Articular Cartilage Defects of the Glenohumeral Joint: A Systematic Review of Treatment Options and Outcomes

Objective To report radiographic and magnetic resonance imaging findings, patient-reported outcomes, and complications and/or reoperations following nonarthroplasty surgical intervention for focal glenohumeral cartilage defects. Design A literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Patients were included if they possessed a chondral defect of the humeral head, glenoid, or both, which had been treated with a joint preserving nonarthroplasty procedure. Risk of bias assessment was performed using the Methodological Index for Non-Randomized Studies scoring system. Study demographics, surgical technique, imaging findings, patient-reported outcomes, complications, failures, and reoperations were collected. Results Fourteen studies with 98 patients (100 shoulders) met the inclusion criteria. Patient ages ranged from 7 to 74 years. The nonarthroplasty surgical techniques utilized included microfracture (67 shoulders), osteochondral transplantation (28 shoulders), chondrocyte transplantation (4 shoulders), and internal fixation (1 shoulder). The rates of radiographic union and progression of osteoarthritis ranged between 90% to 100% and 57% to 100%, respectively. Visual analog scores ranged from 0 to 1.9 at final follow-up. Mean postoperative ASES (American Shoulder and Elbow Surgeons) shoulder scores ranged from 75.8-100. Mean postoperative CSS (Constant Shoulder Score) scores ranged from 83.3-94. Mean postoperative SSV (Subjective Shoulder Value) ranged from 70% to 99%. Failure and reoperation rates ranged between 0% to 35% and 0% to 30%, respectively, with the most common reoperation being conversion to prosthetic arthroplasty. Conclusions In this systematic review, nonarthroplasty surgical techniques demonstrated acceptable rates of radiographic healing, improved patient reported outcomes, minimal complications, and low rates of failure or reoperation. Joint preserving techniques are likely viable options to prolong function of the native shoulder and provide short- to midterm pain relief in young and highly active patients. Level of Evidence Level IV.

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Indications and outcomes of enterovesical and colovesical fistulas: systematic review of the literature and meta-analysis of prevalence

BMC Surgery ◽

10.1186/s12893-021-01272-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Stefano Granieri ◽

Francesco Sessa ◽

Alessandro Bonomi ◽

Sissi Paleino ◽

Federica Bruno ◽

...

Keyword(s):

Systematic Review ◽

Clinical Symptoms ◽

Rare Complication ◽

Meta Analysis ◽

Treatment Options ◽

Palliative Surgery ◽

Review Of The Literature ◽

Colovesical Fistula ◽

Level Of Evidence ◽

Meta Analyses

Abstract Background Entero-colovesical fistula is a rare complication of various benign and malignant diseases. The diagnosis is prominently based on clinical symptoms; imaging studies are necessary not only to confirm the presence of the fistula, but more importantly to demonstrate the extent and the nature of the fistula. There is still a lack of consensus regarding the if, when and how to repair the fistula. The aim of the study is to review the different surgical treatment options, focus on surgical indications, and explore cumulative recurrence, morbidity, and mortality rates of entero-vesical and colo-vesical fistula patients. Methods A systematic review of the literature was conducted according to PRISMA guidelines. Random effects meta-analyses of proportions were developed to assess primary and secondary endpoints. I2 statistic and Cochran’s Q test were computed to assess inter-studies’ heterogeneity. Results Twenty-two studies were included in the analysis with a total of 861 patients. Meta-analyses of proportions pointed out 5, 22.2, and 4.9% rates for recurrence, complications, and mortality respectively. A single-stage procedure was performed in 75.5% of the cases, whereas a multi-stage operation in 15.5% of patients. Palliative surgery was performed in 6.2% of the cases. In 2.3% of the cases, the surgical procedure was not specified. Simple and advanced repair of the bladder was performed in 84.3% and 15.6% of the cases respectively. Conclusions Although burdened by a non-negligible rate of complications, surgical repair of entero-colovesical fistula leads to excellent results in terms of primary healing. Our review offers opportunities for significant further research in this field. Level of Evidence Level III according to ELIS (SR/MA with up to two negative criteria).

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Correction to: Robotic‑arm assisted total knee arthroplasty is associated with improved accuracy and patient reported outcomes: a systematic review and meta‑analysis

Knee Surgery Sports Traumatology Arthroscopy ◽

10.1007/s00167-021-06522-x ◽

2021 ◽

Author(s):

Junren Zhang ◽

Wofhatwa Solomon Ndou ◽

Nathan Ng ◽

Paul Gaston ◽

Philip M. Simpson ◽

...

Keyword(s):

Systematic Review ◽

Total Knee Arthroplasty ◽

Knee Arthroplasty ◽

Patient Reported Outcomes ◽

Meta Analysis ◽

Robotic Arm ◽

Patient Reported ◽

Total Knee ◽

Improved Accuracy

A correction to this paper has been published: https://doi.org/10.1007/s00167-021-06522-x

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AB0116 THE EFFECTS OF DISEASE MODIFYING ANTI-RHEUMATIC DRUGS ON PATIENT REPORTED OUTCOMES; PRELIMINARY RESULTS OF A SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1578 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1087.1-1087

Author(s):

M. Van den Dikkenberg, Msc ◽

N. Luurssen-Masurel ◽

M. Kuijper ◽

M. R. Kok ◽

P. De Jong ◽

...

Keyword(s):

Systematic Review ◽

Patient Reported Outcomes ◽

Treatment Effects ◽

Meta Analysis ◽

Activity Limitations ◽

Definitive Answer ◽

Preliminary Results ◽

Patient Reported ◽

Standard Set ◽

Disease Modifying

Background:The need to involve patient reported outcomes (PROs) in the management of rheumatoid arthritis (RA) increases, since PROs quantify patient relevant outcomes. Although PROs have been incorporated in the core-outcome sets in clinical trials, knowledge about the treatment effects on these PROs is scarce. Therefore, we performed a systematic review on the effects of disease modifying anti-rheumatic drugs (DMARDs), of any type, on relevant PRO domains mentioned in the ICHOM standard set. This might support rheumatologists and RA patients during treatment decisions.Objectives:To get insight in the treatment effects of DMARDs of any type on three PRO domains that matter to patients (pain, activity limitations and fatigue).Methods:A systematic review was performed in Embase, Medline, Web of Science, Cochrane and Google Scholar. Included were all studies that were published before August 2019 and showed DMARD treatment effects in RA on PROs that are part of the ICHOM standard set. Three Bayesian network meta-analyses were performed for the PRO domains pain, activity limitations and fatigue. Preliminary results of DMARDs (in)directly compared to placebo were visualized by forest plots using R.Results:The search strategy yielded n=5974 articles. After selection was performed by 2 independent researchers, n=70 individual articles representing n=53 studies were extracted, over the three PRO domains; pain (n=31), activity limitations (n=41) and fatigue (n=21). In all RCTs, PROs were only reported as secondary or tertiary endpoints. In figure 1, we show the effects on PROs for any type of DMARD investigated compared to placebo. Overall, DMARDs show a greater reduction in pain (standardized mean difference (SMD); -0.97 – -0.22) and most of them in activity limitations (SMD; -0.81 – 0.56). In fatigue, this clear direction is lacking (SMD; -0.86 – 3.5). csDMARDs and anti-TNF seem to perform slightly, but nog significantly, worse than other bDMARDs and tsDMARDs in the first two domains.Conclusion:Within in this systematic review we report a reduction for DMARDs of any type on the domains of pain and activity limitations compared to placebo. However, results are still preliminary and should be interpreted with care. A more comprehensive network analysis might give a more definitive answer which DMARD performs best.Figure 1.Disclosure of Interests:None declared

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Patient-Reported Outcomes and Endoscopic Appearance of Ulcerative Colitis: A Systematic Review and Meta-analysis

Clinical Gastroenterology and Hepatology ◽

10.1016/j.cgh.2018.06.015 ◽

2019 ◽

Vol 17 (3) ◽

pp. 411-418.e3 ◽

Cited By ~ 17

Author(s):

Neeraj Narula ◽

Abdul-Aziz Alshahrani ◽

Yuhong Yuan ◽

Walter Reinisch ◽

Jean-Frederic Colombel

Keyword(s):

Systematic Review ◽

Ulcerative Colitis ◽

Patient Reported Outcomes ◽

Meta Analysis ◽

Endoscopic Appearance ◽

Patient Reported

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Generic Patient-Reported Outcomes and Outcome Measures: A Systematic Review Study Protocol

10.1101/2021.05.28.21257980 ◽

2021 ◽

Author(s):

Yuki Seidler ◽

Erika Mosor ◽

Margaret R Andrews ◽

Carolina Watson ◽

Nick Bott ◽

...

Keyword(s):

Systematic Review ◽

Outcome Measures ◽

Systematic Reviews ◽

Patient Reported Outcomes ◽

Outcome Measurement ◽

Meta Analysis ◽

Patient Reported Outcome ◽

Cochrane Library ◽

Screening Process ◽

Patient Reported

Background: Patient-reported outcomes (PROs) are an essential part of health outcome measurement and vital to patient-centricity and valued-based care. Several international consortia have developed core outcome sets and many of them include PROs. PROs are measured by patient-reported outcome measures (PROMs). PROs and PROMs can be generic or specific to certain diseases or conditions. While the characteristics of generic PROs and PROMs are well recognised as widely relevant and applicable across different domains, diseases and conditions, there is a lack of knowledge on the types of PROs measured by generic PROMs. We also do not know in which disease areas generic PROs and PROMs are commonly used. To date, there has been no systematic review solely focusing on generic PROMs, what they measure and their areas of application. Objectives: This systematic review will identify core PROs measured by generic PROMs used in adult populations and the areas in which they are applied. Methods: We will conduct a systematic review of reviews. The screening process and the reporting will comply with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 Statement. We will use four databases, Medline [PubMed], CINHAL [Ebsco], Cochrane [Cochrane Library], and PsycINFO [Ovid], and reports from international consortia. Inclusion criteria are systematic reviews, meta-analysis or patient-reported outcome sets developed by international consortia reporting on generic PROMs in adult populations. Articles primarily focusing on patient-reported experience measures (PREMs), children or adolescents, or those not written in English will be excluded. Risk of bias will be assessed by checking if the included articles comply with established guidelines for systematic reviews such as the PRISMA statement. We will extract generic PROMs and PROs measured by these PROMs, and the areas applied from the selected articles and reports. Extracted data and information will be quantitatively and qualitatively synthesised without statistical interference. The quality of the synthesised evidences will be assessed by clarifying the strengths, limitations and possible biases in our review.

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The effectiveness of robotic hip and knee arthroplasty on patient-reported outcomes: A systematic review and meta-analysis

International Orthopaedics ◽

10.1007/s00264-018-4140-3 ◽

2018 ◽

Vol 43 (6) ◽

pp. 1283-1295 ◽

Cited By ~ 14

Author(s):

Sascha Karunaratne ◽

Michael Duan ◽

Evangelos Pappas ◽

Brett Fritsch ◽

Richard Boyle ◽

...

Keyword(s):

Systematic Review ◽

Knee Arthroplasty ◽

Patient Reported Outcomes ◽

Meta Analysis ◽

Patient Reported ◽

Hip And Knee Arthroplasty

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Patient-Reported Outcomes Following Total Knee Replacement in Patients <65 Years of Age—A Systematic Review and Meta-Analysis

Journal of Clinical Medicine ◽

10.3390/jcm9103150 ◽

2020 ◽

Vol 9 (10) ◽

pp. 3150

Author(s):

Jason Trieu ◽

Daniel J. Gould ◽

Chris Schilling ◽

Tim Spelman ◽

Michelle M. Dowsey ◽

...

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Patient Reported Outcomes ◽

Meta Analysis ◽

Functional Decline ◽

Older Individuals ◽

Patient Reported ◽

Related Quality ◽

Total Knee

An increasing number of total knee replacements (TKRs) are being performed in response to the growing burden of osteoarthritis. Patients <65 years of age represent the fastest growing group of TKR recipients and are expected to account for an increasing number of primary and revision procedures. Concerns have been raised about the outcomes that can be expected by this age demographic who are more active, physically demanding, and have longer life expectancies compared to older TKR recipients. This systematic review and meta-analysis evaluated the effectiveness of TKR for osteoarthritis in patients <65 years of age, compared to older individuals. A systematic search of Embase and Medline was conducted to identify studies which examined patient-reported outcomes measured using disease-specific and generic health-related quality of life instruments. Ten studies met our inclusion criteria and were included in this review. These studies comprised 1747 TKRs performed between 1977 and 2014. In the meta-analysis of two prospective studies (288 TKRs), patients <65 years of age were able to attain large and clinically meaningful improvements in pain, function, and quality of life. One of these studies (61 TKRs) suggested that patients <55 years of age attained a larger degree of improvement compared to older individuals. Results into the second postoperative decade were less certain, with some data suggesting a high prevalence of pain and patterns of functional decline. Further research is required to investigate longer-term outcomes following TKR for osteoarthritis in younger patients.

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