scholarly journals Complex ruptures of the quadriceps tendon: a systematic review of surgical procedures and outcomes

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Francesco Oliva ◽  
Emanuela Marsilio ◽  
Filippo Migliorini ◽  
Nicola Maffulli
Keyword(s):  
Systematic Review ◽  
Quadriceps Tendon ◽  
Synthetic Mesh ◽  
Surgical Approaches ◽  
Evidence Based ◽  
Group 4 ◽  
First Choice ◽  
Total Knee ◽  
End To End ◽  
Meta Analyses

Abstract Background Chronic ruptures, ruptures following total knee arthroplasty (TKA), and re-ruptures of the quadriceps tendon (QT) are rare. A systematic review of the current literature was conducted on their treatment and outcome to provide evidence-based indications for their management. Methods We searched published articles in English on chronic ruptures of QT, QT ruptures that occurred after TKA, and re-ruptures in PubMed, Scopus, and Google Scholar up to January 2021. Twenty-five articles were included following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Data from 25 articles (97 patients) with a mean age of 57 were retrieved. Patients were classified into three groups depending on the type of rupture: 16 patients suffered chronic QTR, 78 a QTR after a TKA, and 9 patients reported a re-rupture. The most frequent surgical approaches were different for each group: Codivilla’s Y-V technique and end-to-end sutures were the most commonly used in the chronic tears group (62.5%), synthetic MESH was the most frequent choice in QTR after a TKA group (38 patients, 53%), while end-to-end sutures were the first choice in the re-rupture group (4 patients, 44%). Conclusions Complex ruptures of the QT can be chronic ruptures, re-ruptures, or ruptures occurring after TKA. The choice of the best surgical technique depends on the macroscopic quality of the tendon stumps rather than the timing of intervention. Evidence-based preventive and therapeutic strategies should be developed.

scholarly journals Should the patella be everted during primary total knee arthroplasty? A systematic review of overlapping meta-analyses

2019 ◽  
Vol 27 (1) ◽  
pp. 230949901982855
Author(s):  
Alberto Grassi ◽  
Riccardo Compagnoni ◽  
Paolo Ferrua ◽  
Stefano Pasqualotto ◽  
Carlo Zaolino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Primary Total Knee Arthroplasty ◽  
Total Knee ◽  
Meta Analyses ◽  
Primary Total Knee

scholarly journals Not All Embolizations Are Created Equally in the Management of Posterior Epistaxis: Discussion of Safety Measures Avoiding Neurological Complications

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Mareike Franke ◽  
Jasper Franke ◽  
Christian Saager ◽  
Sven Barthel ◽  
Randolf Riemann ◽  
...  
Keyword(s):  
Neurological Complication ◽  
Neurological Complications ◽  
Surgical Approaches ◽  
Success Rates ◽  
Artery Ligation ◽  
Retrospective Data Analysis ◽  
First Choice ◽  
Surgical Methods ◽  
Choice Of Treatment ◽  
Meta Analyses

Today, there are still no uniform guidelines for the treatment of epistaxis. Furthermore, it is widely debated whether embolization or surgical approaches should be the first choice of treatment for intractable posterior epistaxis after conservative measures have failed. In several meta-analyses, it is reported that endoscopic sphenopalatine artery ligation and embolization have similar success rates, but embolization was associated with more severe neurological complications. Regarding existing literature, there are many comparative analyses of surgical methods but none for embolization protocols. Against this backdrop of a lack of uniform standards in embolization techniques, we present a retrospective evaluation of what has emerged to be best procedural practice for endovascular treatment of epistaxis in our department using microsphere particles and microcoils, in particular regarding precaution measures to avoid neurological complications. In our retrospective data analysis of 141 procedures in 123 patients, performed between 2008 and 2019, we find success rates very similar to those reported in other studies (95.1% immediate-stop-of-bleeding success and 90.2% overall embolization success) but did not encounter any major neurological complication opposed to other reports. We suggest some aspects of our protocol as precaution measure to avoid neurological complications. More generally and perhaps even more importantly, we make a strong case for standardization for embolization techniques to the level of details in surgical procedure standardization to enable an apples to apples comparison of embolization techniques to each other and of intervention vs. surgery.

Aseptic Loosening of Porous Metaphyseal Sleeves and Tantalum Cones in Revision Total Knee Arthroplasty: A Systematic Review

2020 ◽  
Author(s):  
Ryan P. Roach ◽  
Andrew J. Clair ◽  
Omar A. Behery ◽  
Savyasachi C. Thakkar ◽  
Richard Iorio ◽  
...  
Keyword(s):  
Systematic Review ◽  
Total Knee Arthroplasty ◽  
Aseptic Loosening ◽  
Knee Arthroplasty ◽  
Revision Total Knee Arthroplasty ◽  
Search Terms ◽  
Mesh Terms ◽  
Total Knee ◽  
Meta Analyses ◽  
Revision Tkas

AbstractBone loss often complicates revision total knee arthroplasty (TKA). Management of metaphyseal defects varies, with no clearly superior technique. Two commonly utilized options for metaphyseal defect management include porous-coated metaphyseal sleeves and tantalum cones. A systematic review was conducted according to the international Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We combined search terms “Total knee arthroplasty” AND/OR “Sleeve,” “Cone” as either keywords or medical subject heading (MeSH) terms in multiple databases according to PRISMA recommendations. All retrieved articles were reviewed and assessed using defined inclusion and exclusion criteria. A total of 27 studies (12 sleeves and 15 cones) of revision TKAs were included. In the 12 studies on sleeve implantation in revision TKAs, 1,617 sleeves were implanted in 1,133 revision TKAs in 1,025 patients. The overall rate of reoperation was 110/1,133 (9.7%) and the total rate of aseptic loosening per sleeve was 13/1,617 (0.8%). In the 15 studies on tantalum cone implantation in revision TKAs, 701 cones were implanted into 620 revision TKAs in 612 patients. The overall rate of reoperation was 116/620 (18.7%), and the overall rate of aseptic loosening per cone was 12/701 (1.7%). Rates of aseptic loosening of the two implants were found to be similar, while the rate of reoperation was nearly double in revision TKAs utilizing tantalum cones. Variability in the selected studies and the likely multifactorial nature of failure do not allow for any definitive conclusions to be made. This review elucidates the necessity for additional literature examining revision TKA implants.

scholarly journals Immediate Sequential Bilateral Cataract Surgery: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Line Kessel ◽  
Jens Andresen ◽  
Ditte Erngaard ◽  
Per Flesner ◽  
Britta Tendal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cataract Surgery ◽  
Meta Analysis ◽  
Cochrane Review ◽  
Visual Outcome ◽  
Evidence Based ◽  
Bilateral Cataract ◽  
Grade Method ◽  
Meta Analyses

The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery on two different dates. The quality of evidence was rated as low to very low. None of the studies reported the prevalence of postoperative anisometropia. In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence. Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.

Chronic Quadriceps Tendon Rupture After Total Knee Arthroplasty Augmented With Synthetic Mesh

Orthopedics ◽  
2016 ◽  
Vol 40 (1) ◽  
pp. 38-42 ◽  
Author(s):  
Amaia Ormaza ◽  
Jesús Moreta ◽  
Javier Mosquera ◽  
Oskar Sáez de Ugarte ◽  
José Luis Martinez-de los Mozos
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Tendon Rupture ◽  
Quadriceps Tendon ◽  
Synthetic Mesh ◽  
Quadriceps Tendon Rupture ◽  
Total Knee

scholarly journals Adjuvant chemotherapy for early female breast cancer: A systematic review of the evidence for the 2014 Cancer Care Ontario systemic therapy guideline

2014 ◽  
Vol 22 ◽  
pp. 82 ◽  
Author(s):  
S. Gandhi ◽  
G.G. Fletcher ◽  
A. Eisen ◽  
M. Mates ◽  
O.C. Freedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Systematic Review ◽  
Endocrine Therapy ◽  
Early Breast Cancer ◽  
Systemic Therapy ◽  
Cancer Care ◽  
Cytotoxic Chemotherapy ◽  
Evidence Based ◽  
Inclusion Criteria ◽  
Meta Analyses

BackgroundThe Program in Evidence-Based Care (PEBC) of Cancer Care Ontario (CCO) has recently created an evidence-based consensus guideline on the systemic treatment of early breast cancer.  The evidence for this guideline was compiled using a systematic review to answer the question:  “What is the optimal systemic therapy for patients with early-stage, operable breast cancer, when patient and disease factors are considered?”  This question was addressed in three parts: cytotoxic chemotherapy, endocrine treatment, and human epidermal growth factor receptor 2 (HER2) directed therapy.MethodsA systematic review was performed using the MEDLINE and EMBASE databases for the period January 2008 to May 2014.  The SAGE Directory of Cancer Guidelines and websites of major oncology guideline organizations were also searched.  The basic search terms were “breast cancer” and “systemic therapy” (chemotherapy, endocrine therapy, targeted agents, ovarian suppression), and was limited to randomized controlled trials (RCTs), guidelines, systematic reviews, and meta-analyses. ResultsSeveral hundred documents were retrieved that met the inclusion criteria; the Early Breast Cancer Trialists Collaborative Group (EBCTCG) meta-analyses encompassed many of the RCTs found. Several additional studies which met the inclusion criteria were included, as well as other guidelines and systematic reviews.  Chemotherapy was largely reviewed as three classes of agents: anti-metabolite based regimens (e.g., CMF), anthracyclines, and taxane-based regimens. Single-agent chemotherapy in general is not recommended for the adjuvant treatment of breast cancer in any patient population.  Anthracycline and taxane-based polychemotherapy regimens are overall considered superior to earlier generation regimens, with the most significant impact on patient survival outcomes. Various regimens with disparate anthracycline and taxane doses and schedules are options; in general, paclitaxel given every 3 weeks is inferior. Evidence does not support the use of bevacizumab in the adjuvant setting; other systemic therapy agents such as metformin and vaccines remain under investigation. Adjuvant bisphosphonates for menopausal women will be discussed in later work.  ConclusionThe results of this systematic review represent a comprehensive compilation of high-level evidence which was the basis for the 2014 PEBC CCO guideline on systemic therapy for early breast cancer. The use of cytotoxic chemotherapy is presented here; the results addressing endocrine therapy and HER-2 targeted treatment, as well as the final clinical practice recommendations, are published separately in this issue.

scholarly journals A bibliometric analysis of systematic review/meta-analysis on dry eye disease

2019 ◽  
Author(s):  
Yonggang Zhang ◽  
An Ping ◽  
Shuyuan Lyu
Keyword(s):  
Systematic Review ◽  
Dry Eye ◽  
Systematic Reviews ◽  
Core Collection ◽  
Meta Analysis ◽  
Dry Eye Disease ◽  
Eye Disease ◽  
Evidence Based ◽  
Meta Analyses ◽  
Number Of Citations

Abstract Background There was no citation analysis about systematic review/meta-analysis published on dry eye disease (DED). The objective of this study was to identify the citations of systematic review/meta-analysis published on DED and to provide information on the achievement and development of evidence-based dry eye research.Methods Web of Knowledge Core Collection was searched for all systematic review/meta-analysis relevant to DED. The number of citations, authorship, year, journal, country, and institution were analyzed for each study.Results A total of 29 systematic reviews/meta-analyses on DED published between 2009 and 2017 were included. The number of citations ranged from 0 to 63, with a medium of 8 citations. These systematic reviews/meta-analyses were from 10 countries, and 15 of them were from China. They were published in 21 journals. Ocular Surface published most studies (n =4), followed by International Journal of Ophthalmology (n =3). The journal with highest impact factor was Nutrition Reviews (IF=5.291 in 2016).Conclusion The citations of systematic reviews/meta-analyses on DED are still low. Further systematic reviews/meta-analyses are needed for providing more evidence for DED.

scholarly journals Systematic review of meta-analyses to assess the impacts of farming practices - A methodological framework

2021 ◽  
Author(s):  
David Makowski ◽  
Simona Bosco ◽  
Mathilde Chen ◽  
Ana Montero-Castaño ◽  
Marta Pérez-Soba ◽  
...  
Keyword(s):  
Systematic Review ◽  
Quality Assessment ◽  
Data Extraction ◽  
Scientific Evidence ◽  
Evidence Based ◽  
Methodological Framework ◽  
Farming Practices ◽  
Policy Makers ◽  
Scientific Experts ◽  
Meta Analyses

Identifying sustainable agricultural practices to support policy development requires a rigorous synthesis of scientific evidence based on experiments carried out around the world. In agricultural science, meta-analyses (MAs) are now commonly used to assess the impact of farming practices on a variety of outcomes, including crop and livestock productions, biodiversity, greenhouse gas emissions, nitrate leaching, soil organic carbon, based on a large number of experimental data. MA has become a gold standard method for quantitative research synthesis, and the growing number of MAs available can potentially be used to inform decisions of policy makers. However, published MAs are heterogeneous both in content and quality, and a framework is needed to help scientists to report the results and quality levels of MAs in a rigorous and transparent manner. Such a framework must be implementable quickly - within weeks - to be operational and compatible with the time constraints of modern policymaking processes. In this paper, we propose a methodological framework for assessing the impacts of farming practices based on a systematic review of published MAs. The framework includes four main steps: (1) literature search of existing MAs, (2) screening and selection of MAs, (3) data extraction and quality assessment, and (4) reporting. Three types of reports are generated from the extracted data: individual reports summarizing the contents of each MA (MA summary reports), reports summarizing each of the impacts of a given farming practice on a specific environmental, climate mitigation, or production outcome (single-impact reports), and report summarizing all the impacts of a given farming practice on all the outcomes considered (general report). All these reports present the quality levels of the MAs examined on the basis of 16 quality criteria. The proposed framework is semi-automatic in the sense that the skeletons of the reports are generated automatically from the spreadsheet used for the data extraction and quality assessment. This semi-automatic procedure allows scientific experts to reduce the time needed in the reporting step. Since 2020, the proposed framework was successfully applied by a group of scientific experts to support decisions of EU policy makers, and examine a large diversity of single farming practices (e.g. nitrification inhibitors, biochar, liming) and cropping systems (e.g. organic systems, agroforestry) in a relatively short period of time. It provides an operational tool for scientists who want to supply policymakers with scientific evidence based on large numbers of experiments, in a timely and reproducible manner.

scholarly journals Evidence-Based Medicine, Systematic Reviews, and Guidelines in Interventional Pain Management: Part 6. Systematic Reviews and Meta-Analyses of Observational Studies

2008 ◽  
Vol 5;12 (5;9) ◽  
pp. 819-850
Author(s):  
Laxmaiah Manchikanti
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Observational Studies ◽  
Meta Analysis ◽  
Evidence Based ◽  
Confounding Bias ◽  
Meta Analyses ◽  
Based Medicine

Observational studies provide an important source of information when randomized controlled trials (RCTs) cannot or should not be undertaken, provided that the data are analyzed and interpreted with special attention to bias. Evidence-based medicine (EBM) stresses the examination of evidence from clinical research and describes it as a shift in medical paradigm, in contrast to intuition, unsystematic clinical experience, and pathophysiologic rationale. While the importance of randomized trials has been created by the concept of the hierarchy of evidence in guiding therapy, much of the medical research is observational. The reporting of observational research is often not detailed and clear enough with insufficient quality and poor reporting, which hampers the assessment of strengths and weaknesses of the study and the generalizability of the mixed results. Thus, in recent years, progress and innovations in health care are measured by systematic reviews and meta-analyses. A systematic review is defined as, “the application of scientific strategies that limit bias by the systematic assembly, clinical appraisal, and synthesis of all relevant studies on a specific topic.” Meta-analysis usually is the final step in a systematic review. Systematic reviews and meta-analyses are labor intensive, requiring expertise in both the subject matter and review methodology, and also must follow the rules of EBM which suggests that a formal set of rules must complement medical training and common sense for clinicians to integrate the results of clinical research effectively. While expertise in the review methods is important, the expertise in the subject matter and technical components is also crucial. Even though, systematic reviews and meta-analyses, specifically of RCTs, have exploded, the quality of the systematic reviews is highly variable and consequently, the opinions reached of the same studies are quite divergent. Numerous deficiencies have been described in methodologic assessment of the quality of the individual articles. Consequently, observational studies can provide an important complementary source of information, provided that the data are analyzed and interpreted in the context of confounding bias to which they are prone. Appropriate systematic reviews of observational studies, in conjunction with RCTs, may provide the basis for elimination of a dangerous discrepancy between the experts and the evidence. Steps in conducting systematic reviews of observational studies include planning, conducting, reporting, and disseminating the results. MOOSE, or Meta-analysis of Observational Studies in Epidemiology, a proposal for reporting contains specifications including background, search strategy, methods, results, discussion, and conclusion. Use of the MOOSE checklist should improve the usefulness of meta-analysis for authors, reviewers, editors, readers, and decision-makers. This manuscript describes systematic reviews and meta-analyses of observational studies. Authors frequently utilize RCTs and observational studies in one systematic review; thus, they should also follow the reporting standards of the Quality of Reporting of Meta-analysis (QUOROM) statement, which also provides a checklist. A combined approach of QUOROM and MOOSE will improve reporting of systematic reviews and lead to progress and innovations in health care. Key words: Observational studies, evidence-based medicine, systematic reviews, metaanalysis, randomized trials, case-control studies, cross-sectional studies, cohort studies, confounding bias, QUOROM, MOOSE

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