF waveform and durations applied to the patients was revealed to have no effect on the continuing substantial disuse bone loss when assessed after 24 weeks.
Pulsing electromagnetic field treatment yields no effect on disuse osteopenia (bone loss)
QOL in women experiencing IPV didn't improve following counselling from family doctor52 family doctors were randomized to provide their female patients (272 female patients in total), who screened positive for intimate partner violence (IPV), with either counselling sessions or give them resource cards and provide usual care, in order to compare the quality of life, safety planning and behaviours, and mental health status between the women). Following 12 months, results indicated that counselling from a family doctor did not improve the quality of life, safety planning and behaviours, mental health, anxiety symptoms, or comfort to discuss fears in women. Patients, who received counselling sessions, however did experience a decrease in depression symptoms, and were more regularly asked about their own and their child’s safety.
QOL in women experiencing IPV didn't improve following counselling from family doctor
Short term immobilization of severe ankle sprains provides the best clinical outcome584 patients with severe ankle sprains were recruited from eight emergency departments to assess the effectiveness of three different bracing options and to compare them with a tubular compression brace. Patients were randomized to treatment with a below-knee cast, an Aircast brace, Bledsoe boot, or tubular compression brace. At three month follow-up, there was a significant improvement in the Foot and Ankle scores of the below-knee casting and Airbrace groups in comparison to the tubular compression brace. There were no differences between groups at a nine month follow-up.
Short term immobilization of severe ankle sprains provides the best clinical outcome
Clinical efficacy of chiropractic care vs sham treatment for spinal pain remains unclear183 patients suffering from at least 1 week of spinal pain were randomized to evaluate the short-term efficacy of chiropractic care in alleviating symptoms against a sham intervention. Patients were evaluated over 2 weeks based on pain intensity (Numerical Rating Scale; NRS), function (Functional Rating Index; FRI), global change, minimum acceptable outcome, and treatment satisfaction. The evidence presented in this study indicated that although statistical significance was displayed with chiropractic care for pain, physical function, perceived global improvement and treatment satisfaction, these treatment effects were not clinically important. There were no between-group differences in achieving a minimally acceptable outcome. Furthermore, the majority of patients correctly guessed which treatment group they had been allocated to.
Clinical efficacy of chiropractic care vs sham treatment for spinal pain remains unclear
Knee OA: NASHA intra-articular hyaluronic acid vs. methylprednisolone acetate442 patients suffering from unilateral knee pain were randomized to evaluate the safety and efficacy of 26 weeks of a single-injection of intra-articular non-animal stabilized hyaluronic acid (NASHA) compared to methylprednisolone acetate (MPA). Following 26 weeks of blinded evaluation, patients were offered a second injection with NASHA and were followed for an additional 26 weeks. The evidence presented in this study demonstrated that NASHA gel produced a non-inferior response rate in comparison to MPA. WOMAC pain, physical function, and stiffness evaluations favored NASHA over MPA during the blinded phase from 12 to 26 weeks. Sustained improvements were apparent in WOMAC outcomes irrespective of initial treatment in response to open-labeled extension with NASHA. No serious device-related adverse events were apparent though significantly more cases of arthralgia in the NASHA group were observed during the blinded phase.
Knee OA: NASHA intra-articular hyaluronic acid vs. methylprednisolone acetate
Collagen nerve guide conduit successfully treated nerve laceration in distal forearmForty-three patients with complete nerve lacerations of the median or ulnar nerves in the distal forearm were treated using either a Collagen Nerve Guide Conduit, in which the gap of the encased nerve is less than 6 mm, or a conventional repair (direct suture or nerve graft). The purpose was to compare the recovery of sensory and motor functions between the two treatments. At 12 months, the Conduit group had significantly longer distal motor latency and lower compound muscle action potential, as well as a significantly lower score in motor domain of the Rosen hand function evaluation, comparatively. However, at 24 months, no significant differences were observed between groups in regards to amplitude, latencies, conduction velocities or Rosen scores.
Collagen nerve guide conduit successfully treated nerve laceration in distal forearm
Lumbar spinal fusion: rehabilitation at 6 weeks after surgery costs more than at 12 weeksEighty-two patients undergoing instrumented lumbar spinal fusion due to degenerative disc disease or spondylolisthesis grade I or II were randomized to have rehabilitation initiated at 6 weeks compared to 12 weeks. The two treatment groups were evaluated for both functional and cost effectiveness. The evidence presented in this study demonstrated that earlier rehabilitation starting 6 weeks postoperatively tended to be more expensive, and contributed to significantly poorer functional disability and quality-adjusted life year outcomes when compared to rehabilitation at 12 weeks. Clinical practices that have implemented rehabilitation at 6 weeks may have reason to reconsider their timing of delivery.
Lumbar spinal fusion: rehabilitation at 6 weeks after surgery costs more than at 12 weeks
Pilates improved pain, function and quality of life for patients with juvenile idiopathicFifty patients between the ages of 8 and 18, diagnosed with oligoarticular, polyarticular and systemic subtypes of juvenile idiopathic arthritis (JIA) were included in this study to establish whether or not Pilates is a beneficial exercise program for young patients with JIA. Patients were randomized to participate in 50 minutes of conventional exercise therapy or Pilates, twice a week for 6 months. Physical and psychological aspects according to PEDsQL, pain, functional ability, range of motion were all improved in Pilates patients and results were significantly better than those who participated in conventional therapy.
Pilates improved pain, function and quality of life for patients with juvenile idiopathic
Platelet-rich plasma injections improve degenerative knee cartilage functional outcomesThis 16 study meta-analysis/systematic review evaluated the ability of platelet-rich plasma (PRP) to improve functional outcomes of patients suffering from knee cartilage degeneration. The aim of the study was to determine the best course of care and treatment for patients with chondral degenerative knee lesions by comparing functional outcomes before and after the use of PRP injections, HA injections, and placebo controls. Results revealed that the injection of PRP improved function and was more effective compared to HA administration. Additionally, patients with minimal cartilage degeneration enjoyed greater benefits from PRP injections than patients suffering from advanced osteoarthritis.
Platelet-rich plasma injections improve degenerative knee cartilage functional outcomes
Mini-incision vs. standard incision for THA: a surgical outcome comparisonFourteen prospective randomized control trials in which patients received total hip arthroplasty through mini-incision (MI) or standard incision (SI) were pooled to determine if mini-incision THA was superior to standard incision THA in general, or through a specific surgical approach. The results of the study indicated that mini-incision THA reduced total blood loss and length of hospital stay. Subgroup analysis of the two treatment methods by surgical approach demonstrated that posterior mini-incision THA led to perioperative advantages in surgical duration, blood loss, and hospital stay. A lateral approach MI THA was also noted to be significantly shorter in surgical duration compared to SI THA. No significant differences in pain medication dose, functional outcomes, radiographic outcomes, or complications were found.
Mini-incision vs. standard incision for THA: a surgical outcome comparison
Radiofrequency-based plasma microtenotomy added no benefits to decompression surgeryEighty patients treated with arthroscopic decompression for shoulder impingement syndrome were enrolled in this study to determine the impact of additional radiofrequency based plasma microtenotomy. Significant reductions were observed in pain in both groups by the third postoperative week and range of motion was better in all measurements by 1 year. No differences between the two groups were observed for any outcome measure at any time point. Decompression surgery is an effective treatment for patients with shoulder impingement syndrome but radiofrequency based plasma microtenotomy added no additional benefits.
Radiofrequency-based plasma microtenotomy added no benefits to decompression surgery
Bioresorbable calcium phosphate paste ([alpha]-BSM) in treatment of calcaneal fractures47 patients with displaced intra-articular calcaneal fractures necessitating fixation (52 fractures), were randomized to receive either open reduction and internal fixation (ORIF) in conjunction with a calcium phosphate paste (bone substitute material (BSM)), or ORIF alone. This study investigated the ability of BSM to preserve Bohler's angle and to reduce calcaneal height collapse. The results indicated that the use of BSM was able to minimize the reduction in Bohler's angle compared to ORIF alone, while not producing differences in general health, and limb specific function.
Bioresorbable calcium phosphate paste ([alpha]-BSM) in treatment of calcaneal fractures
Acupuncture could be beneficial for patients with non-specific chronic low back pain32 randomized control trials were included in this systematic review to compare the use of acupuncture and other varying treatment methods for non-specific chronic low back pain. Acupuncture effectively reduced pain compared to no treatment, sham treatment, and medication but not transcutaneous electrical nerve stimulation; function was improved more so in acupuncture than no treatment or medication, but not when compared to the sham intervention. Usual care (routine physiotherapy, massage or back exercise therapy) was compared to electroacupuncture and to usual care with acupuncture, and usual care proved less effective in both cases.
Acupuncture could be beneficial for patients with non-specific chronic low back pain
Functional outcome improved with PRP treatment for knee osteoarthritisSix studies (4 randomized controlled trials and 2 prospective cohort studies) were included in this quantitative systematic review which investigated the efficacy of platelet-rich plasma (PRP) injections versus hyaluronic acid (HA) or placebo injections. Pooling was performed on outcomes reported at a 24-week follow-up. The pooled results indicated that functional outcomes were significantly better among the PRP treatment cohorts compared to control groups. However, there was no statistically significant difference between groups with respect to pain and treatment satisfaction outcomes.
Functional outcome improved with PRP treatment for knee osteoarthritis
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