A systematic review of the optimal drainage technique for septic hip arthritis in children

2021 ◽  
pp. 112070002198966
Author(s):  
Cornelia Maria Donders ◽  
Anne J Spaans ◽  
Johannes H J M Bessems ◽  
Christiaan J A van Bergen
Keyword(s):  
Systematic Review ◽  
Septic Arthritis ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Paediatric Population ◽  
Scientific Quality ◽  
Comprehensive Overview ◽  
Hip Arthritis ◽  
Drainage Technique

Introduction: The hip is one of the most commonly affected joints in paediatric septic arthritis. Drainage can be performed using arthrocentesis (articular needle aspiration), arthroscopy or arthrotomy. The objective of this systematic review was to identify the most effective drainage technique for septic hip arthritis in the paediatric population. Materials and methods: The electronic MEDLINE, EMBASE and Cochrane databases were systematically searched for original articles that reported outcomes of arthrocentesis, arthroscopy or arthrotomy for septic arthritis of the paediatric hip. Outcome parameters were additional drainage procedures, clinical outcomes and radiological sequelae. The quality of each of the included studies was assessed with the Methodological Index for Non-randomized Studies (MINORS) score. Results: Out of 2428 articles, 19 studies with a total of 406 hip joints were included in the systematic review. Additional arthroscopy or arthrotomy was performed in 15% of the hips treated with arthrocentesis, in 14% after arthroscopy and in 3% after arthrotomy. Inferior clinical outcomes and more radiological sequelae were seen in patients treated with an arthrotomy. A meta-analysis could not be performed due to the diversity and low quality of the studies (MINORS median 4 [range 2–15]). Conclusions: This systematic review gives a comprehensive overview of the available literature on treatment for septic hip arthritis in children. Arthrocentesis and arthroscopic procedures may have a higher risk of additional drainage procedures in comparison with arthrotomy. However, arthrotomy might be associated with inferior outcomes in the longer term. The included studies are diverse and the scientific quality is generally low.

scholarly journals Arthrocentesis, arthroscopy or arthrotomy for septic knee arthritis in children: a systematic review

2020 ◽  
pp. 1-7
Author(s):  
Cornelia M. Donders ◽  
Anne J. Spaans ◽  
Johannes H. J. M. Bessems ◽  
Christiaan J. A. van Bergen
Keyword(s):  
Systematic Review ◽  
Septic Arthritis ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Needle Aspiration ◽  
Scientific Quality ◽  
Knee Arthritis ◽  
Level Of Evidence ◽  
Septic Knee Arthritis

Purpose Septic knee arthritis in children can be treated by arthrocentesis (articular needle aspiration) with or without irrigation, arthroscopy or arthrotomy followed by antibiotics. The objective of this systematic review was to identify the most effective drainage technique for septic arthritis of the knee in children. Methods The electronic PubMed, Embase and Cochrane databases were systematically searched for original articles that reported outcomes of arthrocentesis, arthroscopy or arthrotomy for septic arthritis of the knee. The quality of all included studies was assessed with the Methodological Index for Non-Randomized Studies (MINORS) criteria. This systematic review was performed and reported according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PROSPERO). Results Out of 2428 articles, 11 studies with a total of 279 knees were included in the systematic review. The quality of evidence was low (MINORS median 4 (2 to 7)). A meta-analysis could not be performed because of the diversity and low quality of the studies. In septic knee arthritis, additional drainage procedures were needed in 54 of 156 (35%) knees after arthrocentesis, in four of 96 (4%) after arthroscopy and in two of 12 (17%) after arthrotomy. Conclusion Included studies on treatment strategies for septic arthritis of the knee in children are diverse and the scientific quality is generally low. Knee arthroscopy might have a lower risk of additional drainage procedures as compared with arthrocentesis and arthrotomy, with acceptable clinical outcomes and no radiological sequelae. Level of evidence IV

scholarly journals The Prevalence of Sarcopenia and Its Impact on Clinical Outcomes in Lumbar Degenerative Spine Disease—A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (4) ◽  
pp. 773
Author(s):  
Wei-Ting Wu ◽  
Tsung-Min Lee ◽  
Der-Sheng Han ◽  
Ke-Vin Chang
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Clinical Manifestations ◽  
Current Evidence ◽  
Degenerative Spine ◽  
Degenerative Spine Disease ◽  
Spine Disease

The association of sarcopenia with poor clinical outcomes has been identified in various medical conditions, although there is a lack of quantitative analysis to validate the influence of sarcopenia on patients with lumbar degenerative spine disease (LDSD) from the available literature. Therefore, this systematic review and meta-analysis aimed to summarize the prevalence of sarcopenia in patients with LDSD and examine its impact on clinical outcomes. The electronic databases (PubMed and Embase) were systematically searched from inception through December 2020 for clinical studies investigating the association of sarcopenia with clinical outcomes in patients with LDSD. A random-effects model meta-analysis was carried out for data synthesis. This meta-analysis included 14 studies, comprising 1953 participants. The overall prevalence of sarcopenia among patients with LDSD was 24.8% (95% confidence interval [CI], 17.3%–34.3%). The relative risk of sarcopenia was not significantly increased in patients with LDSD compared with controls (risk ratio, 1.605; 95% CI, 0.321–8.022). The patients with sarcopenia did not experience an increase in low back and leg pain. However, lower quality of life (SMD, −0.627; 95% CI, −0.844–−0.410) were identified postoperatively. Sarcopenia did not lead to an elevated rate of complications after lumbar surgeries. Sarcopenia accounts for approximately one-quarter of the population with LDSD. The clinical manifestations are less influenced by sarcopenia, whereas sarcopenia is associated with poorer quality of life after lumbar surgeries. The current evidence is still insufficient to support sarcopenia as a predictor of postoperative complications.

scholarly journals Aspiration or arthrotomy for paediatric septic arthritis of the shoulder and elbow: a systematic review

2021 ◽  
Vol 6 (8) ◽  
pp. 651-657
Author(s):  
Anne J. Spaans ◽  
C.M. (Lilian) Donders ◽  
J.H.J.M. (Gert) Bessems ◽  
Christiaan J.A. van Bergen
Keyword(s):  
Systematic Review ◽  
Septic Arthritis ◽  
Upper Extremity ◽  
Elbow Joint ◽  
Clinical Results ◽  
Scientific Quality ◽  
Knowing That ◽  
Additional Procedure ◽  
Effective Drainage ◽  
Drainage Technique

Upper extremity arthritis in children can be treated with joint aspiration, arthroscopy or arthrotomy, followed by antibiotics. The literature seems inconclusive with respect to the optimal drainage technique. Therefore, the objective of this systematic review was to identify the most effective drainage technique for septic arthritis of the upper extremity in children. Two independent investigators systematically searched the electronic MEDLINE, EMBASE and Cochrane databases for original articles that reported outcomes of aspiration, arthroscopy or arthrotomy for septic arthritis of the paediatric shoulder or elbow. Outcome parameters were clinical improvement, need for repetitive surgery or drainage, and complications. Out of 2428 articles, seven studies with a total of 171 patients treated by aspiration or arthrotomy were included in the systematic review. Five studies reported on shoulder septic arthritis, one study on elbow septic arthritis, and one study on both joints. All studies were retrospective, except for one randomized prospective study. No difference was found between type of treatment and radiological or clinical outcomes. Aspiration of the shoulder or elbow joint required an additional procedure in 44% of patients, while arthrotomy required 12% additional procedures. Conclusion: Both aspiration and arthrotomy can achieve good clinical results in children with septic arthritis of the shoulder or elbow joint. However, the scientific quality of the included studies is low. It seems that the first procedure can be aspiration and washout and start of intravenous antibiotics, knowing that aspiration may have a higher risk of additional drainage procedures. Cite this article: EFORT Open Rev 2021;6:651-657. DOI: 10.1302/2058-5241.6.200122

scholarly journals The clinical outcomes and effectiveness of mHealth interventions for diabetes and hypertension: a systematic review and meta-analysis

2020 ◽  
Author(s):  
mao yaqian ◽  
Wei Lin ◽  
Junping Wen ◽  
Gang Chen
Keyword(s):  
Systematic Review ◽  
Economic Development ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Developed Countries ◽  
Mhealth Intervention ◽  
Mean Differences ◽  
Development Methods ◽  
Different Levels

Background: With the development of technology, mobile health (mHealth) intervention has been proposed as a treatment strategy for chronic diseases that could improve the quality of chronic care and outcomes in some developed countries. However, the effectiveness of mHealth intervention in developing countries is not clear. Purpose: A systematic review and meta-analysis was conducted to study the clinical outcomes and effectiveness of mHealth interventions for diabetes and hypertension in countries with different levels of economic development. Methods: Pubmed, ResearchGate, Embase and Cochrane documents were searched by computer, and the retrieval period was from 2008 to June 2019. All studies were randomized controlled trials (RCTs) comparing mHealth treatments to other traditional treatments. Meta-analysis was conducted using stata software. Results: 51 RCTs (N=13,054 participants) were eligible for this systematic review and meta-analysis. Compared with the usual care, the mHealth interventions yielded significant mean differences in clinical outcomes, and had a positive effect on countries at different levels of economic development. It is reassuring that we found mHealth interventions combined with human intelligence could significantly improve clinical outcomes more than mHealth interventions alone [WMD (95%Cl)=-6.75 (-9.98, -3.52)] VS [WMD (95%Cl)=-2.53 (-4.99, -0.07)]. The main secondary outcomes showed that mHealth interventions could also improve quality of life, satisfaction and self-efficacy, etc. Conclusion: This review shown that mHealth interventions as a therapeutic strategy could improve the management of diabetes and hypertension in countries with different levels of economic development.

scholarly journals Effect of nonmeat, high-protein supplementation on quality of life and clinical outcomes in older residents of care homes: a systematic review and meta-analysis

2018 ◽  
Vol 77 (2) ◽  
pp. 116-127 ◽  
Author(s):  
Alison I C Donaldson ◽  
Toby O Smith ◽  
Sarah Alder ◽  
Alexandra M Johnstone ◽  
Baukje De Roos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Protein Supplementation ◽  
High Protein ◽  
Care Homes

scholarly journals Conservative and Surgical Treatment of Talar Fractures: A Systematic Review and Meta-Analysis on Clinical Outcomes and Complications

2021 ◽  
Vol 18 (16) ◽  
pp. 8274
Author(s):  
Babak Saravi ◽  
Gernot Lang ◽  
Robert Ruff ◽  
Hagen Schmal ◽  
Norbert Südkamp ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Success Rates ◽  
Posttraumatic Osteoarthritis ◽  
Talar Fractures ◽  
Conservative And Surgical Treatment

The integrity of the talus is crucial for the physiologic function of the feet. The present study sought to summarize the available evidence on clinical outcomes and complications following conservative and surgical treatment of talar fractures. We systematically searched Medline via OVID to find relevant studies with a follow-up of at least six months. Hereafter, the success and complication rates were extracted and analyzed in a random effects proportion meta-analysis. Complications were defined as avascular bone necrosis (AVN) and posttraumatic osteoarthritis (OA). Additionally, a subgroup analysis was performed for fracture localization (talar neck fractures (TN) and combined talar body/neck fractures (TN/TB)) and severity of the fracture. The quality of the included studies was assessed utilizing the Coleman Methodology Score (CMS). A total of 29 retrospective studies, including 987 fractures with a mean follow-up of 49.9 months, were examined. Success rates were 62%, 60%, and 50% for pooled fractures, TN, and TN/TB, respectively. The overall complication rate for AVN was 25%. The rate was higher for TN (43%) than TN/TB (25%). Talar fractures revealed a 43% posttraumatic osteoarthritis (OA) rate in our meta-analysis. Success rates showed an association with fracture severity, and were generally low in complex multi-fragmentary fractures. The mean CMS was 34.3 (range: 19–47), indicating a moderate methodological quality of the studies. The present systematic review on clinical outcomes of patients undergoing conservative or surgical treatment for talar fractures reveals a lack of reliable prospective evidence. Talar fractures are associated with relatively poor postoperative outcomes, high rates of AVN, and posttraumatic osteoarthritis. Poor outcomes revealed a positive association with fracture severity. Prospective studies investigating predictors for treatment success and/or failure are urgently needed to improve the overall quality of life and function of patients undergoing surgical treatment due to talar fractures.

Sign in / Sign up

Export Citation Format

Share Document