scholarly journals Can we predict the clinical outcome of arthroscopic partial meniscectomy? A systematic review

2017 ◽  
Vol 52 (8) ◽  
pp. 514-521 ◽  
Author(s):  
Susanne M Eijgenraam ◽  
Max Reijman ◽  
Sita M A Bierma-Zeinstra ◽  
Daan T van Yperen ◽  
Duncan E Meuffels
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Clinical Outcome ◽  
Knee Osteoarthritis ◽  
Partial Meniscectomy ◽  
Cochrane Central Register ◽  
Inclusion Criteria ◽  
Arthroscopic Partial Meniscectomy ◽  
Duration Of Symptoms ◽  
Moderate Evidence

NHS-Prospero registration number42016048592ObjectiveIn order to make a more evidence-based selection of patients who would benefit the most from arthroscopic partial meniscectomy (APM), knowledge of prognostic factors is essential. We conducted a systematic review of predictors for the clinical outcome following APM.DesignSystematic reviewData sourcesMedline, Embase, Cochrane Central Register, Web of Science, SPORTDiscus, PubMed Publisher, Google ScholarInclusion criteriaReport an association between factor(s) and clinical outcome; validated questionnaire; follow-up >1 year.Exclusion criteria<20 subjects; anterior cruciate ligament-deficient patients; discoid menisci; meniscus repair, transplantation or implants; total or open meniscectomy.MethodsOne reviewer extracted the data, two reviewers assessed the risk of bias and performed a best-evidence synthesis.ResultsFinally, 32 studies met the inclusion criteria. Moderate evidence was found, that the presence of radiological knee osteoarthritis at baseline and longer duration of symptoms (>1 year) are associated with worse clinical outcome following APM. In addition, resecting >50% of meniscal tissue and leaving a non-intact meniscal rim after meniscectomy are intra-articular predictive factors for worse clinical outcome. Moderate evidence was found that sex, onset of symptoms (acute or chronic), tear type or preoperative sport level are not predictors for clinical outcome. Conflicting evidence was found for the prognostic value of age, perioperative chondral damage, body mass index and leg alignment.Summary/conclusionLong duration of symptoms (>1 year), radiological knee osteoarthritis and resecting >50% of meniscus are associated with a worse clinical outcome following APM. These prognostic factors should be considered in clinical decision making for patients with meniscal tears.

scholarly journals Prognostic factors for the long-term clinical outcome of arthroscopic partial meniscectomy - A systematic review

2016 ◽  
Vol 24 ◽  
pp. S344-S345
Author(s):  
S. Eijgenraam ◽  
D. Meuffels ◽  
S. Bierma-Zeinstra ◽  
D. van Yperen ◽  
M. Reijman
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Clinical Outcome ◽  
Partial Meniscectomy ◽  
Arthroscopic Partial Meniscectomy

scholarly journals The Effects of Yoga on Pain, Mobility, and Quality of Life in Patients with Knee Osteoarthritis: A Systematic Review

2016 ◽  
Vol 2016 ◽  
pp. 1-10 ◽  
Author(s):  
Laidi Kan ◽  
Jiaqi Zhang ◽  
Yonghong Yang ◽  
Pu Wang
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Knee Osteoarthritis ◽  
Cochrane Central Register ◽  
Inclusion Criteria ◽  
Positive Effects ◽  
Central Register ◽  
Evidence Database ◽  
And Function

Objective.To systematically assess the effects of yoga on pain, mobility, and quality of life in patients with knee osteoarthritis.Methods.Pubmed, Medline, EMBASE, the Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), and other sources were searched systematically in this study. Two reviewers identified eligible studies and extracted data independently. Downs and Black’s Quality Index were used to evaluate the methodological quality of the included studies.Results.A total of 9 articles (6 studies) involving 372 patients with knee osteoarthritis met the inclusion criteria. The most common yoga protocol is 40~90 minutes/session, lasting for at least 8 weeks. The effect of yoga on pain relief and function improvement could be seen after two-week intervention.Conclusion.This systematic review showed that yoga might have positive effects in relieving pain and mobility on patients with KOA, but the effects on quality of life (QOL) are unclear. Besides, more outcome measure related to mental health of yoga effects on people with KOA should be conducted.

scholarly journals Inflammatory blood parameters as prognostic factors for surgical site infection after primary hip or knee arthroplasty: a systematic review protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046027
Author(s):  
Petr Domecky ◽  
Anna Rejman Patkova ◽  
Katerina Mala-Ladova ◽  
Josef Maly
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Diagnostic Accuracy ◽  
Surgical Site Infection ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Blood Parameters ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Site Infection

IntroductionSurgical site infection (SSI) is a potential complication of surgical procedure. SSI after implant surgery is a disaster both for patients and surgeons. Although predictive tools for SSI are available, none of them estimate early infection based on inflammatory blood parameters. The inflammatory process can be measured using several parameters including interleukin-6, C reactive protein, neutrophil to lymphocyte ratio, white cell count, erythrocyte sedimentation rate or procalcitonin. This systematic review aims to determine whether inflammatory blood parameters could be used as significant predictive factors for SSI after primary hip or knee arthroplasty.Methods and analysisA systematic review of randomised controlled trials, cross-sectional studies, case–control studies and cohort studies, published in English, will be searched in the following electronic bibliographic databases: MEDLINE, Embase, PubMed, Cochrane Central Register of Controlled Trials and Web of Science. Studies performed in adult patients of all ages who underwent knee or hip arthroplasty, studies containing data on the risk/prognostic factors for preknee or postknee or hip arthroplasty SSI and studies with a minimum follow-up of 30 days after surgery will be included. A standardised form will be used to extract data from the included studies comprising study characteristics, participant characteristics, details of the intervention, study methodology and outcomes. Quality Assessment of Diagnostic Accuracy tool, second version, and Standards for Reporting of Diagnostic Accuracy Studies checklist will be used to assess risk of bias. Heterogeneity will be assessed using Cochran χ² statistic and I2 statistics where applicable. Grading of Recommendations Assessment, Development and Evaluation and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance will be used to report findings.Ethics and disseminationNo ethics approval is required. The findings will be disseminated at national and international scientific sessions, also to be published in a peer-reviewed journal.PROSPERO registration numberCRD42020147925.

Comparing the Pilates method with no exercise or lumbar stabilization for pain and functionality in patients with chronic low back pain: systematic review and meta-analysis

2011 ◽  
Vol 26 (1) ◽  
pp. 10-20 ◽  
Author(s):  
Ligia M Pereira ◽  
Karen Obara ◽  
Josilainne M Dias ◽  
Maryela O Menacho ◽  
Débora A Guariglia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Mean Difference ◽  
Cochrane Central Register ◽  
Low Back ◽  
Inclusion Criteria ◽  
Lumbar Stabilization ◽  
Pilates Method

Objective: To perform a systematic review with meta-analyses that evaluates the effectiveness of the Pilates method on the pain and functionality outcome in adults with non-specific chronic low back pain. Data sources: The search was performed in the following databases: Medline, Embase, AMED, Cinahl, Lilacs, Scielo, SportDiscus, ProQuest, Web of Science, PEDro, Academic Search Premier and the Cochrane Central Register of Controlled Trials from 1950 to 2011; the following keywords were used: ‘Pilates’, ‘Pilates-based’, ‘back exercises’, ‘exercise therapy’, ‘low back pain’, ‘back pain’ and ‘backache.’ Review methods: The inclusion criteria were studies that assessed the effects of the Pilates method on patients with chronic low back pain. Results: Five studies met the inclusion criteria. The total number of patients was 71 in the Pilates group and 68 in the control group. Pilates exercise did not improve functionality (standardized mean difference (SMD = –1.34; 95% confidence interval (CI) −2.80, 0.11; P = 0.07) or pain between Pilates and control groups (SMD = –1.99; 95% CI −4.35, 0.37; P = 0.10). Pilates and lumbar stabilization exercises presented no significant difference in functionality (mean difference (MD) = –0.31; 95% CI −1.02, 0.40; P = 0.39) or pain (MD = –0.31; 95% CI −1.02, 0.40; P = 0.39). Conclusion: The Pilates method did not improve functionality and pain in patients who have low back pain when compared with control and lumbar stabilization exercise groups.

A Systematic Review and Meta-Analysis of Radioimmunotherapy Consolidation for Untreated Patients with Follicular Lymphoma (FL)

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 101-101
Author(s):  
Adam C. Rose ◽  
Gia Garrett ◽  
Miray Seward ◽  
Pareen J Shenoy ◽  
Roy A Kucuk ◽  
...  
Keyword(s):  
Systematic Review ◽  
Maintenance Therapy ◽  
Follicular Lymphoma ◽  
Annual Meeting ◽  
Research Funding ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Cochrane Central Register ◽  
Inclusion Criteria ◽  
American Society

Abstract Abstract 101 Background: The disease course of FL is characterized by multiple relapses and progressively shorter response durations with subsequent therapies. As a result, numerous treatment strategies have been developed to reduce the risk of progression including consolidation with transplantation, radio-immunotherapy (RIT), or maintenance therapy with rituximab (R). At present, the optimal therapeutic strategy for FL patients (pts) remains undefined. R maintenance and RIT with an anti-CD20 antibody linked to iodine-131 (I131 Tositumomab) or to yttrium-90 (Y90-ibritumomab tiuxetan) have emerged as well tolerated treatments following induction. To quantify the benefits of consolidative RIT, we conducted a systematic review of the literature and a meta-analysis of selected studies. Methods: As part of a broader review, we searched the Cochrane Central Register of Controlled Trials (Cochrane Library Issue, 2011), MEDLINE (1/1966-6/2011), American Society of Hematology Annual Meeting abstracts (2004–2010), and American Society of Clinical Oncology Annual Meeting abstracts (2007–2010). Each database was searched using combinations of the term ‘follicular lymphoma' and the terms for treatment regimens. Inclusion criteria for studies were as follows: 1) reports on phase 2/3 studies; 2) n≥30; 3) previously untreated patients 4) treatment with RIT targeted at the CD20 antigen following an induction regimen; 5) original reporting in English of the following treatment outcome measures for pts with FL: CR/CR-unconfirmed, OR, and at least one form of survival data. Extracted data included pre-treatment disease status, pt characteristics, treatment regimen, progression free survival (PFS), overall survival (OS), complete response (CR) and overall response (OR). Pooled estimates of the CR rate, OR rate, 2-year PFS and 5-year PFS for pts treated with consolidative RIT were computed using DerSimonian and Laird random effects models. Results: Over 1136 records were reviewed with 8 studies meeting inclusion criteria with 556 patients. Between 1998 and 2007, pts were accrued at multiple sites in all but one study. Median ages ranged from 49–57 years with 41–61% male subjects, among the studies reporting gender. A weighted average of 97.2% of patients had stage III/IV disease with 73–98% pts having grade 1/2 disease, among those studies reporting histology. Among studies reporting this information, 19–44% of patients had abnormal LDH values, and 25–100% had bulky lymph nodes. CR rates ranged from 51% to 97%, 2-year PFS ranged from 65% to 86%, and 5-year PFS ranged from 38% to 67%. The pooled estimates of the CR rate and OR rate following consolidative RIT were 78% (95% CI 66%–87%) and 98% (95% CI 92.9%–99.5%), respectively (Figure A). The pooled estimates for the 2-year and 5-year PFS were 77.0% (95% CI 70.5–82.4%) and 56.0% (95% CI 41.9–69.2%), respectively (Figure B). Conclusions: This analysis suggests that consolidative RIT is beneficial to patients with previously untreated FL with meaningful CR rates and 5-year PFS. In addition, consolidative RIT compares favorably to maintenance therapy with R given after chemotherapy (ECOG 1496) in both 2-year PFS (77.0% vs. 73.5%) and 5-year PFS (56.0% vs. 46.4%), and needs to be compared to maintenance R following R-chemotherapy induction. Disclosures: Flowers: Genentech/Roche (unpaid): Consultancy; Celgene: Consultancy, Research Funding; Millennium/Takeda: Consultancy, Research Funding; Seattle Genetics: Consultancy; Novartis: Research Funding; Spectrum: Consultancy, Research Funding.

scholarly journals A systematic review of clinical and surgical predictors of complications following surgery for degenerative cervical myelopathy

2016 ◽  
Vol 24 (1) ◽  
pp. 77-99 ◽  
Author(s):  
Lindsay Tetreault ◽  
Ahmed Ibrahim ◽  
Pierre Côté ◽  
Anoushka Singh ◽  
Michael G. Fehlings
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Older Patients ◽  
Intervention Studies ◽  
Perioperative Complications ◽  
Patient Specific ◽  
Cochrane Central Register ◽  
Moderate Evidence ◽  
Operative Duration ◽  
Risk Patients

OBJECT Although generally safe and effective, surgery for the treatment of cervical spondylotic myelopathy (CSM) is associated with complications in 11%–38% of patients. Several predictors of postoperative complications have been proposed but few are used to detect high-risk patients. A standard approach to identifying “at-risk” patients would improve surgeons’ ability to prevent and manage these complications. The authors aimed to compare the complication rates between various surgical procedures used to treat CSM and to identify patient-specific, clinical, imaging, and surgical predictors of complications. METHODS The authors conducted a systematic review of the literature and searched MEDLINE, MEDLINE in Process, EMBASE, and Cochrane Central Register of Controlled Trials from 1948 to September 2013. Cohort studies designed to evaluate predictors of complications and intervention studies conducted to compare different surgical approaches were included. Each article was critically appraised independently by 2 reviewers, and the evidence was synthesized according to the principles outlined by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) Working Group. RESULTS A total of 5472 citations were retrieved. Of those, 60 studies met the inclusion criteria and were included in the review. These studies included 36 prognostic cohort studies and 28 comparative intervention studies. High evidence suggests that older patients are at a greater risk of perioperative complications. Based on low evidence, other clinical factors such as body mass index, smoking status, duration of symptoms, and baseline severity score, are not predictive of complications. With respect to surgical factors, low to moderate evidence suggests that estimated blood loss, surgical approach, and number of levels do not affect rates of complications. A longer operative duration (moderate evidence), however, is predictive of perioperative complications and a 2-stage surgery is related to an increased risk of major complications (high evidence). In terms of surgical techniques, higher rates of neck pain were found in patients undergoing laminoplasty compared with anterior spinal fusion (moderate evidence). In addition, with respect to laminoplasty techniques, there was a lower incidence of C-5 palsy in laminoplasty with concurrent foraminotomy compared with nonforaminotomy (low evidence). CONCLUSIONS The current review suggests that older patients are at a higher risk of perioperative complications. A longer operative duration and a 2-stage surgery both reflect increased case complexity and can indirectly predict perioperative complications.

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