scholarly journals Surgical treatment of symptomatic pineal cysts without hydrocephalus—meta-analysis of the published literature

2021 ◽  
Author(s):  
Riccardo Masina ◽  
Ali Ansaripour ◽  
Vladimír Beneš ◽  
Moncef Berhouma ◽  
Joham Choque-Velasquez ◽  
...  
Keyword(s):  
Case Reports ◽  
Meta Analysis ◽  
Visual Disturbance ◽  
Outcome Data ◽  
Current Evidence ◽  
Published Data ◽  
Cyst Size ◽  
Level Of Evidence ◽  
Improvement Rate ◽  
Patient Reported

Abstract    Background To examine published data and assess evidence relating to safety and efficacy of surgical management of symptomatic pineal cysts without hydrocephalus (nhSPC), we performed a systematic review of the literature and meta-analysis. Methods Following the PRISMA guidelines, we searched Pubmed and SCOPUS for all reports with the query ‘Pineal Cyst’ AND ‘Surgery’ as of March 2021, without constraints on study design, publication year or status (PROSPERO_CRD:42,021,242,517). Assessment of 1537 hits identified 26 reports that met inclusion and exclusion criteria. Results All 26 input studies were either case reports or single-centre retrospective cohorts. The majority of outcome data were derived from routine physician-recorded notes. A total of 294 patients with surgically managed nhSPC were identified. Demographics: Mean age was 29 (range: 4–63) with 77% females. Mean cyst size was 15 mm (5–35). Supracerebellar-infratentorial approach was adopted in 90% of cases, occipital-transtentorial in 9%, and was not reported in 1%. Most patients were managed by cyst resection (96%), and the remainder by fenestration. Mean post-operative follow-up was 35 months (0–228). Presentation: Headache was the commonest symptom (87%), followed by visual (54%), nausea/vomit (34%) and vertigo/dizziness (31%). Other symptoms included focal neurology (25%), sleep disturbance (17%), cognitive impairment (16%), loss of consciousness (11%), gait disturbance (11%), fatigue (10%), ‘psychiatric’ (2%) and seizures (1%). Mean number of symptoms reported at presentation was 3 (0–9). Outcomes: Improvement rate was 93% (to minimise reporting bias only consecutive cases from cohort studies were considered, N = 280) and was independent of presentation. Predictors of better outcomes were large cyst size (OR = 5.76; 95% CI: 1.74–19.02) and resection over fenestration (OR = 12.64; 3.07–52.01). Age predicted worse outcomes (OR = 0.95; 0.91–0.99). Overall complication rate was 17% and this was independent of any patient characteristics. Complications with long-term consequences occurred in 10 cases (3.6%): visual disturbance (3), chronic incisional pain (2), sensory disturbance (1), fatigue (1), cervicalgia (1), cerebellar stroke (1) and mortality due to myocardial infarction (1). Conclusions Although the results support the role of surgery in the management of nhSPCs, they have to be interpreted with a great deal of caution as the current evidence is limited, consisting only of case reports and retrospective surgical series. Inherent to such studies are inhomogeneity and incompleteness of data, selection bias and bias related to assessment of outcome carried out by the treating surgeon in the majority of cases. Prospective studies with patient-reported and objective outcome assessment are needed to provide higher level of evidence.

Vitamin D in Basketball Players: Current Evidence and Future Directions

2021 ◽  
pp. 194173812110193
Author(s):  
Emilija Stojanović ◽  
Dragan Radovanović ◽  
Tamara Hew-Butler ◽  
Dušan Hamar ◽  
Vladimir Jakovljević
Keyword(s):  
Systematic Review ◽  
Vitamin D ◽  
Body Composition ◽  
Physical Performance ◽  
Bone Health ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Current Evidence ◽  
Basketball Players ◽  
Level Of Evidence

Context: Despite growing interest in quantifying and correcting vitamin D inadequacy in basketball players, a critical synthesis of these data is yet to be performed to overcome the low generalizability of findings from individual studies. Objective: To provide a comprehensive analysis of data in basketball pertaining to (1) the prevalence of vitamin D inadequacy; (2) the effects of vitamin D supplementation on 25-hydroxyvitamin D [25(OH)D] concentration (and its association with body composition), bone health, and performance; and (3) crucial aspects that warrant further investigation. Data Sources: PubMed, MEDLINE, ERIC, Google Scholar, SCIndex, and ScienceDirect databases were searched. Study Selection: After screening, 15 studies were included in the systematic review and meta-analysis. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 3. Data Extraction: The prevalence of vitamin D inadequacy, serum 25(OH)D, body composition, stress fractures, and physical performance were extracted. Results: The pooled prevalence of vitamin D inadequacy for 527 basketball players in 14 studies was 77% ( P < 0.001; 95% CI, 0.70-0.84). Supplementation with 4000 IU/d and 4000 IU/wk (absolute mean difference [AMD]: 25.39 nmol/L; P < 0.001; 95% CI, 13.44-37.33), as well as 10,000 IU/d (AMD: 100.01; P < 0.001; 95% CI, 70.39-129.63) vitamin D restored 25(OH)D to normal concentrations. Body composition data revealed inverse correlations between changes in serum 25(OH)D (from pre- to postsupplementation) and body fat ( r = −0.80; very large). Data concerning positive impacts of vitamin D supplementation on bone health and physical performance remain sparse. Conclusion: The high proportion of vitamin D inadequacy underscores the need to screen for serum 25(OH)D in basketball players. Although supplementation restored vitamin D sufficiency, the beneficial effects on bone health and physical performance remain sparse. Adiposity can modulate 25(OH)D response to supplementation.

scholarly journals Comparable outcome for autografts and allografts in primary medial patellofemoral ligament reconstruction for patellofemoral instability: systematic review and meta-analysis

2021 ◽  
Author(s):  
Filippo Migliorini ◽  
Andromahi Trivellas ◽  
Jörg Eschweiler ◽  
Matthias Knobe ◽  
Markus Tingart ◽  
...  
Keyword(s):  
Medial Patellofemoral Ligament ◽  
Meta Analysis ◽  
Patellofemoral Instability ◽  
Mpfl Reconstruction ◽  
Current Evidence ◽  
Level Of Evidence ◽  
Feasible Alternative ◽  
The Mean ◽  
Persistent Instability

Abstract Purpose This study updates the current evidence on the role of allografts versus autografts for medial patellofemoral ligament (MPFL) reconstruction in patients with patellofemoral instability. Methods The study was performed according to the PRISMA guidelines. In March 2021, a literature search in the main online databases was performed. Studies reporting quantitative data concerning primary MPFL reconstruction using an allograft were considered for inclusion. The Coleman Methodology Score was used to assess the methodological quality of the selected articles. Results Data from 12 studies (474 procedures) were retrieved. The mean follow-up was 42.2 (15–78.5) months. The mean age was 21.1 ± 6.2 years. 64.9% (285 of 439) of patients were female. At the last follow-up, the Tegner (p < 0.0001), Kujala (p = 0.002) and the Lysholm (p < 0.0001) scores were minimally greater in the autografts. The similarity was found in the rate of persistent instability sensation and revision. The allograft group evidenced a lower rate of re-dislocations (p = 0.003). Conclusion Allografts may represent a feasible alternative to traditional autograft for MPFL reconstruction in selected patients with patellofemoral instability. Allograft tendons yielded similar PROMs, rates of persistent instability, and revision. Allograft reconstructions tended to have modestly lower re-dislocation rates. Level of evidence IV.

Dental implants survival after nasal floor elevation: a systematic review

2021 ◽  
Author(s):  
Eduardo Anitua ◽  
Beatriz Anitua ◽  
Mohammad Hamdan Alkhraisat ◽  
Laura Piñas ◽  
Asier Eguia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Assessment Tool ◽  
Case Reports ◽  
Meta Analysis ◽  
Lateral Approach ◽  
Cochrane Library ◽  
Good Survival ◽  
Quality Level ◽  
Level Of Evidence ◽  
Nasal Floor

Purpose The aim of this work is to assess the clinical outcomes of implants placed after a nasal floor elevation procedure. Methods A systematic review was conducted using four electronic databases; Medline (Pubmed), Cochrane library, DOAJ and SCOPUS, following the PRISMA statement recommendations to answer the PICO question: “In patients undergoing dental implant placement in the maxillary anterior region (P), Do implants placed after nasal floor elevation (I) have a different survival (O) from those implants placed without grafting procedures (C)?. The study was pre-registered in PROSPERO (CRD42021229479). Included articles quality was assessed using the “NIH quality assessment tool”, “The Newcastle-Ottawa scale” and “JBI critical appraisal tools for case reports''. Results Twelve articles were finally selected, including 151 patients and 460 implants. The weighted mean follow-up was 32.2 months, and the weighted survival rate after this period was 97.64% (range 89.2-100%). No statistical differences could be inferred between the treatments performed in one-stage or two-stage, following a lateral approach or a transcrestal approach or using different grafting materials. A great heterogeneity was found in terms of study design and methodological aspects. For this reason, a quantitative analysis followed by meta-analysis was not possible. Conclusion Within the limitations of this study, implants placed after a nasal floor elevation present a good survival and a low range of complications. In absence of randomized studies, the level of evidence was low, attending the GRADE system and based on the study quality level, the strength of evidence attending the SORT taxonomy was B.

scholarly journals Cannabidiol as a Treatment for Mood Disorders: A Systematic Review

2019 ◽  
Vol 65 (4) ◽  
pp. 213-227 ◽  
Author(s):  
Jairo Vinícius Pinto ◽  
Gayatri Saraf ◽  
Christian Frysch ◽  
Daniel Vigo ◽  
Kamyar Keramatian ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Mood Disorders ◽  
Observational Studies ◽  
Case Reports ◽  
Health Conditions ◽  
Current Evidence ◽  
Cochrane Central Register ◽  
Level Of Evidence ◽  
Mood Symptoms ◽  
Affective Symptoms

Objective: To review the current evidence for efficacy of cannabidiol in the treatment of mood disorders. Methods: We systematically searched PubMed, Embase, Web of Science, PsychInfo, Scielo, ClinicalTrials.gov , and The Cochrane Central Register of Controlled Trials for studies published up to July 31, 2019. The inclusion criteria were clinical trials, observational studies, or case reports evaluating the effect of pure cannabidiol or cannabidiol mixed with other cannabinoids on mood symptoms related to either mood disorders or other health conditions. The review was reported in accordance with guidelines from Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. Results: Of the 924 records initially yielded by the search, 16 were included in the final sample. Among them, six were clinical studies that used cannabidiol to treat other health conditions but assessed mood symptoms as an additional outcome. Similarly, four tested cannabidiol blended with Δ-9-tetrahydrocannabinol in the treatment of general health conditions and assessed affective symptoms as secondary outcomes. Two were case reports testing cannabidiol. Four studies were observational studies that evaluated the cannabidiol use and its clinical correlates. However, there were no clinical trials investigating the efficacy of cannabidiol, specifically in mood disorders or assessing affective symptoms as the primary outcome. Although some articles point in the direction of benefits of cannabidiol to treat depressive symptoms, the methodology varied in several aspects and the level of evidence is not enough to support its indication as a treatment for mood disorders. Conclusions: There is a lack of evidence to recommend cannabidiol as a treatment for mood disorders. However, considering the preclinical and clinical evidence related to other diseases, cannabidiol might have a role as a treatment for mood disorders. Therefore, there is an urgent need for well-designed clinical trials investigating the efficacy of cannabidiol in mood disorders.

Hyaluronic acid for post sinus surgery care: systematic review and meta-analysis

2017 ◽  
Vol 131 (S1) ◽  
pp. S2-S11 ◽  
Author(s):  
E Fong ◽  
M Garcia ◽  
C M Woods ◽  
E Ooi
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Endoscopic Sinus Surgery ◽  
Meta Analysis ◽  
Adhesion Formation ◽  
Sinus Surgery ◽  
Current Evidence ◽  
Secondary Outcome ◽  
Control Group ◽  
Patient Reported

AbstractBackground:Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery.Methods:Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates. A meta-analysis was performed on adhesion event frequency. Secondary outcome measures included other endoscopic findings and patient-reported outcomes.Results:Thirteen studies (501 patients) met the selection criteria. A meta-analysis of adhesion formation frequency on endoscopy demonstrated a lower risk ratio in the hyaluronic acid intervention group (42 out of 283 cases) compared to the control group (81 out of 282) of 0.52 (95 per cent confidence interval = 0.37–0.72). Hyaluronic acid use was not associated with any significant adverse events.Conclusion:Hyaluronic acid appears to be clinically safe and well tolerated, and may be useful in the early stages after sinus surgery to limit adhesion rate. Further research, including larger randomised controlled trials, is required to evaluate patient- and clinician-reported outcomes of hyaluronic acid post sinus surgery.

scholarly journals Quilting Sutures in Rhytidectomy: A Systematic Review of the Literature

2019 ◽  
Vol 40 (11) ◽  
pp. 1157-1164 ◽  
Author(s):  
Anthony Ballan ◽  
Samer Jabbour ◽  
Youssef El Rayess ◽  
Khalil Jabbour ◽  
Lena El Hachem ◽  
...  
Keyword(s):  
Systematic Review ◽  
Relative Risk ◽  
Postoperative Complications ◽  
Confidence Interval ◽  
Meta Analysis ◽  
Control Group ◽  
Published Data ◽  
Review Of The Literature ◽  
Level Of Evidence ◽  
Safety And Efficacy

Abstract Background Different technical variations exist for the utilization of quilting sutures (QS) in rhytidectomy. No systematic review or meta-analysis of the studies describing the use of QS in facelifts has been published to date to the authors’ knowledge. Objectives The objective of this study was to summarize all the published data regarding the utilization of QS in rhytidectomy, compare QS techniques, and evaluate their effect on postoperative complications. Methods On April 1, 2019, a systematic search of the Medline, Embase, and Cochrane databases was conducted. All the studies describing the usage of QS in facelifts were included in this review. Studies reporting hematoma rate in a QS group and a control group were included in the meta-analysis part of this study. Results The initial search of the databases yielded 93 results. Four trials were included in the systematic review and 2 were included in the meta-analysis. The total number of included patients with QS was 527. Two studies employed internal QS and the remaining studies utilized external QS. The meta-analysis found a lower rate of hematoma in the QS group (relative risk, 0.02; 95% confidence interval = 0.00-0.13; P &lt; 0.0001). Conclusions QS can be applied either internally or externally and are very effective in reducing hematomas after facelifts. QS could be a great asset in facelifts but should be utilized with caution because additional work is needed to confirm their safety and efficacy. Level of Evidence: 2

scholarly journals Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

Cartilage ◽  
2019 ◽  
pp. 194760351987085 ◽  
Author(s):  
Anthony Fiegen ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
Aaron J. Krych ◽  
Jonathan D. Barlow ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Reported Outcomes ◽  
Glenohumeral Joint ◽  
Meta Analysis ◽  
Treatment Options ◽  
Surgical Techniques ◽  
Cartilage Defects ◽  
Imaging Findings ◽  
Level Of Evidence ◽  
Patient Reported

Objective To report radiographic and magnetic resonance imaging findings, patient-reported outcomes, and complications and/or reoperations following nonarthroplasty surgical intervention for focal glenohumeral cartilage defects. Design A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Patients were included if they possessed a chondral defect of the humeral head, glenoid, or both, which had been treated with a joint preserving nonarthroplasty procedure. Risk of bias assessment was performed using the Methodological Index for Non-Randomized Studies scoring system. Study demographics, surgical technique, imaging findings, patient-reported outcomes, complications, failures, and reoperations were collected. Results Fourteen studies with 98 patients (100 shoulders) met the inclusion criteria. Patient ages ranged from 7 to 74 years. The nonarthroplasty surgical techniques utilized included microfracture (67 shoulders), osteochondral transplantation (28 shoulders), chondrocyte transplantation (4 shoulders), and internal fixation (1 shoulder). The rates of radiographic union and progression of osteoarthritis ranged between 90% to 100% and 57% to 100%, respectively. Visual analog scores ranged from 0 to 1.9 at final follow-up. Mean postoperative ASES (American Shoulder and Elbow Surgeons) shoulder scores ranged from 75.8-100. Mean postoperative CSS (Constant Shoulder Score) scores ranged from 83.3-94. Mean postoperative SSV (Subjective Shoulder Value) ranged from 70% to 99%. Failure and reoperation rates ranged between 0% to 35% and 0% to 30%, respectively, with the most common reoperation being conversion to prosthetic arthroplasty. Conclusions In this systematic review, nonarthroplasty surgical techniques demonstrated acceptable rates of radiographic healing, improved patient reported outcomes, minimal complications, and low rates of failure or reoperation. Joint preserving techniques are likely viable options to prolong function of the native shoulder and provide short- to midterm pain relief in young and highly active patients. Level of Evidence Level IV.

Comparison of Balloon Dilation and Laser Eustachian Tuboplasty in Patients with Eustachian Tube Dysfunction: A Meta-analysis

2018 ◽  
Vol 158 (4) ◽  
pp. 617-626 ◽  
Author(s):  
Tang-Chuan Wang ◽  
Chia-Der Lin ◽  
Tzu-Ching Shih ◽  
Hsiung-Kwang Chung ◽  
Ching-Yuang Wang ◽  
...  
Keyword(s):  
Eustachian Tube ◽  
Balloon Dilatation ◽  
Event Rate ◽  
Valsalva Maneuver ◽  
Meta Analysis ◽  
Balloon Dilation ◽  
Outcome Data ◽  
Eustachian Tube Dysfunction ◽  
Improvement Rate ◽  
Tube Dysfunction

Objective We aimed to perform a meta-analysis examining balloon dilatation and laser tuboplasty for the treatment of eustachian tube dysfunction (ETD). Data Sources PubMed, Cochrane, and Embase search up to April 18, 2016, with the following keywords: eustachian, middle-ear, eustachian tuboplasty, balloon tuboplasty, laser tuboplasty, laser dilatation, and balloon dilatation. Review Methods Randomized controlled trials and prospective, retrospective, and 1-arm studies of patients with ETD treated with balloon dilatation or laser tuboplasty were included. Outcome measures were improvement of eustachian tube score (ETS) and tympanometry and Valsalva maneuver results. Results Two retrospective and 11 prospective studies were included (1063 patients; 942 treated with balloon and 121 with laser tuboplasty). Balloon tuboplasty resulted in a significant improvement of ETS (pooled standardized mean difference [SMD], 0.94; 95% confidence interval [CI], 0.23-1.66; P = .009) and, compared with laser tuboplasty, a greater tympanometry improvement rate (pooled event rate = 73% vs 13%; P = .001). Valsalva maneuver improvement rate was not different between the group results (pooled event rate = 67% vs 50%; P = .472). The maximum number of studies that provided outcome data for any one measure was only 4, and sensitivity analysis indicated ETS results may have been overly influenced by 2 studies. No balloon tuboplasty studies reported ETS data, preventing comparison between the 2 procedures. Conclusion Both procedures can improve symptoms of ETD; however, because of the limited numbers of studies reporting data of the outcomes of interest, it remains unclear if one procedure provides greater benefits.

scholarly journals Mannitol cannot reduce the mortality on acute severe traumatic brain injury (TBI) patients: a meta–analyses and systematic review

2015 ◽  
Vol 3 ◽  
pp. 1-8 ◽  
Author(s):  
Kai Wang ◽  
Mingwei Sun ◽  
Hua Jiang ◽  
Xiao-ping Cao ◽  
Jun Zeng
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Severe Traumatic Brain Injury ◽  
Brain Injuries ◽  
Meta Analysis ◽  
Outcome Data ◽  
Control Treatment ◽  
Current Evidence ◽  
Cochrane Library

Abstract Background We aimed to systematically review the efficacy of mannitol (MTL) on patients with acute severe traumatic brain injury (TBI). Methods Databases such as PubMed (US National Library of Medicine), CENTRAL (The Cochrane Library 2014, Issue 3), ISI (Web of Science: Science Citation Index Expanded), Chinese Biomedicine Database (CBM), and China Knowledge Resource Integrated Database (CNKI) have been searched for relevant studies published between 1 January 2003 and 1 October 2014. We have established inclusion and exclusion criteria to identify RCTs, which were suitable to be enrolled in the systematic review. The comparison group could be hypertonic saline (HS), hydroxyethyl starch, or others. The quality assessment was based on the Cochrane Handbook for Systematic Reviews of Interventions Version 5.0.1 and modified Jadad score scale. The major outcome was mortality, followed by the secondary outcomes such as neurological outcome, days on intensive care unit (ICU), and ventilator day. In addition, intracranial pressure (ICP), cerebral perfusion pressure (CPP), and mean arterial pressure (MAP) were used as the surrogate endpoints. Data synthesis and meta-analysis was conducted by using R (version 3.7-0.). Results When 176 potential relevant literatures and abstracts have been screened, four RCTs met all the inclusion criteria and were enrolled for the meta-analysis. Amongst all the enrolled studies, two trials have provided the primary outcome data. There was no heterogeneity between two studies (I2 = 0 %) and a fixed model was used for meta-analysis (n = 53), pooled result indicated that the mortality was similar in mannitol intervention and control treatment, OR = 0.80, 95 % CI [0.27, 2.37], P = 0.38. We found that both mannitol and HS were efficient in decreasing the ICP. Furthermore, the effect of the HS on the ICP appeared to be more effective in the patients with diffuse brain injuries than mannitol did. Conclusions As a conclusion, the mannitol therapy cannot reduce the mortality risk of acute severe traumatic brain injury. Current evidence does not support the mannitol as an effective treatment of acute severe traumatic brain injury. The well-designed randomized controlled trials are in urgent need to demonstrate the adoption of mannitol to acute severe traumatic brain injury.

scholarly journals Lisfranc injuries: fix or fuse?

2021 ◽  
Vol 2 (10) ◽  
pp. 842-849
Author(s):  
Noortje Anna Clasina van den Boom ◽  
Guido A. N. L. Stollenwerck ◽  
Laureanne Lodewijks ◽  
Jeroen Bransen ◽  
Silvia M. A. A. Evers ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Risk Of Bias ◽  
Level Of Evidence ◽  
Assessment Development ◽  
Significant Difference ◽  
Patient Reported ◽  
Mean Differences ◽  
Lisfranc Injuries

Aims This systematic review and meta-analysis was conducted to compare open reduction and internal fixation (ORIF) with primary arthrodesis (PA) in the treatment of Lisfranc injuries, regarding patient-reported outcome measures (PROMs), and risk of secondary surgery. The aim was to conclusively determine the best available treatment based on the most complete and recent evidence available. Methods A systematic search was conducted in PubMed, Cochrane Controlled Register of Trials (CENTRAL), EMBASE, CINAHL, PEDro, and SPORTDiscus. Additionally, ongoing trial registers and reference lists of included articles were screened. Risk of bias (RoB) and level of evidence were assessed using the Cochrane risk of bias tools and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. The random and fixed-effect models were used for the statistical analysis. Results A total of 20 studies were selected for this review, of which 12 were comparative studies fit for meta-analysis, including three randomized controlled trials (RCTs). This resulted in a total analyzed population of 392 patients treated with ORIF and 249 patients treated with PA. The mean differences between the two groups in American Orthopedic Foot and Ankle Society (AOFAS), VAS, and SF-36 scores were -7.41 (95% confidence interval (CI) -13.31 to -1.51), 0.77 (95% CI -0.85 to 2.39), and -1.20 (95% CI -3.86 to 1.46), respectively. Conclusion This is the first study to find a statistically significant difference in PROMs, as measured by the AOFAS score, in favour of PA for the treatment of Lisfranc injuries. However, this difference may not be clinically relevant, and therefore drawing a definitive conclusion requires confirmation by a large prospective high-quality RCT. Such a study should also assess cost-effectiveness, as cost considerations might be decisive in decision-making. Level of Evidence: I Cite this article: Bone Jt Open 2021;2(10):842–849.

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