A randomized controlled trial comparing functional outcome and cost efficiency of a total surface-bearing socket versus a conventional patellar tendon-bearing socket in transtibial amputees

Background: Lateral epicondylitis is a tendinopathy characterized by pain around the lateral aspect of the elbow occuring more frequently in nonathletes than athletes significantly affecting the patient’s life in terms of the quantity and quality of work done. In resistant cases of tennis elbow, a number of treatment options have been tried including extracorporeal shockwave therapy, autologous blood injections and surgery as last resort but none of them has proved to be superior over another. Recent studies show that 25% dextrose prolotherapy which induces an inflammatory reaction at site of administration would be a better treatment option in resistant cases.Methods: A prospective randomized controlled trial was done in Department of Physical Medicine & Rehabilitation, Regional Institute of Medical Sciences, Imphal to compare the effectiveness of 25% dextrose prolotherapy injection and extracorporeal shockwave therapy in management of pain and improvement of functional outcome in patients suffering from chronic lateral epicondylitis.Results: The outcome variables VAS for pain and Grip strength for function were measured at baseline, 1 month, 3 months and 6months. Data collected were analysed using SPSS version 21. For analytical purpose, description statistics like mean and standard deviation were used. Statistical tests like t-test, Chi square test, Fisher’s exact test were used for intra group and inter group analysis. P-value <0.05 was taken as significant. In study group 2ml of 25% dextrose mixed with 2% lignocaine (0.5ml) was given to the affected lateral epicondyle. In control group, weekly sessions of single sitting ESWT was given to the lateral epicondyle for 3 consecutive weeks. In the follow up assessment at 1 month, 3 months and 6 months, there was significant improvement in mean score of VAS and Grip Strength scores in both the groups (p<0.05). When both the groups were compared with each other, study group showed a better improvement and was found to be significantly more effective than shockwave therapy group in reducing pain and improvement of functional outcome in chronic lateral epicondylitis (p = 0.001).Conclusions: Prolotherapy may be considered as a novel alternative conservative management before opting for surgery in resistant cases of lateral epicondylitis.

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Functional outcome of retrograde nailing versus locked plating of extra-articular distal femoral fractures in adults: A randomized controlled trial

Journal of Kathmandu Medical College ◽

10.3126/jkmc.v9i3.36404 ◽

2020 ◽

Vol 9 (3) ◽

pp. 122-129

Author(s):

Chandra Bhusan Yadav ◽

Asish Rajak ◽

Bikram Prasad Shrestha ◽

Raju Rijal ◽

Rajiv Maharjan ◽

...

Keyword(s):

Randomized Controlled Trial ◽

Functional Outcome ◽

Femoral Fracture ◽

Distal Femur ◽

Controlled Trial ◽

Distal Femoral Fracture ◽

Randomized Controlled ◽

Significant Difference ◽

Special Surgery ◽

Hospital For Special Surgery

Background: Distal femoral fracture constitutes the supracondylar and intercondylar fractures of femur. These are treated by locking plates as well as with nails. Despite the widespread use of both techniques, there are only few comparative studies. The two clinical techniques used to stabilize distal femur fractures are compared in this study. Objectives: The aim of this study was to compare plating and nailing in terms of functional outcome using the Hospital for Special Surgery (HSS) Knee Score of operative fixation of extra-articular femur fracture. Methodology: A randomized controlled trial was conducted with a total of 30 patients presenting to BP Koirala Institute of Health Sciences in a period of twelve months. All skeletally mature (>16 years) adult patients with isolated traumatic closed extra-articular fracture of distal femur without distal neurovascular deficit and giving written and informed consent were included. Patients with re-fractures, poly-trauma, fracture dislocations, pathological fracture and compartment syndrome were excluded. They were operated and followed up at 2, 6, 12 and 24 weeks. Results: The demographic profiles of the two groups were comparable. There was no significant difference in functional outcome (Hospital for Special Surgery score), union or complications between them. Conclusion: This study showed that there was no significant difference in terms of functional outcome (Hospital for Special Surgery score), union, fracture alignment, range of motion (knee, hip joint), infection, other outcome measures between plating and nailing in the treatment of distal femoral fracture in adults. Hence, further study is required to come to firm conclusions.

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Effects of handwriting exercise on functional outcome in Parkinson disease: A randomized controlled trial

Journal of Clinical Neuroscience ◽

10.1016/j.jocn.2019.08.119 ◽

2020 ◽

Vol 72 ◽

pp. 298-303 ◽

Cited By ~ 1

Author(s):

Nisa Vorasoot ◽

Pichet Termsarasab ◽

Kunlawat Thadanipon ◽

Teeratorn Pulkes

Keyword(s):

Randomized Controlled Trial ◽

Parkinson Disease ◽

Functional Outcome ◽

Controlled Trial ◽

Randomized Controlled

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Flexible versus standard intramedullary rod in posterior stabilized primary total knee arthroplasty: protocol for a randomized controlled trial

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01989-9 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

M. R. Bénard ◽

R. F. M. van Doremalen ◽

A. B. Wymenga ◽

P. J. C. Heesterbeek

Keyword(s):

Total Knee Arthroplasty ◽

Randomized Controlled Trial ◽

Functional Outcome ◽

Distal Femur ◽

Controlled Trial ◽

Sagittal Profile ◽

Randomized Controlled ◽

Total Knee ◽

Intramedullary Rod ◽

Group Allocation

Abstract Background In total knee arthroplasty (TKA) a flexible intramedullary rod can be used to account for sagittal bowing of the distal femur. Although patients report better post-operative functional outcome when the flexible rod was used, it is unknown how the use of the flexible rod affects the placement of the femoral TKA component, and how this relates to activities of daily living. It is expected that the use of the flexible rod will result in a more flexed femoral component, a larger patellar tendon moment arm, and consequently in better functional outcome. The goal of this study is to compare the flexible rod to the standard intramedullary rod in primary TKA in terms of fit of the TKA, functional outcome, and sizing of the femoral component. Methods A single-blind randomized controlled trial with two groups (flexible vs standard rod), with patients blinded for group allocation, and 2 years post-operative follow-up. The fit of the TKA is quantified by two parameters: (1) the flexion angle of the TKA in the sagittal plane and (2) the sagittal profile of the distal femur compared between the pre-operative bone and the TKA. Both parameters are calculated in 3D volume images obtained using fluoroscopy. Functional outcome will be measured using (1) the timed Get-up and Go test (2), the stair climbing test (3), knee power output, and (4) patient and clinician reported outcomes. Different parameters will be measured during the TKA procedure to account for the invisibility of cartilage in the 3D volumes and to study if the amount of bone removed during the procedure is affected by group allocation. Discussion The sagittal fit of TKA is not a standardized outcome measure. We discuss our choice of parameters to define the sagittal fit (i.e., flexion angle and sagittal profile), our choice for the parameters we measure during the TKA procedure to account for the lack of cartilage thickness in fluoroscopy, and our choice for the parameters to study if the amount of bone removed during the procedure is affected by group allocation. Lastly, we discuss the merits of this planned trial. Trial registration Netherlands Trial Register, 4888, registered 30 March 2015. https://www.trialregister.nl/trial/4888

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