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We found 2473 reports published by T (Newest First)

Early surgery vs prolonged conservative treatment for sciatica patients with motor deficit

150 patients with 6-12 weeks of sciatica due to a lumbar disc herniation and moderate to severe motor deficit were randomly allocated to undergo early surgery or prolonged conservative treatment. This subgroup analysis of a previously published randomized controlled trial aimed to compare motor deficit recovery between groups. Patients allocated to...

Spine J. 2014 Sep 1;14(9):1817-24.

The effect of opioid therapy on osteoarthritis progression

200 patients with hip or knee osteoarthritis (OA) were randomized to conservative treatment with loxoprofen, tramadol/acetaminophen, or transdermal fentanyl. The purpose of this study was to compare rate of OA progression in the three treatments. Patients were treated for 12 weeks with the allocated therapy, then radiographically followed-up. The r...

Yonsei Med J. 2014 Sep;55(5):1379-85

Calcifying tendinitis of shoulder: high- vs low-energy extracorporeal shock wave therapy

This meta-analysis/systematic review identified 5 randomized controlled trials (359 patients) that compared high- to low-energy extracorporeal shock wave therapy (ESWT) for calcifying tendinitis of the shoulder. The aim of this analysis was to investigate functional outcome using Constant-Murley scores and radiologic resorption of calcium deposits ...

Clin Orthop Relat Res. 2014 Sep;472(9):2816-25. doi: 10.1007/s11999-014-3680-0. Epub 2014 May 29.

Periarticular injection for pain relief and early knee flexion angle after TKA

111 adult patients undergoing unilateral total knee arthroplasty were randomly assigned to periarticular injection or epidural analgesia for postoperative pain management. The purpose of this study was to compare the efficacy of each pain management technique in terms of pain relief and the frequency of opioid-related adverse effects. Results indic...

J Bone Joint Surg Am. 2014 Sep 3;96(17):1433-8

Time to anaesthesia similar between proximal & distal adductor canal block insertion sites

50 patients undergoing primary unilateral knee arthroplasty with an adductor canal block were randomized to either proximal or distal adductor canal catheter insertion. The purpose was to compare time to anaesthesia onset between the two insertion sites, and the effect each had on motor block. The results demonstrated no significant differences bet...

J Ultrasound Med. 2014 Sep;33(9):1653-62

Plate vs intramedullary nail fixation for distal metadiaphyseal tibial fractures

8 studies (N=455, 4 prospective randomized and 4 retrospective cohort or matched) were included in this meta-analysis/systematic review to determine if there are advantages to using plate fixation over intramedullary nailing for the treatment of distal meta-diaphyseal tibial fractures. Pooled analysis revealed plating of distal tibial fractures is ...

J Orthop Trauma. 2014 Sep;28(9):542-8.

Comparison of primary tendon repair vs physiotherapy treatment for rotator cuff tears

103 patients with a rotator cuff tear (less than 3 cm) were randomly assigned to primary tendon repair or physiotherapy treatment. The purpose of this trial was to compare surgical to non-operative treatment methods for rotator cuff tears. The primary outcome of interest was the Constant score. Findings indicated superior outcomes in Constant score...

J Bone Joint Surg Am. 2014 Sep 17;96(18):1504-14

Ferric carboxymaltose vs oral ferrous glycine sulphate for postoperative anaemia after TKA

122 adult patients with anaemia, iron deficiency, or both following total knee arthroplasty were randomly allocated to receive intravenous ferric carboxymaltose (FCM) or oral ferrous glycine sulphate (FS), with the purpose of comparing changes in hemoglobin (Hb) levels from postoperative day 4 to 30. Patients who received intravenous FCM experience...

Br J Anaesth. 2014 Sep;113(3):402-9.

Stellate ganglion block for upper limb surgery reduces pain and tramadol consumption

Thirty patients undergoing upper limb othropedic surgery were randomized to receive a stellate ganglion block injection of either lidocaine or saline. This randomized controlled trial aimed to determine the analgesic effect of a pre-operative stellate ganglion block on postoperative pain relief following orthopaedic surgery on the upper limb. Pre-o...

Anaesthesia. 2014 Sep;69(9):954-660

No significant advantage in neck coordination exercises in women with chronic neck pain

One hundred and eight female patients suffering from chronic, non-specific neck pain were randomly assigned to neck coordination exercises, strength training for the neck and shoulders or massage therapy. The purpose of this trial was to evaluate the sensorimotor effects of neck coordination exercises using a newly developed training device. The pr...

J Rehabil Med. 2014 Sep 30;46(9):908-14

Intensive strengthening and endurance exercise improves QoL after lumbar discectomy

Nintey eight patients with single-level lumbar disc herniation and scheduled for microdiscectomy were randomized to one of two groups postoperatively. One group underwent an intensive strengthening and endurance program, while the other group simply received an education session about back care. The purpose was to compare improvement between groups...

Clin Rehabil. 2014 Sep;28(9):892-901

Re-rupture rate appears similar between IT band and BPTB autografts in ACL reconstruction

60 patients scheduled for primary anterior cruciate ligament (ACL) reconstruction were randomized to receive either an iliotibial band autograft (ITB) or bone-patella-tendon-bone (BPTB) autograft. This study aimed to investigate whether an ITB autograft is a reliable long-term alternative to a bone-patella-tendon-bone (BPTB) autograft in ACL recons...

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2094-101.

Eccentric exercise beneficial over concentric in treating chronic lateral epicondylitis

One hundred and twenty patients with chronic lateral epicondylitis were randomized to undergo a 3-month home-based eccentric or concentric graded exercise regimen. The purpose of this study was to compare the impact of eccentric versus concentric exercise on elbow pain and function up to 12 months post-intervention. Eccentric graded exercise reduce...

Clin Rehabil. 2014 Sep;28(9):862-72.

No difference between one- and two-injection corticosteroid treatments for trigger finger

Ninety-seven adult patients suffering from stenosing tenosynovitis, also known as trigger finger, were randomly allocated to treatment using either two staged corticosteroid injections or a single injection. Disabilities of the Arm, Shoulder and Hand (DASH) scores were used to assess effectiveness of treatment; no significant differences in DASH sc...

Hand (N Y). 2014 Sep;9(3):340-5

Early ankle movement vs immobilization after ankle fracture surgery

This meta-analysis/systematic review contained 14 randomized or quasi-randomized controlled trials investigating early ankle movement compared to immobilization after ankle fracture surgery. Pooled analysis revealed the effect of early ankle movement on short-term functional outcomes remained unclear compared to immobilization, while no observable ...

J Orthop Sports Phys Ther. 2014 Sep;44(9):690-C7.

Similar outcomes in ultrasound and low-level laser therapy for myofascial trigger points

Sixty patients suffering from at least one myofascial trigger point in the upper trapezius muscle were randomly assigned to one of five different intervention groups: active ultrasound, placebo ultrasound, active low-level laser therapy, placebo low-level laser therapy, and no treatment. The purpose of this study was to evaluate the effectiveness o...

Physiother Res Int. 2014 Sep;19(3):166-75

Immobilization and passive motion yield similar tendon healing after rotator cuff repair

Data from 3 randomized controlled trials (265 patients) investigating early passive motion versus immobilization after arthroscopic rotator cuff repair was pooled in this meta-analysis in order to determine which rehabilitation protocol led to superior postoperative tendon healing. The pooled analysis revealed there were no significant differences ...

Arch Orthop Trauma Surg. 2014 Sep;134(9):1279-85.

Uni- versus bipolar hemiarthroplasty in eldery patients with femoral neck fractures

175 elderly patients with displaced intracapsular femoral neck fractures were randomly assigned to undergo unipolar or bipolar hemiarthroplasty (HA). The purpose of this study was to compare implant survival, ambulatory ability, and mortality rates between groups up to 5 years post-surgery. Unipolar HA resulted in a significantly higher dislocation...

Arch Orthop Trauma Surg. 2014 Sep;134(9):1251-9.

Addition of static progressive stretch device to physical therapy for adhesive capsulitis

60 patients (60 shoulders) with a diagnosis of adhesive capsulitis of the shoulder were randomized to traditional therapy either combined with the use of a static progressive stretch device, or to traditional therapy alone. The efficacy of the device was evaluated with respect to clinical and functional outcomes up to 1 year. Results indicated that...

Physiotherapy. 2014 Sep;100(3):228-34. doi: 10.1016/j.physio.2013.08.006. Epub 2013 Oct 3.

Compressive versus noncompressive stockings in the treatment of a lateral ankle sprain

126 patients with a lateral ankle sprain were randomized to receive either compressive or noncompressive (placebo) stockings. The purpose of this study was to investigate the efficacy and safety of compressive stockings by evaluating the amount of time for the patient to achieve pain-free, normal walking. The difference in time to normal painless w...

Am J Emerg Med. 2014 Sep;32(9):1005-10

No difference in 5-yr survival between computer-assisted and conventional TKA

200 patients scheduled to total knee arthroplasty were randomized to either receive a component implantation using computer assistance or through the conventional technique. The purpose was to determine if groups differed in component survival, radiological, clinical evaluation or clinical scoring at a minimum of 5 years follow-up. Overall, no sign...

J Arthroplasty. 2014 Sep;29(9):1795-802

External rotation immobilization does not reduce recurrence rate for shoulder dislocation

60 patients with a primary anterior glenohumeral dislocation were randomized to either immobilization in external rotation or internal rotation, following reduction. This study aimed to determine whether external immobilization reduced the frequency of recurrent instability as compared to internal immobilization. The results at the minimum 12 month...

Clin Orthop Relat Res. 2014 Aug;472(8):2380-6. doi: 10.1007/s11999-013-3432-6.

Electrothermal arthroscopic capsulorrhaphy in the treatment of shoulder instability

54 patients, with multidirectional instability or multidirectional laxity, were randomly assigned to either one of the two groups; electrothermal arthroscopic capsulorrhaphy (ETAC) or open inferior capsular shift (ICS). This study aimed to determine the difference in clinical outcomes in patients with shoulder instability due to ligamentous or caps...

J Shoulder Elbow Surg. 2014 Aug;23(8):1171-80

Rotator cuff repair: Axillary nerve block combined with suprascapular nerve block

42 patients, that underwent arthroscopic rotator cuff repair, were randomly assigned to one of the two groups; group 1 received both ultrasonographically guided axillary nerve block (ANB) and suprascapular nerve block (SSNB) and group 2 received SSNB alone. The aim of this study was to compare the results of ANB combined with SSNB with those of SSN...

Arthroscopy. 2014 Aug;30(8):906-14

Evicel fibrin sealant does not appear to reduce total blood loss/transfusion rates for TKA

62 patients scheduled to undergo primary TKA for knee osteoarthritis were randomly allocated to receive a topical application of a novel fibrin sealant (Evicel) or standard treatment (no application of Evicel), with the purpose of examining its ability to limit blood loss and reduce the need for blood transfusions. Results of this trial revealed Ev...

J Arthroplasty. 2014 Aug;29(8):1516-20

Plasma rich in growth factors intra-articular infiltrations effective and safe for knee OA

This systematic review identified 5 studies (2 randomized controlled trials, 2 prospective studies, 1 retrospective analysis) that compared plasma rich in growth factors (PRGF) to a control group for the treatment of knee osteoarthritis symptoms, with the aim of determining the efficacy and safety of PRGF. Final analysis revealed PRGF intra-articu...

Arthroscopy. 2014 Aug;30(8):1006-1017

Potential efficacy of low-molecular-weight heparin in preventing thromboembolic events

Data from 14 Level I or Level II randomized controlled trials (N=4726) was gathered in this meta-analysis. The aim of this study was to assess the efficacy of low-molecular-weight heparin venous thromboprophylaxis versus placebo/no treatment in non-major orthopaedic patients with transient reduced mobility. Findings indicated significant risk reduc...

Arthroscopy. 2014 Aug;30(8):987-96

Sealing of the femoral canal in TKA has no effect on postoperative blood loss

201 patients, diagnosed with degenerative arthritis of the knee, who underwent total knee arthroplasty were randomly allocated to 3 groups; A) bone graft sealing of the femoral canal, B) cement sealing and C) leaving the canal unsealed. The purpose of this study was to determine if sealing of the femoral canal was associated with reduced postoperat...

Knee. 2014 Aug;21(4):853-7

Non-inferior efficacy of topical TXA to IV TXA in total knee arthroplasty patients

89 patients undergoing unilateral total knee arthroplasty were randomly assigned to receive either topical Tranexamic Acid or Intravenous Tranexamic Acid. This study aimed to compare the efficacies of each route of administration on the reduction of blood loss following primary total knee arthroplasty. Results suggested no statistical difference in...

J Arthroplasty. 2014 Aug;29(8):1528-31

Minimally invasive therapies for treatment of rotator cuff chronic calcific tendinopathy

The 20 studies (1544 patients) identified in this meta-analysis explored the short to midterm effectiveness of minimally invasive (conservative) treatments for chronic calcific tendinopathy of the rotator cuff. The purpose of this analysis was to determine pain reduction, functional improvement, and size of calcific deposits in the rotator cuff fol...

J Shoulder Elbow Surg. 2014 Aug;23(8):1240-1249

Intraoperative infusion of lidocaine reduces postoperative pain after lumbar discectomy

51 patients undergoing lumbar discectomy surgery were randomized to receive an intraoperative intravenous lidocaine infusion or placebo, with the purpose of determining the analgesic effect of lidocaine on postoperative pain. Results revealed intraoperative lidocaine significantly decreases pain perception compared to a control up to 24 hours posto...

Spine J. 2014 Aug 1;14(8):1559-66

Microwave diathermy provides no additional benefit to physiotherapy for chronic neck pain

149 patients with nonspecific neck pain were randomly allocated into three groups: 1) continuous microwaves, 2) pulsed microwaves and 3) unplugged microwave diathermy (control group). All patients also performed range of motion and isometric exercises, and recevied transcutaneous electrical nerve stimulation. This study aimed to determine the effic...

Spine J. 2014 Aug 1;14(8):1712-21

Periarticular injection has similar analgesic effects to peripheral nerve block after TKA

210 patients undergoing total knee arthroplasty were randomly divided into two treatment groups: Peripheral Nerve Block (PNB) or Periarticular Injection Analgesia (PAI). Patients in the PNB group received combined peripheral nerve blocks of both the femoral and the sciatic nerve, while patients in PAI received a mixture of local anesthetic, morphin...

Knee. 2014 Aug;21(4):848-52

Continuous and pulsed ultrasound show similar efficacy for knee osteoarthritis

12 studies investigating the efficacy of continuous and pulsed ultrasound therapies in patients with knee osteoarthritis were included in this systematic review, and 8 of these studies were used in a network meta-analysis. This study aimed to assess the effects of both continuous and pulsed ultrasound therapies on pain relief and function improveme...

Osteoarthritis Cartilage. 2014 Aug;22(8):1090-9

Clinical value of tranexamic acid for blood loss in unilateral and bilateral TKAs

180 unilateral and 150 bilateral total knee arthroplasty (TKA) patients were randomly allocated into either a tranexamic acid (TXA) group or a control group. There were similar trends found in both unilateral and bilateral TKA groups treated with TXA, in regards to reducing total blood loss, blood loss via the drain, and haemoglobin drop. However, ...

Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1870-8

Metal release does not translate to increased metal allergy in metal-on-polyethylene THA

54 patients with primary osteoarthritis were randomized to undergo either reintroduced metal-on-metal (MOM) total hip resurfacing arthroplasty or metal-on-polyethylene (MOP) total hip arthroplasty, with the purpose of determining if the added excretion of metal ions from MOM results in heightened prevalence of metal allergies. A significant increas...

Acta Orthop. 2014 Aug;85(4):348-54. doi: 10.3109/17453674.2014.922730. Epub 2014 Jun 16.

No clinical benefit in gender-specific knee prostheses in females after TKA

Six randomized controlled trials were included in the meta-analysis, the purpose of which was to evaluate the clinical and radiographic outcomes of gender-specific prostheses to standard unisex prostheses in female patients undergoing total knee arthroplasty. Pooled data showed no significant benefit to using gender-specific components for total kn...

Acta Orthop. 2014 Aug;85(4):415-21

Tranexamic acid effectively reduces blood loss after TKA without adverse events

The purpose of this review was to determine the comparative efficacy between systemic and topical routes of tranexamic acid administration, optimal doses and timings, and the safety considerations of its use. 28 randomized controlled trials comparing the efficacy and safety of tranexamic acid use after total knee arthroplasty were included in this ...

Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1849-58

No differences between K-wires & locking plates at 1 year after dorsally displaced DRF

461 patients with a dorsally displaced distal radius fracture were randomized to either percutaneous fixation with Kirschner wires or to fixation with a volar locking plate. Follow-up was performed at 3, 6, and 12 months. Results demonstrated no statistically significant differences between groups on the Patient-Rated Wrist Evaluation at any time p...

BMJ. 2014 Aug 5;349:g4807. doi: 10.1136/bmj.g4807

TKA without tourniquet application improves the speed of functional recovery

70 patients with stage 3-5 gonarthrosis were randomized to undergo total knee arthroplasty (TKA) with or without the application of a tourniquet. The purpose of this trial was to determine whether TKA should be performed with or without the use of a tourniquet, based on functional and clinical outcomes at one year postoperatively. Results revealed ...

Acta Orthop. 2014 Aug;85(4):422-6. doi: 10.3109/17453674.2014.931197. Epub 2014 Jun 23.

Surgical preparation for spine surgery: monopolar electrosurgery vs. ultrasound scissors

41 patients with vertebral body fractures from T10 to L2 who required mono or bisegmental ventral spondylodesis were randomly divided into two groups. In one group, the surgical dissection was done using monopolar electrosurgery whereas in the other group, dissection was done using ultrasound scissors. The purpose of this study was to compare both ...

Eur Spine J. 2014 Aug;23(8):1783-90

Periarticular multimodal drug injections effective and safe analgesic for TKA

This meta-analysis was comprised of 10 randomized controlled trials comparing the efficacy and safety of periarticular multimodal drug injections to placebo/no-injection for primary total knee arthroplasty. Upon analysis, pooled results revealed that periarticular multimodal drug injections improved short-term pain relief, as well as the proportion...

Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1949-57. doi: 10.1007/s00167-013-2566-0. Epub 2013 Jun 20.

Reverse Shoulder Arthroplasty: A Comparison of Concentric and Eccentric Glenospheres

50 consecutive patients, who were undergoing reverse shoulder arthroplasty due to the diagnosis of cuff tear arthroplasty, were randomly assigned to either receive a concentric or an eccentic glenosphere. This study aimed to investigate whether the inferior positioning of the center of rotation with eccentric glenosphere designs decreases the adduc...

J Bone Joint Surg Am. 2014 Aug 20;96(16):e138

No difference between cemented and hybrid component fixation in Rotaglide TKA

100 patients suffering from knee osteoarthritis were randomized to undergo total knee arthroplasty with either cemented or hybrid fixation (cementless femoral fixation/cemented tibia component). The purpose of this study was to determine the optimal fixation method of Rotaglide mobile-bearing total knee arthroplasty with respect to survival and rev...

Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1843-8

Combined & extended alendronate with teriparatide improves BMD in women with osteoporosis

125 postmenopausal women with osteoporosis who had undergone 9 months of teriparatide monotherapy were randomized to three treatment groups. Patients were allocated to either (1) continued 9 months combined teriparatide/alendronate therapy followed by 12 months extended alendronate; (2) continued 9 months combined teriparatide/raloxifene followed b...

J Bone Miner Res. 2014 Aug;29(8):1777-85

Blood loss similar in posterior-cruciate-ligament-retaining vs -stabilized TKA

100 patients diagnosed with unilateral primary knee osteoarthritis were randomized to receive a posterior-cruciate-ligament-retaining (PCR) or a posterior-cruciate-ligament stabilized (PS) approach to primary cemented total knee arthroplasty. Blood loss and blood transfusion volumes were compared between treatment groups. Results revealed the PS ap...

Knee Surg Sports Traumatol Arthrosc. 2014 Aug;22(8):1865-9. doi: 10.1007/s00167-013-2818-z. Epub 2014 Jan 3.

No difference between bipolar/unipolar hemiarthroplasty in displaced femoral-neck fracture

9 randomized controlled trials comparing bipolar and unipolar hemiarthroplasty in elderly patients with displaced femoral-neck fractures were included in this meta-analysis. Investigators aimed to quantitatively compare the clinical efficacy and complications of both types of hemiarthroplasty. Findings indicated that there was no statistically sign...

Int Orthop. 2014 Aug;38(8):1691-6

No difference of manual therapy vs. kinesiotaping in subacromial impingement syndrome

54 patients, diagnosed with subacromial impingement syndrome, were randomly allocated into 2 study groups: kinesiotaping with exercise or manual therapy with exercise. This study aimed to compare the effects of manual therapy with exercise to kinesiotaping with exercise for patients with subacromial impingement syndrome. There was no significant di...

J Manipulative Physiol Ther. 2014 Jul-Aug;37(6):422-32

Patient-specific instrumentation TKA offers no advantage in gait or functional outcomes

40 patients suffering from severe knee arthritis were randomized to undergo unilateral primary total knee arthroplasty using either patient-specific or conventional instrumentation, with the purpose of comparing gait and functional outcomes between treatment groups. Results revealed patient-specific instrumentation does not offer a significant adva...

Clin Orthop Relat Res. 2014 Aug;472(8):2468-76

Preoperative fentanyl patches offer effective analgesia in TKA patients managed with PCA

40 patients scheduled for total knee arthroplasty were randomized to receive a transdermal fentanyl patch or a placebo patch preoperatively. The purpose was to assess the effect of the fentanyl patch for postoperative analgesia. The dose of the fentanyl patch was 50ug/hour, and all patients received patient controlled analgesia (PCA) after surgery....

J Pain Res. 2014 Aug 1;7:449-54

Balance training with XBox Kinect in previously injured young male athletes

63 previously injured young competitive male athletes were included in this study to evaluate the effectiveness of an exergaming (exercises through video games) program on balance ability in comparison to conventional physiotherapy. The results from this study indicated that both interventions provided an improvement in overall stability and limits...

Phys Ther Sport. 2014 Aug;15(3):148-55

Patient-specific instrumentation does not improve alignment accuracy in TKR

Data from 8 RCTs and 8 cohort studies were pooled to investigate the effect of patient-specific instruments (PSI) on radiological outcomes after total knee replacement (TKR). The pooled analyses examined the following outcomes; mechanical axis alignment and malalignment of the femoral and tibial components in the coronal, sagittal and axial planes,...

Bone Joint J. 2014 Aug;96-B(8):1052-61

Pulsed electromagnetic field does not accelerate bone healing in scaphoid fractures

51 adult patients with unilateral undisplaced fracture of the scaphoid were randomly assigned to receive either pulsed electromagnetic field (PEMF) bone growth stimulation in addition to conservative treatment or conservative treatment alone (placebo). Findings suggested significantly improved grip strength in the PEMF group compared to placebo in ...

Bone Joint J. 2014 Aug;96-B(8):1070-6.

Ankle injury stocking compression aids recovery in ankle fracture patients

90 patients who sustained an ankle fracture were randomized to receive an Aircast boot with either a fitted ankle injury stocking or Tubigroup underneath the boot within 72 hours post-fracture. The purpose of this trial was to determine if elastic compression using an ankle injury stocking aided recovery up to 6 months postoperatively. Upon analysi...

Bone Joint J. 2014 Aug;96-B(8):1062-9

Preoperative neuroscience education program for lumbar radiculopathy

Sixty-seven adult patients suffering from lumbar radiculopathy were randomly assigned to receive usual preoperative care with or without neuroscience education prior to lumbar surgery. This study aimed to determine if neuroscience education would result in superior clinical and functional outcomes. Findings revealed that preoperative neuroscience e...

Spine (Phila Pa 1976). 2014 Aug 15;39(18):1449-57

Shoulder surface replacement: the addition of DuoFix hydroxyapatite coating

A total of 20 patients with shoulder osteoarthritis and scheduled for shoulder surface replacement were randomly assigned to two groups. Using the Global CAP prosthesis with two different coatings, 10 patients were treated with Porocoat and the other 10 patients with DuoFix hydroxyapatite (HA). Patients were monitored for a duration of 2 years afte...

Bone Joint J. 2014 Aug;96-B(8):1077-81

The effect of pulsed/low-intensity bone growth stimulation in acute fractures

The role of pulsed electromagnetic fields (PEMF) and low-intensity pulsed ultrasound (LIPUS) on healing in acute ankle fractures has been the subject of various studies. Thirteen randomized controlled trials with a total of 355 participants treated with (PEMF) (n=146) or low-intensity pulsed ultrasound (LIPUS) (n=209) bone growth stimulation and 38...

Arch Orthop Trauma Surg. 2014 Aug;134(8):1093-106

Methadone PCA may be used as a first-line drug for acute pain management following THA

Thirty four patients undergoing elective total hip arthroplasty were randomized to a methadone or morphine patient-controlled analgesia (PCA) system for the first 24 hours post-surgery with the purpose of comparing the analgesia effect between the two groups. Methadone PCA resulted in less opioid consumption and lower pain scores in the first 24 ho...

J Anesth. 2014 Aug;28(4):505-10. doi: 10.1007/s00540-013-1785-3. Epub 2014 Jan 21.

Tibial fracture: Magnetic-guided IM nailing reduced operation time and radiation exposure

Eighty patients having sustained a tibial fracture were randomly divided into 2 treatment groups. This study aimed to determine whether the new magnetic-locking technique is superior to the standard freehand technique in regards to operation time and exposure to radiation. Results revealed that the magnetic locking system had the same degree of eff...

Eur J Orthop Surg Traumatol. 2014 Aug;24(6):1005-11

Group exercises effective in reducing LBP in women with postmenopausal osteoporosis

90 postmenopausal women with osteoporosis and low back pain were randomly assigned to either a treatment group or a control group. Patients in the treatment group participated in a group physical rehabilitation program, while patients in the control group received an instructional booklet and were directed to perform the exercises independently. Fi...

Aging Clin Exp Res. 2014 Aug;26(4):395-402.

Improved early postoperative knee extension and flexion after midvastus approach for TKA

21 randomized controlled trials comparing medial parapatellar approach versus midvastus approach for primary total knee arthroplasty were included in this meta-analysis. Pooled analysis of postoperative knee extensor and flexion function revealed superior outcomes in patients in the midvastus approach group. In addition to these early functional im...

Chin Med J (Engl). 2014 Aug;127(16):2982-90.

Approaches to total hip arthroplasty: micro-hip versus Bauer

A total of 143 patients, 80 women and 63 men, with primary hip osteoarthritis were randomly scheduled to undergo unilateral total hip arthroplasty (THA) either through a mini-incision approach (micro-hip) or a standard, lateral, transgluteal approach (Bauer). The purpose of the study was to compare the post-operative outcomes of both approaches for...

J Orthop Surg (Hong Kong). 2014 Aug;22(2):168-72

Cementless/screw fixation vs. cemented fixation of tibial component in young TKA patients

93 younger patients (ie <55 years) undergoing primary total knee arthroplasty were randomized to either cemented or cementless fixation of the tibial component. In cementless fixation, screw augmentation was used. Patients were followed for an average of 7 years postoperatively for clinical and radiological outcome. Cementless fixation was observed...

Knee Surg Sports Traumatol Arthrosc. 2014 Jul;22(7):1585-90

Intra-articular hylastan vs intra-articular steroid in knee OA treatment

391 patients with mild-moderate knee osteoarthritis (K-L grade I-III) were randomized to three different intra-articular injection groups: 1x4mL injection of hylastan, 2x4mL injections of hylastan separated by two weeks, or an injection of methylprednisolone acetate 40mg. Patients were followed-up for 26 weeks after the first injection. Pain relief...

Knee Surg Sports Traumatol Arthrosc. 2014 Jul;22(7):1684-92

Effect of osteopathic manual treatment on biomechanical dysfunction in patients with LBP

230 patients, between the ages of 21 and 69, who had been experiencing persistent/chronic low back pain for 3 months, were randomly assigned into 1 of 2 groups (in the OSTEOPATHIC Trial) to determine the effect osteopathic manual treatment (OMT) and ultrasound had on chronic low back pain. Patients took part in a treatment regimen either consisting...

Man Ther. 2014 Aug;19(4):324-30

Efficacy of the addition of dexamethasone to local infiltration analgesia for TKA

40 patients with knee osteoarthritis and scheduled to undergo primary TKA were randomized to receive intraoperative local infiltration analgesia (LIA) with or without the addition of dexamethasone. This study aimed to evaluate the efficacy of the addition of a steroid to LIA. The results indicated that local infiltration analgesia with steroid addi...

Knee Surg Sports Traumatol Arthrosc. 2014 Jul;22(7):1638-43. doi: 10.1007/s00167-013-2367-5. Epub 2013 Jan 11.

Higher impact clinical journals offer higher quality systematic reviews

Over a 6 month period, 327 interventional systematic reviews were analyzed to determine the relation between high impact journals and systematic review quality. Results from the review indicated that systematic reviews published in higher impact clinical journals had higher methodological quality than those found in journals with a lower impact fac...

J Clin Epidemiol. 2014 Jul;67(7):754-9

Extracorporeal shock wave therapy and exercise for knee OA and popliteal cyamella

120 patients with bilateral moderate knee osteoarthritis and popliteal cyamella were randomized to one of four groups to determine the efficacy of shock wave therapy in comparison to common conservative treatments. Patients in groups (I-III) received physical therapy (PT) isokinetic muscular strengthening exercises either alone (Group I), with puls...

Kaohsiung J Med Sci. 2014 Jul;30(7):362-70

Hip structural analysis of teriparatide vs placebo for postmenopausal osteoporotic women

209 postmenopausal osteoporotic women who were randomized in the TOWER trial in 2012 were analyzed to evaluate bone structural and strength changes at the hip after treatment with Teriparatide injection or placebo over 72 weeks. Patients were evaluated using hip structural analysis (HSA) based on dual-energy X-ray absorptiometry. The evidence prese...

Bone. 2014 Jul;64:75-81

Better clinical outcome with kinematically vs. mechanically aligned TKAs

120 patients with end-stage arthritis were randomized to either undergo kinematically aligned total knee arthroplasty (TKA) with patient-specific guides or mechanically aligned TKA with intramedullary instrumentation, to compare outcomes of pain, function, and range of motion after 2 years. The results indicated that clinical outcomes, proportion o...

Bone Joint J. 2014 Jul;96-B(7):907-13. doi: 10.1302/0301-620X.96B7.32812.

Massage plus topical analgesic more effective than massage alone for hand arthritis pain

20 females, who had been diagnosed with hand arthritis, were randomly assigned into 1 of 2 groups to determine the effect massage therapy with or without a topical analgesic had on patient important outcomes. Results from the study demonstrated that massage therapy with a topical analgesic significantly improved hand function, grip strength, hand p...

J Bodyw Mov Ther. 2014 Jul;18(3):322-5

Clinic-based therapy vs home-based exercise treatment for distal radius fracture

Data from 7 randomized controlled trials examining 381 patients after a distal radial fracture was analyzed to determine the efficacy of rehabilitation at the clinic or at home. The evidence presented in this systematic review indicated that patients who had suffered a distal radius fracture benefited equally from treatment in the form of a home pr...

J Hand Ther. 2014 Jul-Sep;27(3):165-74

Effect of indomethacin on heterotopic ossification and nonunion after acetabular fracture

98 patients with an acute acetabular fracture requiring operative treatment were administered 75 mg of prophylactic indomethacin daily for either 3 days, 1 week, 6 weeks, or were administered a placebo for 6 weeks. Results from the study demonstrated that the overall incidence of heterotrophic ossification was significantly lower in the 3 day and 1...

J Orthop Trauma. 2014 Jul;28(7):377-83

The effect of nonoperative treatments on discogenic low back pain

A systematic review of 11 RCTs was completed with the goal of determining the efficacy of a variety of non-operative techniques on discogenic back pain. Results from the review suggested that a variety of non-operative modalities such as methylene blue injection, steroid injection, ramus communicans ablation, intradiscal electrothermal therapy, and...

Spine (Phila Pa 1976). 2014 Jul 15;39(16):1314-24

Low-Level Laser Therapy (LLLT) vs placebo in the treatment of knee osteoarthritis

49 patients with knee osteoarthritis were randomized to evaluate the efficacy of Active Low-Level Laser Therapy (LLLT) against a placebo over 6 months. Patients were assessed using VAS, the Saudi Knee Function Scale (SKFS), and active range of motion (ROM). The evidence presented in this trial demonstrated that LLLT was associated with significantl...

Physiotherapy. 2014 Sep;100(3):242-8

Continuous passive motion offers no benefit in postacute rehabilitation after TKA

145 patients who had undergone total knee arthroplasty and had poor postoperative knee range of motion were included in this study. Patients randomized to either a continuous passive motion group or control group for rehabilitation at an inpatient rehabilitation facility. Measures of range of motion (flexion and extension), functional outcome, walk...

Arch Phys Med Rehabil. 2014 Jul;95(7):1240-5

Quality of randomized controlled trials on pediatric physical therapy increasing over time

1367 RCTs were analyzed from the PEDro database to determine the quality of reports published on the topic of pediatric physical therapy (PPT). Results from the analysis indicated that only 29% of the studies analyzed obtained a “high quality” PEDro score of 6 or greater, while 56% obtained a score of 5 or greater. The number of RCTs and qualit...

Phys Occup Ther Pediatr. 2014 Aug;34(3):260-70

Transdermal fentanyl patches reduce pain and morphine consumption after TKA

40 patients scheduled to undergo total knee arthroplasty were randomized to a group that received transdermal fentanyl patches or to a placebo group to compare postoperative pain relief, rescue opiate requirements, active knee flexion, and incidence of side effects. Results indicated that postoperative VAS pain scores were significantly lower in th...

Knee Surg Sports Traumatol Arthrosc. 2014 Jul;22(7):1580-4. doi: 10.1007/s00167-012-2287-9. Epub 2012 Dec 2.

Unstable intertrochanteric fracture: PFN vs reverse distal femoral locking plate

40 patients with unstable intertrochanteric fractures with compromised lateral wall were randomized to determine a superior method of fixation between proximal femoral nail (PFN) and contralateral reverse distal femoral locking compression plate (reverse-DFLCP). Patients were monitored over 1 year and were evaluated based on intraoperative measures...

Int Orthop. 2014 Jul;38(7):1443-9

Single-dose intra-articular bupivacaine significantly reduces pain after knee arthroscopy

23 studies comparing the use of single-dose intra-articular (IA) bupivacaine to placebo intervention for the reduction of pain following arthroscopic knee surgery were analyzed to determine if a single dose of intra-articular bupivacaine was a safe and effective pain management intervention. Results from the analysis demonstrated that a single IA d...

Knee Surg Sports Traumatol Arthrosc. 2014 Jul;22(7):1517-28

Comparison of two thoracic spinal manipulation techniques for chronic mechanical neck pain

64 patients with medical diagnosis of chronic non-specific neck pain (NSNP) were randomized to one of two thoracic spinal manual therapy techniques: dog-technique and toggle recoil technique. Results indicated that although neck mobility, pain, and mechanosensitivity improved within both groups immediately following intervention and 20 minutes afte...

Man Ther. 2014 Aug;19(4):331-7. doi: 10.1016/j.math.2014.03.002. Epub 2014 Mar 14.

Bone marrow concentrate improves fusion with allograft in posterolateral fusion

80 patients undergoing instrumented posterolateral fusion with allograft were randomized to one of two groups: one group had the allograft augmented by autologous bone marrow concentrate, while the other group received the allograft alone. Radiographic and CT evaluation was performed during 12 and 24 month follow-ups. Improved fusion rate was obser...

Spine J. 2014 Jul 1;14(7):1318-24

Position of screws in polyaxial vs. monoaxial locking plates for proximal humeral fracture

124 patients who suffered a proximal humeral fracture with displacement >1 cm and angulation of fragments > 45 degrees, were randomly assigned to treatment with either monoaxial or polyaxial screw-inserted locking plate fixation. The primary purpose of this study was to compare the chosen positioning of locking screws between the two treatment grou...

Eur J Orthop Surg Traumatol. 2014 Jul;24(5):747-52

Traumatic thoracolumbar fracture: Adverse events in Operative vs Nonoperative management

19 papers investigating 1355 patients were systematically reviewed to compare the incidence of adverse events between patients who were operatively or non-operatively treated for traumatic thoracolumbar fracture. The evidence presented in this systematic review indicated that the incidence of all complications, and incidence of infection, was signi...

Neurosurg Focus. 2014 Jul;37(1)

The effect of physiotherapy and sustained inferior capsule stretching on frozen shoulders

100 patients diagnosed with a frozen shoulder were randomly assigned into 1 of 2 groups to determine the additive effect a countertraction device had on conventional physiotherapy. Participants received an intervention that consisted of countertraction intervention and physiotherapy (group 1) or physiotherapy alone (group 2). Results from the study...

Clin Orthop Relat Res. 2014 Jul;472(7):2262-8

Bone scans vs. radiographs for diagnosing occult scaphoid fractures

27 patients (aged 18-80) who had been diagnosed with a clinical scaphoid fracture by an emergency department physician, were randomly assigned into 1 of 2 groups to determine if early bone scans resulted in shorter cast immobilization periods in patients than those analyzed with radiographs. All patients were placed in molded, below-elbow thumb spi...

CJEM. 2014 Jul 1;16(4):296-303

Comparison of different doses of spinal manipulation for chronic low back pain

400 patients with nonspecific chronic low back pain were included in this study to identify if there was a dose dependent effect of spinal manipulation in this patient population. Patients were randomized to groups receiving 18, 12, 6 or 0 sessions of spinal manipulation from a chiropractor. Session occurred 3 times a week over a 6 week period. At ...

Spine J. 2014 Jul 1;14(7):1106-16

Operative vs nonoperative care of closed, displaced, intraarticular calcaneal fractures

One hundred and fifty one patients with a recent (<3 weeks) closed, intra-articular, displaced calcaneal fracture were randomized to either operative or nonoperative treatment. This study aimed to determine the efficacy of operative treatment after 2 years. Results indicated that there were no treatment effects for Kerr-Atkins scores, as well as fo...

BMJ. 2014 Jul 24;349:g4483. doi: 10.1136/bmj.g4483.

Effect of preoperative indicators on mortality after hip fracture fixation

Fifty three articles, investigating 544,733 patients, were systematically reviewed to determine the predictive effects of preoperative characteristics on mortality after hip fracture. Data from 26 included studies was pooled to investigate the role of 13 preoperative factors. The evidence presented in this paper reported that: male gender, age over...

Age Ageing. 2014 Jul;43(4):464-71

The effect of Balneotherapy treatment on knee osteoarthritis

Seventy seven patients, between the ages of 45 and 75 years, who had been diagnosed with mild to moderate bilateral primary osteoarthritis of the knee, were randomly assigned into 1 of 2 groups to determine the effect balneotherapy (thermal water therapy) had on individuals with knee osteoarthritis. Patients were randomized to take part in a therma...

Eur J Phys Rehabil Med. 2014 Aug;50(4):373-81

Comparison of adverse events between metal-on-metal hip resurfacing prostheses and THA

Data from 236 studies (17 RCTS) was pooled to investigate the adverse events, revision rates, and reoperation rates associated with metal-on-metal hip resurfacing prostheses compared to total hip arthroplasty (THA) devices. The evidence presented in this analysis suggested that MoMs were revised significantly earlier than THA devices. Revisions an...

Clin Orthop Relat Res. 2014 Jul;472(7):2217-30

A 12-week medical exercise therapy improves outcomes after degenerative meniscectomy

42 patients with knee pain (>2 months), who had undergone partial menisectomy for a degenerative meniscus tear were randomized to either supervised medical exercise therapy or no treatment. The study aimed to evaluate the clinical and functional outcomes up to 1 year. Results indicated that VAS scores, quadriceps muscle strength deficit, KOOS, HADS...

J Bodyw Mov Ther. 2014 Jul;18(3):374-82. doi: 10.1016/j.jbmt.2013.11.015. Epub 2013 Dec 11.

Comprehensive exercise programme comparable to advice for chronic whiplash

Patients between 18 and 65 years old with a chronic (>3months and <5 years) grade 1 or 2 whiplash-associated disorder were randomized to either undergo a supervised 12-week comprehensive exercise program or receive advice to compare outcomes up to 1 year. Results indicated that pain intensity (during the week prior to follow-up assessments) was not...

Lancet. 2014 Jul 12;384(9938):133-41. doi: 10.1016/S0140-6736(14)60457-8. Epub 2014 Apr 4.

Low-pressure CO2 insufflation appears safe and effective for arthroscopic ACLR

Ninety four patients undergoing anterior cruciate ligament (ACL) reconstruction were randomized to evaluate the safety and efficacy of low-pressure CO2 knee joint insufflation as compared to conventional fluid-based distention. Patients were monitored over 6 months. The evidence presented in this trial revealed no significant difference between the...

Knee Surg Sports Traumatol Arthrosc. 2014 Jul;22(7):1483-90

Rotating-platform TKA comparable to fixed-bearing TKA

17 studies were included in this meta-analysis (15 randomized controlled trials without blinding or prospective comparative studies and 2 retrospective comparative studies) comparing the outcomes of rotating-platform mobile-bearing prostheses to fixed bearing prostheses for total knee arthroplasty. Results from the meta-analyses of clinical scores,...

Clin Orthop Relat Res. 2014 Jul;472(7):2185-93. doi: 10.1007/s11999-014-3539-4. Epub 2014 Mar 4.

Low and high intensity extracorporeal shock wave therapy for chronic plantar fasciitis

Data from 7 studies (RCTs and Quasi-RCTs), examining 550 patients with chronic recalcitrant plantar fasciitis, was pooled to investigate the safety and efficacy of extracorporeal shockwave therapy (ESWT). The evidence presented in this meta-analysis and systematic review indicated that low intensity ESWT delivered higher success rates than control ...

Arch Phys Med Rehabil. 2014 Aug;95(8):1585-1593

Effect of trigger point dry needling on patients with plantar heel pain

84 patients, >18 years of age, who had been suffering from plantar heel pain for at least 1 month prior to study initiation, were randomly assigned into an intervention or sham group, to determine the effect trigger point dry needling had on plantar heel pain and other important patient outcomes. Outcomes were assessed during treatment (2, 4, and 6...

Phys Ther. 2014 Aug;94(8):1083-94

Femoral offset of short and straight stem prostheses in total hip arthroplasty patients

80 patients scheduled to undergo total hip arthroplasty were randomly assigned into 1 of 2 groups to determine if short stem prostheses resulted in femoral offsets comparable to those obtained with standard stem prostheses in patients undergoing a minimally invasive anterolateral approach. Patients either received a short stem (Fitmore; Zimmer, War...

Orthopedics. 2014 Jul 1;37(7):e678-84

Analysis of various THA interventions for the treatment of end stage arthritis of the hip

Results from 14 RCTs and 5 systematic reviews were reviewed and pooled to determine the effect various THA interventions had on the pain, disability, and function experienced by patients with end stage arthritis of the hip. Results from the analysis indicated that patients experienced significant postoperative THA improvements in Harris Hip scores ...

PLoS One. 2014 Jul 8;9(7):e99804

Quadriceps muscle-strengthening exercise in the treatment of patellofemoral pain syndrome

Data extracted from 7 RCTs (n=626) was analyzed to evaluate the role of quadriceps muscle-strengthening exercise in the treatment of patellofemoral pain syndrome (PFPS). 3 studies (n=204) compared quadriceps muscle-strengthening exercise against advice and information. 5 studies compared quadriceps muscle-strengthening exercise combined with other ...

J Orthop Sports Phys Ther. 2014 Jun;44(6):391-B1

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