Prostheses for Primary Total Hip Replacement: A Critical Appraisal of the Literature

1995 ◽  
Vol 11 (4) ◽  
pp. 770-778 ◽  
Author(s):  
Delma E. Cowley
Keyword(s):  
Randomized Controlled Trials ◽  
Total Hip Replacement ◽  
Comparative Studies ◽  
Hip Replacement ◽  
Critical Appraisal ◽  
Case Series ◽  
Controlled Trials ◽  
Total Hip ◽  
Randomized Controlled

AbstractEighty-one published papers on the performance of prostheses in total hip replacement were appraised. Sound methodology was demonstrated in 1 of 8 randomized controlled trials and 4 of 17 nonrandomized comparative studies. Of 56 case series without controls, 32 met the appraisal criteria, but these are intrinsically less useful. The published literature does not provide solid evidence for the superiority of cement-free or hybrid prostheses over modern cemented types.

Making a Difference

2018 ◽  
Author(s):  
Rani Lill Anjum ◽  
Stephen Mumford
Keyword(s):  
Randomized Controlled Trials ◽  
Comparative Studies ◽  
Gold Standard ◽  
Controlled Trials ◽  
Positive Difference ◽  
Randomized Controlled ◽  
Difference Making ◽  
Making A Difference ◽  
Difference Makers ◽  
Trial Intervention

One view of what links a cause to an effect is that causes make a difference to whether or not the effect is produced. This assumption is behind comparative studies, such as the method of randomized controlled trials, aimed at showing whether a trial intervention makes a positive difference to outcomes. Comparative studies are regarded as the gold standard in some areas of research but they are also problematic. There can be causes that make no difference and some difference-makers that are not causes. This indicates that difference-making should be taken as a symptom of causation: a feature that accompanies it in some, though not all, cases. Symptoms can be useful in the discovery of causes but they cannot be definitive of causation.

scholarly journals Lessons Learnt from Recent Trials in Ischemic Heart Disease

2020 ◽  
Author(s):  
John M. Mandrola ◽  
Sanjay Kaul ◽  
Andrew Foy
Keyword(s):  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Randomized Controlled Trials ◽  
Patient Care ◽  
Critical Appraisal ◽  
Ischemic Heart ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Stable Ischemic Heart Disease ◽  
Trial Evidence

AbstractFour recently published randomized controlled trials have informed the care of patients with stable ischemic heart disease. The purpose of this clinical focus article is to offer a summary and critical appraisal of the recent evidence. We aim to aid clinicians in the translation of the trial evidence to patient care.

scholarly journals Cemented versus uncemented fixation in total hip replacement: a systematic review and meta-analysis of randomized controlled trials

2013 ◽  
Vol 5 (1) ◽  
pp. 8 ◽  
Author(s):  
Ali Abdulkarim ◽  
Prasad Ellanti ◽  
Nicola Motterlini ◽  
Tom Fahey ◽  
John M. O’Byrne
Keyword(s):  
Systematic Review ◽  
Randomized Controlled Trials ◽  
Controlled Trials ◽  
Implant Fixation ◽  
Short Term ◽  
Optimal Method ◽  
Radiographic Findings ◽  
Total Hip ◽  
Randomized Controlled ◽  
Significant Difference

The optimal method of fixation for primary total hip replacements (THR), particularly fixation with or without the use of cement is still controversial. In a systematic review and metaanalysis of all randomized controlled trials comparing cemented versus uncemented THRS available in the published literature, we found that there is no significant difference between cemented and uncemented THRs in terms of implant survival as measured by the revision rate. Better short-term clinical outcome, particularly an improved pain score can be obtained with cemented fixation. However, the results are unclear for the long-term clinical and functional outcome between the two groups. No difference was evident in the mortality and the post operative complication rate. On the other hand, the radiographic findings were variable and do not seem to correlate with clinical findings as differences in the surgical technique and prosthesis design might be associated with the incidence of osteolysis. We concluded in our review that cemented THR is similar if not superior to uncemented THR, and provides better short term clinical outcomes. Further research, improved methodology and longer follow up are necessary to better define specific subgroups of patients in whom the relative benefits of cemented and uncemented implant fixation can be clearly demonstrated.

Thromboembolic complications of endovenous thermal ablation and foam sclerotherapy in the treatment of great saphenous vein insufficiency

2014 ◽  
Vol 30 (5) ◽  
pp. 357-364 ◽  
Author(s):  
Meghan Dermody ◽  
Marlin W Schul ◽  
Thomas F O’Donnell
Keyword(s):  
Venous Thromboembolism ◽  
Randomized Controlled Trials ◽  
Thermal Ablation ◽  
Meta Analysis ◽  
Case Series ◽  
Controlled Trials ◽  
Foam Sclerotherapy ◽  
Bootstrap Analysis ◽  
Randomized Controlled ◽  
Endovenous Thermal Ablation

Objective Portions of these data were presented in a poster at the XVII World Meeting of the International Union of Phlebology, 8–13 September 2013, Boston, MA, USA. We assessed the incidence of venous thromboembolism following treatment of great saphenous insufficiency by endovenous thermal ablation or foam sclerotherapy using meta-analysis of published randomized controlled trials and case series. Methods Medline, Embase, Cochrane, and Clinical Trials Registry databases were searched from January 2000 through January 2013 for randomized controlled trials and large case series employing endovenous thermal ablation or foam sclerotherapy as a single modality for the treatment of great saphenous insufficiency, with concomitant postoperative duplex scanning. Pooled (stratified) incidence of venous thromboembolism with 95% confidence intervals was estimated using the DerSimonian–Laird procedure for random effects meta-analysis. A bootstrap analysis was performed to examine between-modality differences. Results Twelve randomized controlled trials and 19 case series investigating endovenous thermal ablation (radiofrequency ablation with VNUS/Covidien ClosureFAST™ catheter only, endovenous laser ablation, or both) were included. Data from 12 randomized controlled trials and 6 case series investigating nonproprietary foam preparations were analyzed. Estimated incidence of venous thromboembolism was low (mostly <1%) and similar across treatment modalities and study types. Conclusions Treatment of great saphenous insufficiency by endovenous thermal ablation or foam sclerotherapy is a common vascular intervention. The stratified incidence of venous thromboembolism appears to be low as reported in both randomized controlled trials and case series investigating these modalities. Although duplex scans were obtained postoperatively, a minority of studies specified protocols for venous thromboembolism detection.

Systematic Review of Radiological Analysis of Total Hip Replacement via Direct Anterior Approach in Comparison to Other Approaches – Study Protocol

2020 ◽  
Author(s):  
Bartosz Maciąg ◽  
Kuba Radzimowski ◽  
Piotr Stępiński ◽  
Jakub Szymczak ◽  
Tomasz Albrewczyński ◽  
...  
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Hip Replacement ◽  
Anterior Approach ◽  
Femoral Stem ◽  
Direct Anterior Approach ◽  
Controlled Trials ◽  
Total Hip ◽  
Randomized Controlled ◽  
Radiological Analysis

Abstract Background Total hip arthroplasty (THR) is considered as the most effective available method of treatment of end-stage hip osteoarthritis (OA). This surgery can be performed via many different approaches. One of the newly developed technique is called direct anterior approach (DAA). It gains popularity and recognition as the least traumatic to the soft tissues, thus quickening rehabilitation and improving joint stability in the early postoperative period. There are no systematic reviews covering this subject in terms of potential differences in radiological prosthesis placement, and while there is still unsatisfactory evidence concerning long-term outcomes of DAA, such review may prove useful in the debate. The objective of our study was to systematically collect and review available data from randomized-controlled trials (RCTs) regarding radiographic assessment of prosthesis placement after total hip arthroplasty using direct anterior approach compared to other common approaches.Methods A systematic review of randomized controlled trials (RCTs) will be conducted. SciFinder, Scopus, ScienceDirect, PubMed, Embase, Clinical Key and The Cochrane Library databases will be searched without restriction to date up to June 2020. Primary outcomes will include measurements related with the radiological analysis of trials comparing use of DAA to other approaches used for THR, containing at least two of the following: femoral stem alignment, mean radiographic cup inclination, mean radiographic cup anteversion, mean radiographic cup abduction, position in Lewinnek's safe zone. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and the methodological appraisal of the studies will be assessed by the Cochrane Risk-of-Bias Tool for RCTs. Discussion This systematic review will provide missing information regarding influence of differences between DAA and other surgical approaches in total hip replacement on prosthesis implants placement in case of femoral stem and cup. This may result in improving knowledge and awareness of surgeons, improving patients satisfaction and functional outcome and lowering the risk of hip dislocations and other complications. Trial registration International Registration of Systematic reviews (PROSPERO) number CRD42019122675

scholarly journals Characteristic of Clinical Studies on Baduanjin during 2000–2019: A Comprehensive Review

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Jing Zhou ◽  
Yunyang Yu ◽  
Biwei Cao ◽  
Xiaoya Li ◽  
Miao Wu ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Clinical Studies ◽  
Methodological Quality ◽  
Case Reports ◽  
Case Series ◽  
Small Sample ◽  
Chronic Obstructive ◽  
Controlled Trials ◽  
Randomized Controlled

To date, a growing number of clinical studies have demonstrated the safety and health benefits from Baduanjin intervention. Based on this, our objective is to systematically retrieve and summarize the clinical studies on Baduanjin, with a view to providing more evidence-based evidence in support of the application of Baduanjin for healthcare, and to identify the shortcomings of existing research and provide feasibility suggest for further clinical research. Both four English language and four Chinese language electronic databases were used to search articles related to Baduanjin during 2000–2019. SPSS 22.0 software was used to analyze the data, and the risk of bias tool in the RevMan 5.3.5 software was used to evaluate the methodological quality of randomized controlled trials. A total of 810 publications were identified, including 43 (5.3%) systematic reviews, 614 (75.8%) randomized controlled trials, 66 (8.1%) nonrandomized controlled clinical studies, 84 (10.4%) case series, and 3 (0.4%) case reports. The top 10 diseases/conditions included diabetes, chronic obstructive pulmonary disease, hypertension, low back pain, neck pain, stroke, coronary heart disease, cognitive impairment, insomnia, and osteoporosis or osteopenia. The style of State General Administration of Sport of China in 2003 was the most commonly used version of Baduanjin, and Baduanjin was practiced with an average of 35 minutes, 1 or 2 times a day, 3–5 days per week, and a 18-week average duration. It is also worth noting that there were no serious adverse events related to Baduanjin intervention. Most studies were small sample size research, and the methodological quality of randomized controlled trials is generally low. The clinical studies of Baduanjin have a substantial quantity and evidence base. However, there are significant differences among different studies in the specific intervention measures such as style, intensity, duration, learning, and practice methods, which need to be further standardized and unified. Further high-quality designed and reporting studies are recommended to further validate the clinical benefits of Baduanjin.

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