Adequate return to sports and sports activities after treatment of Lisfranc injury: a meta-analysis

2020 ◽  
pp. jisakos-2020-000477
Author(s):  
Carlijn S ter Laak Bolk ◽  
Jari Dahmen ◽  
Kaj T A Lambers ◽  
Leendert Blankevoort ◽  
Gino M M J Kerkhoffs
Keyword(s):  
Conservative Treatment ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Physical Activities ◽  
Return To Sports ◽  
Level Of Evidence ◽  
Partial Arthrodesis ◽  
Lisfranc Injuries ◽  
Sports Activities

ImportanceAlthough a large number of Lisfranc injuries occur during sports, data on sports outcomes, such as return to sport (RTS) rates and times as well as level of sports activities after treatment of this injury remain limited.ObjectiveThe aim is to assess the RTS rates, times and the sports activity levels after different treatments of Lisfranc injuries.Evidence reviewThe electronic databases PubMed (MEDLINE), EMBASE, CDSR, DARE and CENTRAL were searched to identify relevant articles from January 1985 to July 2020. The mean RTS rates (to any level and preinjury level of sports) and times were extracted per study, and pooled wherever methodologically possible. Methodological quality of the included studies was assessed using the Methodological Index for Non-Randomized Studies criteria (MINORS).FindingsFifteen studies were included in this review. Methodological quality of the studies was poor. The treatments reported in the studies were conservative treatment, surgical fixation and primary partial arthrodesis. For conservative treatment, the RTS rate regardless of sports level was 93% (95% CI 81% to 98%; n=42) and for return to preinjury level of sports was 88% (95% CI 75% to 95%; n=42). The fixation group showed a RTS percentage of 94% (95% CI 91% to 97%; n=270) to each level of sports and for return to the level before injury was 86% (95% CI 80% to 90%; n=188). In the primary partial arthrodesis group, the return to any level of sports was 94% (95% CI 85% to 98%; n=65) and for return to preinjury level was 74% (95% CI 62% to 83%; n=65). Mean time to RTS ranged from 7 to 33 weeks across all treatment groups. No data pooling was possible for this outcome measure. From the different studies, a total of 43 different sports and 440 physical activities were reported before treatment. After treatment, patients participated in 37 different sports (88%) and 391 different physical activities (89%).Conclusions and relevanceThe different treatment options for Lisfranc injuries allow for good sport-specific outcomes with 93% to 94% of athletes returning to any level of sports, and 74% to 88% of athletes returning to their preinjury level of sport. These sport-specific outcomes can be used to inform patients about their expected sport-specific outcomes after different treatments of Lisfranc injuries.Level of evidenceSystematic review and meta-analysis.

Surgery is no more effective than conservative treatment for Femoroacetabular impingement syndrome: Systematic review and meta-analysis of randomized controlled trials

2020 ◽  
pp. 026921552096669 ◽  
Author(s):  
Robson Massi Bastos ◽  
Jorge Geraldo de Carvalho Júnior ◽  
Suellen Aline Martinez da Silva ◽  
Shirley Ferreira Campos ◽  
Matheus Vieira Rosa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Femoroacetabular Impingement ◽  
Methodological Quality ◽  
Impingement Syndrome ◽  
Level Of Evidence ◽  
Femoroacetabular Impingement Syndrome ◽  
Quality Evidence

Objective: To summarize the effects of surgical treatment compared to conservative treatment in femoroacetabular impingement syndrome in the short, medium, and long term. Study Design: Systematic review Methods: The following databases were searched on 14/09/2020: MEDLINE, EMBASE, CENTRAL, Web of Science, and PEDro. There were no date or language limits. The methodological quality assessment was performed using the PEDro scale and the quality of the evidence followed the GRADE recommendation. The outcomes pain, disability, and adverse effects were extracted. Results: Of 6264 initial studies, three met the full-text inclusion criteria. All studies were of good methodological quality. Follow up ranged from six months to two years, with 650 participants in total. The meta-analyses found no difference in disability between surgical versus conservative treatment, with a mean difference (MD) between groups of 3.91 points (95% CI –2.19 to 10.01) at six months, MD of 5.53 points (95% CI –3.11 to 14.16) at 12 months and 3.8 points (95% CI –6.0 to 13.6) at 24 months. The quality of the evidence (GRADE) varied from moderate to low across all comparisons. Conclusion: There is moderate-quality evidence that surgical treatment is not superior to conservative treatment for femoroacetabular impingement syndrome in the short term, and there is low-quality evidence that it is not superior in the medium term. Level of evidence: Therapy, level 1a. Registration number: PROSPERO CRD42019134118

scholarly journals Integrated care programmes for sport and work participation, performance of physical activities and quality of life among orthopaedic surgery patients: a systematic review with meta-analysis

2020 ◽  
Vol 6 (1) ◽  
pp. e000664 ◽  
Author(s):  
Pieter Coenen ◽  
Gerben Hulsegge ◽  
Joost G Daams ◽  
Rutger C van Geenen ◽  
Gino M Kerkhoffs ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Integrated Care ◽  
Orthopaedic Surgery ◽  
Meta Analysis ◽  
Physical Activities ◽  
Work Participation ◽  
Return To Sports ◽  
High Quality Research

ObjectivesOrthopaedic surgery is primarily aimed at improving function and pain reduction. Additional integrated care may enhance patient’s participation in sports and work, possibly improving performance of physical activities and quality of life (QoL). We aimed to assess the effectiveness of integrated care among orthopaedic surgery patients.DesignSystematic review with meta-analysis.Data sourceMedline, EMBASE and CINAHL (until 17 June 2019).Eligibility for selecting studiesWe searched for controlled studies on integrated care interventions consisting of active referral to case managers, rehabilitation with participation-based goals and/or e/mHealth, with outcomes of sports and work participation, performance of physical activities and/or QoL. Outcomes were normalised to 0–100 scales and statistically pooled.ResultsSeventeen articles (n=2494) of moderate quality were included reporting on patients receiving back, upper limb, knee or hip surgery. Only one study reported on return to sports and found no significant benefit. For return to work, one study did (90% vs 82%) and one did not (relative risk=1.18 (0.80 to 1.70)) observe significant benefits. Integrated care showed small effects for improving performance of physical activities (2.69 (–0.20 to 5.58); eight studies, n=1267) and QoL (2.62 (1.16 to 5.05); nine studies, n=1158) compared with usual care.Summary/ConclusionWe found insufficient and inconsistent evidence for the effectiveness of integrated care for orthopaedic surgery patients regarding sport and work participation. Small effects were found for performance of physical activities and QoL. High quality research on integrated care focusing on sports and work participation is needed before integrated care can be implemented for orthopaedic surgery patients.

Return to Sports and Physical Activities After Primary Partial Arthrodesis for Lisfranc Injuries in Young Patients

2015 ◽  
Vol 37 (4) ◽  
pp. 355-362 ◽  
Author(s):  
Aoife MacMahon ◽  
Paul Kim ◽  
David S. Levine ◽  
Jayme Burket ◽  
Matthew M. Roberts ◽  
...  
Keyword(s):  
Young Patients ◽  
Physical Activities ◽  
Return To Sports ◽  
Partial Arthrodesis ◽  
Lisfranc Injuries

scholarly journals The prevalence of diabetes in Afghanistan: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sohail Akhtar ◽  
Jamal Abdul Nasir ◽  
Amara Javed ◽  
Mariyam Saleem ◽  
Sundas Sajjad ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Population Based ◽  
Included Study ◽  
Cochrane Library ◽  
Or Education ◽  
Meta Regression

Abstract Background The aim of this paper is to investigate the prevalence of diabetes and its associated risk factors in Afghanistan through a systematic review and meta–analysis. Methods A comprehensive literature search was conducted using EMBASE, PubMed, Web of Sciences, Google Scholar and the Cochrane library, carried out from inception to April 312,020, without language restriction. Meta–analysis was performed using DerSimonian and Laird random-effects models with inverse variance weighting. The existence of publication bias was initially assessed by visual inspection of a funnel plot and then tested by the Egger regression test. Subgroup analyses and meta-regression were used to explore potential sources of heterogeneity. This systematic review was reported by following the PRISMA guidelines and the methodological quality of each included study was evaluated using the STROBE guidelines. Results Out of 64 potentially relevant studies, only 06 studies fulfilled the inclusion criteria and were considered for meta-analysis. The pooled prevalence of diabetes in the general population based on population-based studies were 12.13% (95% CI: 8.86–16.24%), based on a pooled sample of 7071 individuals. Results of univariate meta-regression analysis revealed that the prevalence of diabetes increased with mean age, hypertension and obesity. There was no significant association between sex (male vs female), smoking, the methodological quality of included articles or education (illiterate vs literate) and the prevalence of diabetes. Conclusions This meta-analysis reports the 12.13% prevalence of diabetes in Afghanistan,with the highest prevalence in Kandahar and the lowest in Balkh province. The main risk factors include increasing age, obesity and hypertension. Community-based care and preventive training programmes are recommended. Trial registration This review was registered on PROSPERO (registration number CRD42020172624).

Criteria for Return to Play After Hip Arthroscopy in the Treatment of Femoroacetabular Impingement: A Systematic Review

2021 ◽  
pp. 036354652110389
Author(s):  
Martin S. Davey ◽  
Eoghan T. Hurley ◽  
Matthew G. Davey ◽  
Jordan W. Fried ◽  
Andrew J. Hughes ◽  
...  
Keyword(s):  
Systematic Review ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Operative Management ◽  
Return To Play ◽  
Return To Sports ◽  
Level Of Evidence ◽  
The Mean

Background: Femoroacetabular impingement (FAI) is a common pathology in athletes that often requires operative management in the form of hip arthroscopy. Purpose: To systematically review the rates and level of return to play (RTP) and the criteria used for RTP after hip arthroscopy for FAI in athletes. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature, based on the PRISMA guidelines, was performed using PubMed, Embase, and Scopus databases. Studies reporting outcomes after the use of hip arthroscopy for FAI were included. Outcomes analyzed were RTP rate, RTP level, and criteria used for RTP. Statistical analysis was performed using SPSS software. Results: Our review found 130 studies, which included 14,069 patients (14,517 hips) and had a mean methodological quality of evidence (MQOE) of 40.4 (range, 5-67). The majority of patients were female (53.7%), the mean patient age was 30.4 years (range, 15-47 years), and the mean follow-up was 29.7 months (range, 6-75 months). A total of 81 studies reported RTP rates, with an overall RTP rate of 85.4% over a mean period of 6.6 months. Additionally, 49 studies reported the rate of RTP at preinjury level as 72.6%. Specific RTP criteria were reported in 97 studies (77.2%), with time being the most commonly reported item, which was reported in 80 studies (69.2%). A total of 45 studies (57.9%) advised RTP at 3 to 6 months after hip arthroscopy. Conclusion: The overall rate of reported RTP was high after hip arthroscopy for FAI. However, more than one-fourth of athletes who returned to sports did not return at their preinjury level. Development of validated rehabilitation criteria for safe return to sports after hip arthroscopy for FAI could potentially improve clinical outcomes while also increasing rates of RTP at preinjury levels.

Intra-articular distal radius fractures in elderly patients: a randomized prospective study of casting versus volar plating

2017 ◽  
Vol 43 (2) ◽  
pp. 142-147 ◽  
Author(s):  
Daniel Martinez-Mendez ◽  
Alejandro Lizaur-Utrilla ◽  
Joaquin de-Juan-Herrero
Keyword(s):  
Conservative Treatment ◽  
Elderly Patients ◽  
Distal Radius ◽  
Articular Surface ◽  
Distal Radius Fractures ◽  
Volar Plating ◽  
Radius Fractures ◽  
Level Of Evidence ◽  
Loss Of Reduction

We compared outcomes in elderly patients with intra-articular distal radius fractures treated by closed reduction and plaster immobilization or open reduction and internal fixation with a volar plate. Ninety-seven patients older than 60 years were randomly allocated to conservative (47 patients) or surgical (50 patients) treatment. Over a 2-year period, we assessed patient-rated wrist evaluation score, DASH (disability arm, shoulder and hand) questionnaire, pain, wrist range of motion, grip strength, and radiological parameters. The functional outcomes and quality of life were significantly better after volar plating fixation compared with conservative treatment. We found that restoration of the articular surface, radial inclination, and ulnar variance affected the outcomes, but the articular step-off did not. Twenty-five per cent of the patients with conservative treatment had secondary loss of reduction. We conclude that surgical plating leads to better outcomes than conservative treatment for elderly patients with intra-articular distal radius fractures. Level of evidence: I

scholarly journals Seroprevalence of hepatitis C virus infection in Cameroon: a systematic review and meta-analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015748 ◽  
Author(s):  
Jean Joel Bigna ◽  
Marie A Amougou ◽  
Serra Lem Asangbeh ◽  
Angeladine Malaha Kenne ◽  
Jobert Richie Nansseu
Keyword(s):  
Systematic Review ◽  
Hepatitis C ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Hcv Infection ◽  
Representative Study ◽  
East Region ◽  
Pooled Prevalence ◽  
Rural Settings

ObjectiveBetter knowledge of hepatitis C virus (HCV) seroprevalence at the national level can help to implement pertinent strategies to address the HCV-related burden. The aim of this paper was to estimate the seroprevalence of HCV infection in Cameroon.DesignSystematic review and meta-analysis.ParticipantsPeople residing in Cameroon.Data sourcesElectronic databases including PubMed/MEDLINE, AJOL, WHO-Afro Library, Africa Index Medicus, National Institute of Statistics and National AIDS Control Committee, Cameroon from 1 January 2000 to 15 December 2016 were searched. English and French languages papers were considered. Two independent investigators selected studies. The methodological quality of the studies was assessed using the Newcastle–Ottawa scale.Results31 studies including 36 407 individuals were finally considered. There was no national representative study. The overall pooled prevalence was 6.5% (95% CI 4.5% to 8.8%; I²=98.3%). A sensitivity analysis of individuals at low risk of HCV infection showed a pooled prevalence of 3.6% (95% CI 2.3% to 5.2%, I²=97.7%, 18 studies) among 22 860 individuals (general population, blood donors and pregnant women), which was higher than for a high-risk population (healthcare workers and people with other identified comorbidities), 12.2% (95% CI 4.9% to 22.2%; I²=98.3%, 13 studies); p=0.018. The prevalence was higher in the East region, in rural settings, and when using an enzyme immunoassay technique for detecting HCV antibodies. Sex, sites, study period, sample size, timing of data collection and methodological quality of studies were not sources of heterogeneity.LimitationOne-third of studies (29.0%) had a low risk bias in their methodology and most were facility-based (87.1%).ConclusionThe seroprevalence of HCV infection in Cameroon indicates the need for comprehensive and effective strategies to interrupt HCV transmission in the Cameroonian population. Specific attention is needed for the East region of the country, rural settings and high-risk populations. A national representative study is needed to provide better estimates.

Acupuncture for Amnestic Mild Cognitive Impairment: A Meta-Analysis of Randomised Controlled Trials

2016 ◽  
Vol 34 (5) ◽  
pp. 342-348 ◽  
Author(s):  
Min Deng ◽  
Xu-Feng Wang
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Methodological Quality ◽  
Randomised Controlled Trials ◽  
Meta Analysis ◽  
Scientific Journal ◽  
Adjunctive Treatment ◽  
Controlled Trials ◽  
Randomised Controlled

Objective Mild cognitive impairment (MCI) is a pre-dementia state; 5–10% of cases per year will evolve into dementia. MCI can be amnestic (AMCI) or non-amnestic. AMCI is associated with a higher risk of progression. In recent years, interest in acupuncture as a potential treatment for AMCI has grown. The aim of this meta-analysis was to estimate the clinical effectiveness and safety of acupuncture for AMCI. Methods Randomised controlled trials (RCTs) of acupuncture versus medical treatment for AMCI were identified using the following databases from inception to July 2015: PubMed; Medline; CENTRAL; Chinese Scientific Journal Database; The Chinese Acupuncture Trials Register; China National Knowledge Infrastructure (CNKI); and Wanfang database. Data were extracted from RCTs meeting the inclusive criteria according to Cochrane methods. Meta-analyses were conducted using Rev Man V.5.3 software. Results Five trials involving 568 subjects were included. Meta-analysis showed that participants receiving acupuncture had better outcomes than those receiving nimodipine with greater clinical efficacy rates (odds ratio (OR) 1.78, 95% CI 1.19 to 2.65; p<0.01), mini-mental state examination (MMSE) scores (mean difference (MD) 0.99, 95% CI 0.71 to 1.28; p<0.01), and picture recognition score (MD 2.12, 95% CI 1.48 to 2.75; p<0.01). Meta-analysis also showed acupuncture in conjunction with nimodipine significantly improved MMSE scores (MD 1.09, 95% CI 0.29 to 1.89; p<0.01) compared to nimodipine alone. Three trials reported adverse events. Methodological quality of the included studies was judged to be generally poor. Conclusions Acupuncture appears effective for AMCI when used as an alternative or adjunctive treatment; however, caution must be exercised given the low methodological quality of included trials. Further, more rigorously designed studies are needed.

scholarly journals Safety and Efficacy of Therapeutic Taping in Primary Dysmenorrhea: a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Bandara EMIA ◽  
Kularathne WNI ◽  
K Brain ◽  
Weerasekara I
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Adult Women ◽  
Primary Dysmenorrhea ◽  
Level Of Evidence ◽  
Effective Measure ◽  
Safety And Efficacy ◽  
Pain Anxiety

Abstract Primary dysmenorrhea (PD) is a common gynecological complaint among adolescents and adult women. Various pharmacological and alternative therapies such as therapeutic taping have been used as a treatment of PD. Although several studies have been conducted to evaluate the safety and efficacy of therapeutic taping in PD, these studies have not provided adequate level of evidence related to the safety and efficacy of therapeutic taping in PD. Hence, a systematic review and meta-analysis was performed to evaluate the safety and efficacy of therapeutic taping in PD. The following databases; Medline, Cochrane Library, Embase, PEDro, CINAHL and any other gray literature sources were searched for randomized controlled trials (RCTs) that used therapeutic taping to treat PD from inception to June 2021 with the language restricted to English. Independently screened articles by two reviewers were extracted according to the study objectives. A total of nine studies were included in the systematic review, involving 577 participants. Three studies were eligible for meta-analysis to find the pooled effect of taping on pain intensity. The review indicates that therapeutic taping is an effective measure in improving pain, anxiety and quality of life of women with PD. Meta-analysis conducted to compare the effect of elastic therapeutic taping (ETT) to sham taping showed that the ETT is an effective measure in improving pain among women with PD (MD = -3.12 (95% CI -5.64, -0.60); p=0.02; I2=95 %). The quality of the studies was assessed using the PEDro scale and the included RCTs indicated a fair to good level of quality. Our systematic review and meta-analysis demonstrated that therapeutic taping is an effective intervention for PD. However, RCTs with higher quality and larger sample sizes are necessary to verify the current results of the review.

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