scholarly journals Patients Generally May Return to Driving 4 Weeks After Hip Arthroscopy and 6 Weeks After Knee Arthroscopy: A Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Samantha Palma ◽  
Vasileios Giannoudis ◽  
Purva Patel ◽  
Jeya Palan ◽  
Stephen Guy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Arthroscopy ◽  
Knee Arthroscopy ◽  
Meta Analysis

scholarly journals Return to Driving After Hip and Knee Arthroscopic Procedures: A systematic review and meta-analysis

2020 ◽  
Vol 3 ◽  
Author(s):  
Samantha Palma ◽  
Purva Patel ◽  
Jeya Palan ◽  
HG Pandit ◽  
BH Van Duren
Keyword(s):  
Systematic Review ◽  
Reaction Time ◽  
Hip Arthroscopy ◽  
Knee Arthroscopy ◽  
Meta Analysis ◽  
Post Surgery ◽  
Mesh Terms ◽  
Harm To Others ◽  
Assess Quality ◽  
Arthroscopic Procedures

Background: Hip and knee arthroscopies are common orthopaedic procedures. As patients are looking to return to their regular schedules and regain their independence post-surgery, physicians often encounter the question of, “when can I drive again?” While safety of the patient is of the utmost importance when making these recommendations, it is equally important to consider the possibility of harm to others and potential legal ramifications. The purpose of this study is to consolidate evidence from available literature and undertake a systematic review and meta-analysis to determine when it is safe for patients to return to driving after hip and knee arthroscopic procedures.  Methods:  A systematic review was conducted using PRISMA guidelines. OVID, EMBASE, and COCHRANE databases were searched through June 2020 for articles containing keywords and/or MeSH terms “Hip arthroscopy” and “knee arthroscopy” in conjunction with “total brake response time” or “reaction time” in the context of automobile driving. Title review and full article review were done to assess quality and select relevant articles. Review Manager Version 5.4 was utilized for statistical analysis.   Results: 8 papers were included in the meta-analysis of Brake Reaction Time (BRT). Meta-analysis of all Knee BRTs showed times slower-than or equal-to-baseline BRTs through 5 weeks, with a trend of improving BRT from 6 to 10 weeks (only weeks 8 and 10 were significant P < 0.05). Of all Hip BRTs, week 2 showed slower-than-baseline BRTs, but after week 4 demonstrated a trend toward faster BRTs through week 8 (only week 8 was significant P < 0.05).   Conclusion: BRTs met baseline/control values and continued to improve after 6 weeks following knee arthroscopy and after 4 weeks following hip arthroscopy. Based on these results it would be safe to recommend return to driving at 6 weeks after knee arthroscopy and 4 weeks after hip arthroscopic procedures.   

Return to Play After Hip Arthroscopy: A Systematic Review and Meta-analysis

2018 ◽  
Vol 46 (11) ◽  
pp. 2780-2788 ◽  
Author(s):  
Michaela O’Connor ◽  
Anas A. Minkara ◽  
Robert W. Westermann ◽  
James Rosneck ◽  
T. Sean Lynch
Keyword(s):  
Systematic Review ◽  
Hip Arthroscopy ◽  
Meta Analysis ◽  
Return To Play ◽  
Sufficient Evidence ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Evidence Based ◽  
Rehabilitation Protocols ◽  
The Mean

Background: The use of arthroscopic treatment for intra-articular hip pathology has demonstrated improved patient-reported outcomes (PROs) with a lower rate of complications, reoperation, and patient morbidity as compared with traditional methods. Although the use of this minimally invasive approach has increased in prevalence, no evidence-based return-to-play (RTP) criteria have been developed to ensure an athlete’s preparedness for sporting activities. Purpose: To determine if there exists sufficient evidence in the literature to support an RTP protocol and functional assessment after hip arthroscopy, as well as to assess the mean rate and duration of RTP. Study Design: Systematic review and meta-analysis. Methods: The search terms “hip arthroscopy,” “return to play,” and 10 related terms were searched in PubMed, Cochrane Library, Scopus, and Web of Science, yielding 263 articles. After screening, 22 articles were included. RTP timeline, rehabilitation protocols, and conditional criteria measures were assessed with previously established criteria. Pooled estimates were calculated for RTP rate and duration, and weighted mean scores were determined for PROs. Results: A total of 1296 patients with 1442 total hips were identified. Although 54.5% (12 of 22) of studies did not provide a guideline for RTP duration after hip arthroscopy, 36.4% (8 of 22) recommended a duration of 4 months, while 9.1% (2 of 22) recommended 3 months. The most frequently described postoperative rehabilitation protocols were weightbearing guidelines (15 studies) and passive motion exercises (9 studies). Only 2 studies satisfied the criteria for a sufficient RTP protocol, and 3 provided a specific replicable test for RTP. The mean RTP duration was 7.4 months (95% CI, 6.1-8.8 months), and the return rate was 84.6% (95% CI, 80.4%-88.8%; P = .008) at a mean ± SD follow-up of 25.8 ± 2.4 months. Mean modified Harris Hip Score (mHHS) improved from 63.1 to 84.1 postoperatively (+33.3%), while Non-arthritic Hip Score improved from 61.7 to 86.8 (+40.7%). A lower preoperative mHHS was significantly associated with a higher postoperative improvement ( r = −0.95, P = .0003). Conclusion: Significant variability exists in RTP protocols among institutions owing to a lack of standardization. Despite a high overall rate of RTP and improvement in PROs after hip arthroscopy, the majority of rehabilitation protocols are not evidence based and rely on expert opinion. No validated functional test currently exists to assess RTP.

scholarly journals Effect of Capsular Closure on Outcomes of Hip Arthroscopy for Femoracetabular Impingement: A Systematic Review and Meta‐analysis

2020 ◽  
Vol 12 (4) ◽  
pp. 1153-1163 ◽  
Author(s):  
Liang Liu ◽  
Yan Zhang ◽  
Qi Gui ◽  
Feng Zhao ◽  
Xue‐Zhen Shen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Arthroscopy ◽  
Meta Analysis ◽  
Femoracetabular Impingement

Tramadol as an adjunct to intra‐articular local anaesthetic infiltration in knee arthroscopy: a systematic review and meta‐analysis

2019 ◽  
Vol 89 (7-8) ◽  
pp. 827-832 ◽  
Author(s):  
Thomas Ryan ◽  
Anthony Hodge ◽  
Rhys Holyoak ◽  
Ruan Vlok ◽  
Thomas Melhuish ◽  
...  
Keyword(s):  
Systematic Review ◽  
Local Anaesthetic ◽  
Knee Arthroscopy ◽  
Meta Analysis

Intra-articular Alpha-2 Agonists as an Adjunct to Local Anesthetic in Knee Arthroscopy: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 32 (02) ◽  
pp. 138-145 ◽  
Author(s):  
Rhys Holyoak ◽  
Ruan Vlok ◽  
Thomas Melhuish ◽  
Anthony Hodge ◽  
Matthew Binks ◽  
...  
Keyword(s):  
Systematic Review ◽  
Side Effects ◽  
Postoperative Pain ◽  
Local Anesthetic ◽  
Knee Arthroscopy ◽  
Meta Analysis ◽  
Intervention Group ◽  
Control Group ◽  
Antiinflammatory Drugs ◽  
Level Of Evidence

AbstractThe infiltration of local anesthetic has been shown to reduce postoperative pain in knee arthroscopy. Several studies have shown that the addition of agents such as magnesium and nonsteroidal antiinflammatory drugs (NSAIDs) result in an increased time to first analgesia and overall reduction in pain. The aim of this systematic review and meta-analysis was to determine whether the addition of an α-2 agonist (A2A) to intra-articular local anesthetic, results in a reduction in postoperative pain. Four major databases were systematically searched for relevant randomized controlled trials (RCTs) up to July 2017. RCTs containing a control group receiving a local anesthetic and an intervention group receiving the same with the addition of an A2A were included in the review. The included studies were assessed for level of evidence and risk of bias. The data were then analyzed both qualitatively and where appropriate by meta-analysis. We reviewed 12 RCTs including 603 patients. We found that the addition of an A2A resulted in a significant reduction in postoperative pain up to 24 hours. The addition of the A2A increased time to first analgesia request by 258.85 minutes (p < 0.00001). Total 24-hour analgesia consumption was analyzed qualitatively with all included studies showing a significant reduction in total analgesia requirement. Interestingly, none of the studies found an increase in side effects associated with the A2A. This study provides strong evidence for the use of A2As as a means to reduce postoperative pain post arthroscopic knee surgery, without a corresponding increase in side effects.

Deep Venous Thrombosis After Knee Arthroscopy: A Systematic Review and Meta-Analysis

2014 ◽  
Vol 30 (3) ◽  
pp. 406-412 ◽  
Author(s):  
Ye Sun ◽  
Dongyang Chen ◽  
Zhihong Xu ◽  
Dongquan Shi ◽  
Jin Dai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Knee Arthroscopy ◽  
Meta Analysis

Complications following hip arthroscopy: a systematic review and meta-analysis

2012 ◽  
Vol 21 (7) ◽  
pp. 1669-1675 ◽  
Author(s):  
M. Kowalczuk ◽  
M. Bhandari ◽  
F. Farrokhyar ◽  
I. Wong ◽  
M. Chahal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Arthroscopy ◽  
Meta Analysis

scholarly journals A Single-Dose Intra-Articular Morphine plus Bupivacaine versus Morphine Alone following Knee Arthroscopy: A Systematic Review and Meta-Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (10) ◽  
pp. e0140512 ◽  
Author(s):  
Dong-xing Xie ◽  
Chao Zeng ◽  
Yi-lun Wang ◽  
Yu-sheng Li ◽  
Jie Wei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Single Dose ◽  
Knee Arthroscopy ◽  
Meta Analysis

Repaired or unrepaired capsulotomy after hip arthroscopy: a systematic review and meta-analysis of comparative studies

2019 ◽  
Vol 30 (3) ◽  
pp. 256-266 ◽  
Author(s):  
Yipeng Lin ◽  
Tao Li ◽  
Xinghao Deng ◽  
Xihao Huang ◽  
KaiBo Zhang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Outcomes ◽  
Narrative Analysis ◽  
Comparative Studies ◽  
Hip Arthroscopy ◽  
Meta Analysis ◽  
Surgical Techniques ◽  
Harris Hip Score ◽  
Outcome Score ◽  
Published Evidence

Purpose: To conduct a systematic review and meta-analysis comparing the surgical techniques, clinical outcomes, rates of revision and conversion to arthroplasty and complications between a repaired and unrepaired capsulotomy after hip arthroscopy. Methods: A search of the PubMed, Embase and Google Scholar databases was performed to identify comparative articles published prior to 10 July 2019 that reported the capsule management strategy and clinical outcomes after hip arthroscopy. A narrative analysis and meta-analysis were performed to integrate and compare the results of the 2 groups. Results: 12 comparative studies ( n = 1185 hips) with an average (methodological index for non-randomized studies) MINORS score of 17.45 ± 2.02 were identified for analysis, of which 5 were included in the meta-analysis. The pre- to postoperative improvements in the modified Harris Hip Score (mHHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SS), and Hip Outcome Score–Activities of Daily Living (HOS-ADL) revealed no significant differences between the repaired and unrepaired groups ( p = 0.40, 0.26 and 0.61, respectively). The risk ratio of the revision rate for the 2 groups was 0.66 ( p = 0.21). Evaluation of the MRI scans and the rate of heterotopic ossification also showed no significant differences. The most preferred capsulotomy techniques were interportal and T-shape. No postoperative hip instability was reported in any of the 12 studies. Conclusion: The currently published evidence is still not strong enough to confirm the superiority of repairing the capsule after hip arthroscopy; hence, routine repair of the capsule during surgery cannot be suggested.

Sign in / Sign up

Export Citation Format

Share Document