scholarly journals Prognostic Factors to Determine Survivorship of Meniscal Allograft Transplant: A Systematic Review

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110072
Author(s):  
Ding-yu Wang ◽  
Cassandra A. Lee ◽  
Yan-zhang Li ◽  
Bo Zhang ◽  
Nan Li ◽  
...  

Background: There is much room for improvement and optimization of meniscal allograft survivorship. Purpose: To understand prognostic factors for survivorship using evidence-based selection criteria in order to identify patients who would best benefit from meniscal allograft transplant (MAT). Study Design: Systematic review; Level of evidence, 4. Methods: We conducted this systematic review to analyze prognostic factors for survivorship of MAT. The Cochrane Central Register, PubMed publisher, Embase.com , and Web of Science databases were searched through August 8, 2019. Included studies entailed patients of any age who received MAT with a reported association between prognostic factors and survivorship of the allograft. Two reviewers independently screened all titles and abstracts for eligibility, extracted the data, assessed the risk of bias using the Newcastle-Ottawa Scale, and performed a best-evidence synthesis. Results: The review included 18 studies with a total of 1920 patients. The mean follow-up time was 6.0 years (range, 2.1-11.2 years). A total of 20 prognostic factors were identified and shown to be associated with survivorship of MAT. Strong evidence was found that severe cartilage damage was associated with poor survivorship. Strong evidence was also found showing that sex, knee compartment, surgical side, concomitant anterior cruciate ligament (ACL) reconstruction, and concomitant osteotomy for malalignment had no effect on survivorship. Moderate evidence was found that body mass index (<36), tobacco use, and arthroscopic versus open procedure had no influence on survivorship. Conflicting evidence was found that older age and kissing cartilage lesions (lesions on both the femur and tibia vs on a single side) decreased survivorship. Conclusion: Severe cartilage damage decreases the survivorship of MAT. Concomitant ACL reconstruction and osteotomy showed no relationship to survivorship. Many determinants showed conflicting and limited evidence. Older age may be of interest and should be further studied.

Rheumatology ◽  
2020 ◽  
Author(s):  
Karishma Shah ◽  
He Cai ◽  
Jennifer C E Lane ◽  
Gary S Collins ◽  
Nigel K Arden ◽  
...  

Abstract Objective Radiographic hand OA affects one in five adults. Symptomatic hand OA can result in functional impairment, pain and reduced quality of life. A prevalent form of hand OA is IP joint OA, however prognostic factors for IP joint OA remain poorly understood. This systematic review aimed to identify prognostic factors for IP joint OA, and to summarize the diagnostic criteria for IP joint OA in prognostic studies. Methods EMBASE, MEDLINE, Scopus and The Cochrane Library were searched from inception until 19 February 2020 (PROSPERO CRD42019116782). Eligible studies described diagnostic criteria defining IP joint OA, and assessed potential prognostic factors for IP joint OA. Risk of bias was assessed using a modified Quality in Prognosis Studies (QUIPS) tool and a best evidence synthesis was used. Results Eighteen studies were included (risk of bias: eight high, three moderate, seven low). All defined OA radiographically, and three studies incorporated clinical symptoms into their definition of OA. Forty-nine potential prognostic factors were assessed. Eight were prognostic: older age in women, female gender (both moderate evidence); family history of Heberden’s nodes, Kashin–Beck disease, older age in men, dental occupation in men, finger fracture, parity (all limited evidence). Higher BMI in women (limited evidence) was prognostic for symptomatic radiographic OA. No prognostic factors for symptomatic OA were identified. Conclusion IP joint OA is most commonly defined radiographically, yet criteria were heterogeneous. Eight prognostic factors for radiographic IP joint OA and one for symptomatic radiographic IP joint OA were identified, all with limited or moderate evidence. Further studies on causality and on prognostic pathways are needed.


2018 ◽  
Vol 53 (4) ◽  
pp. 251-262 ◽  
Author(s):  
Dimitris Challoumas ◽  
Paul D Kirwan ◽  
Dmytro Borysov ◽  
Christopher Clifford ◽  
Michael McLean ◽  
...  

ObjectiveTo produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate (GTN) in the treatment of tendinopathies.DesignA systematic review of published randomised controlled trials (RCTs) of the use of GTN in patients with tendinopathy.Data sourcesMEDLINE, Embase, Scopus and CINAHL from database inception to January 2018.MethodsWe examined RCTs comparing the effects of topical GTN with either placebo or other treatments on tendinopathy. Overall quality of each eligible study was determined based on a combined assessment of internal validity, external validity and precision. The level of evidence for each assessed parameter was rated based on the system by van Tulderet al.ResultsA total of 10 eligible RCTs were identified including patients with tendinopathy of the rotator cuff (n=4), wrist extensors (n=3), Achilles (n=2) and patellar (n=1) tendons. For all tendinopathies, improvements in pain were significant when comparing GTN versus placebo in the short term (<8 weeks; poor evidence). Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following: patient satisfaction (strong evidence); chances of being asymptomatic with activities of daily living (strong evidence); range of movement (moderate evidence); strength (moderate evidence); pain (at night and with activity; poor evidence) and local tenderness (poor evidence). Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo (moderate evidence).Conclusions and relevanceTreatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions.


2020 ◽  
Vol 54 (18) ◽  
pp. 1081-1088 ◽  
Author(s):  
Brady Green ◽  
Matthew N Bourne ◽  
Nicol van Dyk ◽  
Tania Pizzari

ObjectiveTo systematically review risk factors for hamstring strain injury (HSI).DesignSystematic review update.Data sourcesDatabase searches: (1) inception to 2011 (original), and (2) 2011 to December 2018 (update). Citation tracking, manual reference and ahead of press searches.Eligibility criteria for selecting studiesStudies presenting prospective data evaluating factors associated with the risk of index and/or recurrent HSI.MethodSearch result screening and risk of bias assessment. A best evidence synthesis for each factor and meta-analysis, where possible, to determine the association with risk of HSI.ResultsThe 78 studies captured 8,319 total HSIs, including 967 recurrences, in 71,324 athletes. Older age (standardised mean difference=1.6, p=0.002), any history of HSI (risk ratio (RR)=2.7, p<0.001), a recent HSI (RR=4.8, p<0.001), previous anterior cruciate ligament (ACL) injury (RR=1.7, p=0.002) and previous calf strain injury (RR=1.5, p<0.001) were significant risk factors for HSI. From the best evidence synthesis, factors relating to sports performance and match play, running and hamstring strength were most consistently associated with HSI risk. The risk of recurrent HSI is best evaluated using clinical data and not the MRI characteristics of the index injury.Summary/conclusionOlder age and a history of HSI are the strongest risk factors for HSI. Future research may be directed towards exploring the interaction of risk factors and how these relationships fluctuate over time given the occurrence of index and recurrent HSI in sport is multifactorial.


2016 ◽  
Vol 19 (2;2) ◽  
pp. 1-10 ◽  
Author(s):  
Filip Struyf

Background: Shoulder pain is the third most common musculoskeletal complaint and many patients have an unfavorable outcome with long-term disability. Only 50% of all new episodes of shoulder pain show complete recovery within 6 months. Little is known about factors that contribute to chronicity of shoulder pain, although such information is needed for the management of patients with acute and sub-acute shoulder pain. Objective: To systematically review the literature for prognostic factors which are potential predictors for either recovery or chronification in patients with acute and sub-acute nontraumatic shoulder pain. Study Design: Systematic review. Setting: This systematic review examined all studies involving the prognosis of shoulder pain patients. Methods: This systematic review was reported following the guidelines outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two reviewers independently scored the methodological quality of the selected studies. Due to heterogeneity of studies, a best-evidence synthesis of the available prognostic factors was provided. Results: Nine studies met our inclusion criteria and were included in this systematic review. There is strong evidence that high scores on the Shoulder Pain and Disability Index (SPADI), high scores on shoulder pain severity, and a long duration of complaints are factors that contribute to the chronification of shoulder pain. Moderate evidence was found supportive for other prognostic factors that enhance chronification, like being male, being over 55 years of age, having poor general health, having a gradual onset of complaints, a large amount of sick leave, the perception of high job demand, the perception of low social support, and the amount of visits to a health care professional. Also moderate evidence exists regarding factors that contributed to a reduced possibility of chronification: an active treatment policy and not taking medication on regular basis. Limitations: The large variability in definitions of shoulder pain, and patient selection bias. In addition, there is a paucity of strong longitudinal prospective studies. Conclusion: This systematic review found evidence that high scores on the SPADI questionnaire, more shoulder pain, and a longer duration of complaints are associated with chronification of shoulder pain. In order to reduce chronification, clinicians can use the International Classification of Functioning based model presented here that could aid their decision-making. Key words: Shoulder pain, prognostic factors, systematic review, prognosis, assessment


2021 ◽  
Vol 63 (1) ◽  
Author(s):  
Stefania Curti ◽  
Stefano Mattioli ◽  
Roberta Bonfiglioli ◽  
Andrea Farioli ◽  
Francesco S. Violante

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e046027
Author(s):  
Petr Domecky ◽  
Anna Rejman Patkova ◽  
Katerina Mala-Ladova ◽  
Josef Maly

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.


2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095965
Author(s):  
Bailey J. Ross ◽  
Ian Savage-Elliott ◽  
Symone M. Brown ◽  
Mary K. Mulcahey

Background: Anterior cruciate ligament (ACL) injuries are among the most common sports-related injuries, and they can have a negative impact on players’ ability to return to play (RTP). There is a paucity of literature focused on RTP after ACL reconstruction (ACLR) in collision sports. Purpose: To characterize the impact that an ACL injury has on the ability to RTP and the post-ACLR performance level in American football players. Study Design: Systematic review; Level of evidence, 4. Methods: An electronic search was performed using the following databases: the Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed, Embase, and the Cumulative Index to Nursing and Allied Health Literature. Included studies were written in English; were published since the year 2000; examined only American football players; and reported on RTP, performance, and/or career length after primary ACLR. Results: The initial search yielded 442 unique studies. Of these, 427 were removed after screening, leaving 15 studies that met inclusion criteria. An additional 2 studies were identified in these studies’ references, yielding a total of 17. The rate of RTP after ACLR for football players was 67.2% (1249/1859), and the mean time to return was 11.6 months (range, 35.8-55.8 weeks). Although considerable heterogeneity existed in the study design and outcomes measured, in general, a majority of football players experienced greater declines from their preinjury performance level than controls over the same time period. Conclusion: An ACL injury negatively affected football players’ ability to RTP and their post-ACLR performance. The degree of effect varied by several factors, including playing position, preinjury performance level, and National Football League Draft round. These results may be used by physicians and football players to develop reasonable expectations for returning to play and performance after an ACL injury.


2018 ◽  
Vol 52 (20) ◽  
pp. 1312-1319 ◽  
Author(s):  
Martin Asker ◽  
Hannah L Brooke ◽  
Markus Waldén ◽  
Ulrika Tranaeus ◽  
Fredrik Johansson ◽  
...  

ObjectiveTo assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports.DesignSystematic review with best-evidence synthesis.Data sourcesMedline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017.Eligibility criteria for selecting studiesRandomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria.ResultsOf 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power.ConclusionsAll investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports.PROSPERO trial registration numberCRD42015026850.


Nutrients ◽  
2020 ◽  
Vol 12 (9) ◽  
pp. 2664
Author(s):  
Ethan Lowry ◽  
Joanne Marley ◽  
Joseph G. McVeigh ◽  
Emeir McSorley ◽  
Philip Allsopp ◽  
...  

Fibromyalgia syndrome (FMS) is characterised by chronic widespread pain alongside fatigue, poor sleep quality and numerous comorbidities. It is estimated to have a worldwide prevalence of 1.78%, with a predominance in females. Treatment interventions for fibromyalgia have limited success, leading to many patients seeking alternative forms of treatment, including modifications to their diet and lifestyle. The effectiveness of dietary changes in fibromyalgia has not been widely researched or evaluated. This systematic review identified twenty-two studies, including 18 randomised control trials (RCTs) and four cohort studies which were eligible for inclusion. In total these studies investigated 17 different nutritional interventions. Significant improvements in reported pain were observed for those following a vegan diet, as well as with the low fermentable oligo di-mono-saccharides and polyols (FODMAP) diets. Supplementation with Chlorella green algae, coenzyme Q10, acetyl-l-carnitine or a combination of vitamin C and E significantly improved measures of pain. Interpretation of these studies was limited due to the frequent poor quality of the study design, the wide heterogeneity between studies, the small sample size and a high degree of bias. Therefore, there is insufficient evidence to recommend any one particular nutritional intervention for the management of fibromyalgia and further research is needed.


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