JBJS reviews
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Rotator cuff tears are a common pathology, with an increasing number of repairs being performed arthroscopically. The purpose of this study was to systematically review the results in the current meta-analyses on arthroscopic rotator cuff repair, looking specifically at double-row repair compared with single-row repair, at whether platelet-rich plasma should be used adjunctively at the time of the surgical procedure, and at the effects of early-motion compared with late-motion rehabilitation postoperatively. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Guidelines recommending various nonoperative treatments for patients with knee osteoarthritis remain inconsistent. Much of this controversy relates to what constitutes a clinically important effect. The purposes of the present study were to compare treatment effect sizes from recent meta-analyses evaluating pharmacological or medical device interventions for the treatment of knee osteoarthritis and to further assess the clinical impact that the intra-articular placebo effect may have on intra-articular injection therapies. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Existing evidence regarding the value of preoperative education and/or exercise (prehabilitation) for patients undergoing total joint replacement is conflicting. The purpose of this study was to conduct an updated, comprehensive systematic review with meta-analyses to determine the longitudinal effects and efficacy of prehabilitation on postoperative outcomes in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA). ⋯ Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Traditional socket prostheses are not a viable option for all lower-limb prosthetic users. Discomfort, pain in the residual limb, and problems related to the fit of the socket are common and have been shown to negatively impact quality of life and mobility. Osseointegrated or bone-anchored prosthetic implants have evolved over the past 2 decades as a promising alternative for patients who are experiencing substantial issues with socket prostheses. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.