scholarly journals A meta-analysis into the effect of lateral-wedged insoles with subtalar strapping versus traditional insoles in adults with medial knee osteoarthritis.

2011 ◽  
Vol 67 (1) ◽  
Author(s):  
L. Duvenhage ◽  
T. Mushaike ◽  
N. Parker ◽  
L. Swartz ◽  
M. Rensburg ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Narrative Form ◽  
Short Term ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Knee Oa ◽  
Randomised Controlled

To  systematically  identify,  collate,  and  analyze  the  current available evidence  for  the  effectiveness  of  lateral-wedged  insoles,  with subtalar strapping,  on  reducing  pain,  improving  function  and  improving  the femoral-tibial  angle  (FTA),  in  adults  with  medial  knee osteoarthritis compared to traditional insoles without subtalar strapping.Six computerised databases, namely Cochrane Library, CiNAHL, PEDro, BIOMED central,  PubMed  and  ScienceDirect  were  searched. The  included articles were  then  all  rated  using  the  PEDro  scale  to  determine  their meth-odological quality.  Homogeneous data were pooled in a meta-analysis using Review Manager (REVMAN) software.  Where statistical pooling of the results was not possible, findings were summarised in narrative form. Three randomised controlled trials were selected for this review. The average PEDro score was 5.7. A meta-analysis demonstrated that lateral-wedged insoles with subtalar strapping significantly reduced pain in the short-term (p=0.004). The review found that lateral-wedge insoles with subtalar strapping significantly decreased pain in the short-term and seemed to have a positive effect on the FTA in the long-term, when compared to traditional insoles without  subtalar strapping. The lateral-wedge insole with subtalar strapping may provide a financially feasible adjunctive self-management treatment for knee OA and should be considered before invasive procedures such as surgery.

scholarly journals Unicondylar knee replacement versus total knee replacement for the treatment of medial knee osteoarthritis: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Meichao Deng ◽  
Yang Hu ◽  
Zhongzu Zhang ◽  
Hongjun Zhang ◽  
Yiming Qu ◽  
...  
Keyword(s):  
Total Knee Replacement ◽  
Knee Osteoarthritis ◽  
Knee Replacement ◽  
Meta Analysis ◽  
Medial Knee ◽  
Medial Knee Osteoarthritis ◽  
Knee Oa ◽  
Unicondylar Knee Replacement ◽  
Total Knee

Abstract Background Since the optimal surgery for isolated medial knee osteoarthritis (OA) is unclear, this study aimed at comparing the effectiveness of unicondylar knee replacement (UKR) with total knee replacement (TKR) for simple medial knee OA. Methods Literature searches of PubMed, Embase, Web of Science, and the Cochrane Library were searched up to 1th April 2020. Only studies comparing UKR with TKR for isolated medial knee OA were included. Data collection and extraction, quality assessment, and data analyses were performed according to the Cochrane standards. Results A total of 13 articles with 1888 patients were included, among which, 944 and 944 underwent UKR and TKR, respectively. The analyzed postoperative outcomes were mostly within 5 years of follow-up. The meta-analysis showed that UKR improved knee general function (P < 0.00001) and health (P = 0.02), moreover, reduced post-operative pain (P = 0.01) and complications (P < 0.05) more than TKR. There were no significant differences in postoperative revision (P = 0.252), high-activity arthroplasty score (HAAS) (P = 0.307) and Oxford knee score (OKS) (P = 0.15) between the two techniques. Conclusions The patients of UKR could achieve better clinical results than that of TKR, moreover, there were negligible differences between the two techniques in postoperative revision in the early and mid-term follow-up and surgeons should be aware of the important reasons for revision of UKR. Thus, UKR instead of TKR should be performed in patients with late-stage isolated medial knee OA.

scholarly journals POS1099 EFFICACY OF INTRA-ARTICULAR CORTICOSTEROID INJECTIONS IN KNEE OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 829.2-830
Author(s):  
A. Najm ◽  
A. Alunno ◽  
C. Weill ◽  
J. Gwinnutt ◽  
F. Berenbaum
Keyword(s):  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Medium Term ◽  
Short Term ◽  
Knee Oa ◽  
Randomized Controlled ◽  
And Function

Background:Knee osteoarthritis (OA) is a frequent degenerative disease representing an important health and economic burden. Symptomatic medical treatments available include intra-articular (IA) injections of corticosteroids (GC) but their efficacy is debated. In addition, safety signals regarding cartilage damage with IA GC have been highlighted in a few studies.Objectives:To perform a meta-analysis of studies assessing IA GC efficacy and safety in knee OA.Methods:A systematic literature review and a meta-analysis of randomized controlled trials (RCTs) assessing the effect of GC IA injections versus other interventions (IA Hyaluronic Acid, IA placebo, IA NSAID, oral NSAID or physiotherapy) in knee OA was performed. The effect of the interventions on pain and function were extracted from the single studies and pooled and are presented as short term (<6weeks), medium term (6-24 weeks) and long term (>24 weeks) follow-up period. Standardized mean differences (SMD) are reported.Results:Of 520 studies screened, 23 were included in the SLR and 14 subsequently included in the MA. While IA GC showed a superior effect compared to control on both pain (SMD -0.61 (95% CI -1,25, 0.03)) and function (SMD -1.02 (95% CI -2.14, 0.10)) in short term follow-up; long term follow-up analysis favored controls (IA HA, IA NSAID, physiotherapy) for both pain (SMD 0.68 (95% CI -0.11, 1.47)) and function (SMD 0.88 (95% CI -0.36, 2.12) outcomes (Figure 1). No difference was found between interventions in the medium term. Safety data were reported in 18/23 studies (n= 1936/2314 patients); and side effects were reported as follows: arthralgia (69 IA GC patients, 146 IA HA patients, and 20 saline patients); site injection pain (7 in the IA GC group, 2 in the IA saline group, 14 in the IA HA group); 16 post injection knee swelling without signs of septic arthritis in the IA GC group and 24 in the IA HA group. In one study assessing cartilage effects of GCs, the rate of cartilage loss was greater in the GC group with a reduction of cartilage thickness at 2 year compared to placebo group. No difference was observed in the progression of cartilage denudation or bone marrow lesion. On the contrary, another study showed no effect of injections on the cartilage structure.Conclusion:We demonstrate in this work that IA GC injections reduce pain and improve function in the early phase (≤6 weeks) of treatment. In the long term (≥24 weeks), other intervention such as IA HA injections or physiotherapy seem to be more efficient, but this effect was largely driven by single studies with large effect sizes and the comparators were heterogeneous.Figure 1.Knee pain outcome at short term (≤6weeks) (A), medium term (>6 & <24 weeks) (B), and long term (≥24 weeks) (C) follow up.Disclosure of Interests:None declared.

scholarly journals Preoperative Somatostatin Analogues in Patients with Newly-diagnosed Acromegaly: A Systematic Review and Meta-analysis of Comparative Studies

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Chengxian Yang ◽  
Ge Li ◽  
Shenzhong Jiang ◽  
Xinjie Bao ◽  
Renzhi Wang
Keyword(s):  
Systematic Review ◽  
Comparative Studies ◽  
Meta Analysis ◽  
Somatostatin Analogues ◽  
Long Term Results ◽  
Current Evidence ◽  
Cochrane Library ◽  
Cure Rate ◽  
Short Term

Abstract Biochemical remission after transsphenoidal surgery is still unsatisfied in acromegaly patients with macroadenomas, especially with invasive macroadenomas. Concerning the impact of preoperative somatostatin analogues (SSAs) on surgical outcomes, previous studies with limited cases reported conflicting results. To assess current evidence of preoperative medical treatment, we performed a systematic review and meta-analysis of comparative studies. A literature search was conducted in Pubmed, Embase, and the Cochrane Library. Five randomized controlled trials (RCT) and seven non-RCT comparative studies were included. These studies mainly focused on pituitary macroadenomas though a small number of microadenoma cases were included. For safety, preoperative SSAs were not associated with elevated risks of postoperative complications. With respect to efficacy, the short-term cure rate was improved by preoperative SSAs, but the long-term cure rate showed no significant improvement. For invasive macroadenomas, the short-term cure rate was also improved, but the long-term results were not evaluable in clinical practice because adjuvant therapy was generally required. In conclusion, preoperative SSAs are safe in patients with acromegaly, and the favorable impact on surgical results is restricted to the short-term cure rate in macroadenomas and invasive macroadenomas. Further well-designed RCTs to examine long-term results are awaited to update the finding of this meta-analysis.

scholarly journals Mesenchymal stem cells - a promising strategy for treating knee osteoarthritis

2020 ◽  
Vol 9 (10) ◽  
pp. 719-728
Author(s):  
Jiaqian Wang ◽  
Liang Zhou ◽  
Yong Zhang ◽  
Lixin Huang ◽  
Qin Shi
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Knee Osteoarthritis ◽  
Low Dose ◽  
Meta Analysis ◽  
Cartilage Regeneration ◽  
Cochrane Library ◽  
P Values ◽  
Knee Oa ◽  
Primary Evaluation

Aims The purpose of our study was to determine whether mesenchymal stem cells (MSCs) are an effective and safe therapeutic agent for the treatment of knee osteoarthritis (OA), owing to their cartilage regeneration potential. Methods We searched PubMed, Embase, and the Cochrane Library, with keywords including “knee osteoarthritis” and “mesenchymal stem cells”, up to June 2019. We selected randomized controlled trials (RCTs) that explored the use of MSCs to treat knee OA. The visual analogue scale (VAS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), adverse events, and the whole-organ MRI score (WORMS) were used as the primary evaluation tools in the studies. Our meta-analysis included a subgroup analysis of cell dose and cell source. Results Seven trials evaluating 256 patients were included in the meta-analysis. MSC treatment significantly improved the VAS (mean difference (MD), –13.24; 95% confidence intervals (CIs) –23.28 to –3.20, p = 0.010) and WOMAC (MD, –7.22; 95% CI –12.97 to –1.47, p = 0.010). The low-dose group with less than 30 million cells showed lower p-values for both the VAS and WOMAC. Adipose and umbilical cord–derived stem cells also had lower p-values for pain scores than those derived from bone marrow. Conclusion Overall, MSC-based cell therapy is a relatively safe treatment that holds great potential for OA, evidenced by a positive effect on pain and knee function. Using low-dose (25 million) and adipose-derived stem cells is likely to achieve better results, but further research is needed. Cite this article: Bone Joint Res 2020;9(10):719–728.

scholarly journals Association between the polymorphism of IL-17A and IL-17F gene with knee osteoarthritis risk: a meta-analysis based on case-control studies

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Feifan Lu ◽  
Pei Liu ◽  
Qidong Zhang ◽  
Weiguo Wang ◽  
Wanshou Guo
Keyword(s):  
Knee Osteoarthritis ◽  
Gene Polymorphisms ◽  
Meta Analysis ◽  
Case Control ◽  
Joint Disease ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Knee Oa ◽  
Statistical Heterogeneity ◽  
Bone Changes

Abstract Background Knee osteoarthritis is a joint disease which is characterized by degeneration of articular cartilage and subsequent subchondral bone changes. Polymorphisms of IL-17A/F gene were the recognized candidate genes associated with knee osteoarthritis risk although the results were conflicting. The aim of this study was to determine whether IL-17A(rs2275913) and IL-17F(rs763780) polymorphisms confer susceptibility to knee osteoarthritis. Method Literature search was performed in PubMed, Medline, Cochrane Library, Web of science, Embase, and Google Scholar (last search was updated on June 20, 2019), and assessing this association was performed by calculating odds ratios with 95% confidence intervals. Statistical heterogeneity was quantitatively evaluated by using the Q statistic with its p value and I2 statistic. Result Six case-control based studies were included involving IL-17A(rs2275913) (2134 cases and 2306 controls) and IL-17F(rs763780) (2134 cases and 2426 controls). The overall analysis suggested that the A allele of the rs2275913 polymorphism, and the C allele of the rs763780 polymorphism in the IL-17 gene may increase the risk of OA. However, subgroup analysis revealed that no association between IL-17A(rs2275913) gene and knee OA risk was found in Caucasian population. Conclusions This meta-analysis revealed that the IL-17A(rs2275913) gene polymorphisms may increase the risk of knee OA in Asians, and the IL-17F(rs763780) gene polymorphisms may increase the risk of knee OA both in Asians and Caucasians. However, because of the limitations of the present study, additional larger studies are needed to confirm our findings in the future.

scholarly journals A meta-analysis of fast track surgery for patients with gastric cancer undergoing gastrectomy

2015 ◽  
Vol 97 (1) ◽  
pp. 3-10 ◽  
Author(s):  
S Chen ◽  
Z Zou ◽  
F Chen ◽  
Z Huang ◽  
G Li
Keyword(s):  
Gastric Cancer ◽  
Perioperative Care ◽  
Fast Track ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Fast Track Surgery ◽  
Short Term ◽  
Readmission Rates ◽  
Randomised Controlled

Introduction This meta-analysis evaluated the safety and efficacy of fast track surgery (FTS) for patients with gastric cancer undergoing gastrectomy. Methods Randomised controlled trials (RCTs) published between 1 January 1995 and 21 June 2013 comparing FTS with conventional perioperative care for patients with gastric cancer undergoing gastrectomy were identified in the PubMed, Embase™ and Cochrane Library databases, and were analysed systematically using RevMan software (Nordic Cochrane Centre, Copenhagen, Denmark). Results Seven RCTs (524 patients) were analysed. Compared with conventional perioperative care, FTS treatment with/without laparoscopy was associated with shorter postoperative hospitalisation, less hospitalisation expenditure (both p<0.00001), less pain and better quality of life. Short-term morbidity and readmission rates did not differ between treatments. No incidents of death occurred during the short-term follow-up period. Conclusions In patients with gastric cancer undergoing gastrectomy, the FTS pathway reduces the length and cost of postoperative hospitalisation while maintaining short-term morbidity, readmission and mortality rates comparable with those of conventional care.

scholarly journals Metabolic Syndrome Increases the Risk for Knee Osteoarthritis: A Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Huajun Wang ◽  
Yanmei Cheng ◽  
Decheng Shao ◽  
Junyuan Chen ◽  
Yuan Sang ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Knee Osteoarthritis ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Significant Heterogeneity ◽  
Metabolic Factors ◽  
Knee Oa ◽  
The Metabolic Syndrome ◽  
The Cochrane Library ◽  
The Relationship

Background. Studies revealed that metabolic factors might contribute substantially to osteoarthritis (OA) pathogenesis. There has been an increasing interest to understand the relationship between knee OA and the metabolic syndrome (MetS). The purpose of this study was to explore the association between metabolic syndrome and knee osteoarthritis using meta-analysis.Methods. Databases, including PUBMED, EMBASE, and the Cochrane Library, were searched to get relevant studies. Data were extracted separately by two authors and pooled odds ratio (OR) with 95% confidence interval (CI) was calculated.Results. The meta-analysis was finished with 8 studies with a total of 3202 cases and 20968 controls finally retrieved from the database search. The crude pooled OR is 2.24 (95% CI = 1.38–3.64). Although there was significant heterogeneity among these studies, which was largely accounted for by a single study, the increase in risk was still significant after exclusion of that study. The pooled adjusted OR remained significant with pooled adjusted OR 1.05 (95% CI = 1.03–1.07,p<0.00001). No publication bias was found in the present meta-analysis.Conclusions. The synthesis of available evidence supports that metabolic syndrome increases the risk for knee osteoarthritis, even after adjustment for many risk factors.

scholarly journals Association between the polymorphism of MMP-1 gene with knee osteoarthritis risk: a meta-analysis

2019 ◽  
Author(s):  
Feifan Lu ◽  
Pei Liu ◽  
Weiguo Wang ◽  
Qidong Zhang ◽  
Wanshou Guo
Keyword(s):  
Knee Osteoarthritis ◽  
Web Of Science ◽  
Meta Analysis ◽  
Recessive Model ◽  
Cochrane Library ◽  
Knee Oa ◽  
Matrix Metalloproteinase 1 ◽  
Statistical Heterogeneity ◽  
Different Populations ◽  
Allele Model

Abstract Background: The existing studies on the association between polymorphisms of Matrix metalloproteinase-1 (MMP-1) (-1607 1G/2G) (rs1799750) polymorphism and the risk of knee osteoarthritis (OA, a complex multifactorial disease and a major degenerative form of arthritis) in different populations have yielded conflicting findings. Method: Literature search was performed in PubMed, Cochrane Library, Web of science, Google Scholar (From January 1990 to June 2019), and assessing this association by calculating odds ratios with 95% confidence intervals. Subgroup analyses stratified by ethnicity were also conducted. Statistical heterogeneity was quantitatively evaluated by X 2 test with the significance set P<0.10 or I 2 >50%. Result: Five case-control based studies (924 cases and 928 controls) were included. The results suggested that the MMP-1 (-1607 1G/2G) (rs1799750) gene polymorphisms were not associated with knee OA risk in all genetic models (Allele model OR =1.22, 95% CI: 0.72-1.76, p=0.615, Recessive model OR = 1.12, 95% CI: 0.70-2.15, p=0.486, and Dominant model OR = 1.14, 95%CI: 0.64-2.04, p=0.659, Figure 3-5) Conclusions: There is no association between the polymorphism of MMP-1 (-1607 1G/2G) (rs1799750) polymorphism with the risk of knee osteoarthritis, a large number of studies may be necessary to verify this association in different populations and environmental factors.

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