Bmc Musculoskel Dis
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Bmc Musculoskel Dis · Aug 2015
Review Meta Analysis Comparative StudyComparison of bipolar hemiarthroplasty and total hip arthroplasty for displaced femoral neck fractures in the healthy elderly: a meta-analysis.
Displaced femoral neck fractures (FNFs) in healthy elderly patients have traditionally been managed with hemiarthroplasty (HA) or total hip arthroplasty (THA), with studies suggesting that THA may be the better option. However, it has recently been reported that bipolar HA (BHA) also provides good outcomes, and it is not clear as to whether BHA or THA is most appropriate. The purpose of this study was to conduct a meta-analysis of randomized controlled trials (RCTs) comparing the outcomes of BHA with THA for treating FNF in healthy elderly patients. ⋯ For healthy elderly patients with displaced FNFs, treatment with BHA led to better outcomes regarding dislocation rate, while THA was better regarding acetabular erosion rate and reoperation rate. When comparing BHA with THA, there were no significant differences in other important outcomes such as Harris Hip Score, infection rate, general complications, and 1-year mortality. Further high-quality RCTs are needed to provide robust evidence and evaluate the treatment options.
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Bmc Musculoskel Dis · Aug 2015
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of tonic spinal cord stimulation, high-frequency and burst stimulation in patients with complex regional pain syndrome: a double-blind, randomised placebo controlled trial.
Complex Regional Pain Syndrome (CRPS) is a disabling disease that is sometimes difficult to treat. Although spinal cord stimulation (SCS) can reduce pain in most patients with CRPS, some do not achieve the desired reduction in pain. Moreover, the pain reduction can diminish over time even after an initially successful period of SCS. Pain reduction can be regained by increasing the SCS frequency, but this has not been investigated in a prospective trial. This study compares pain reduction using five SCS frequencies (standard 40 Hz, 500 Hz, 1200 Hz, burst and placebo stimulation) in patients with CRPS to determine which of the modalities is most effective. ⋯ Currently no trials are available that systematically investigate the importance of variation in frequency during SCS in patients with CRPS. Data from this trial will provide better insight as to whether SCS with a higher frequency, or with burst stimulation, results in more effective pain relief.
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Bmc Musculoskel Dis · Aug 2015
Comparative Study Clinical TrialInfluence of pelvic incidence-lumbar lordosis mismatch on surgical outcomes of short-segment transforaminal lumbar interbody fusion.
The importance of pelvic incidence-lumbar lordosis (PI-LL: PI minus LL) mismatch is emphasized in long-segment fusion for adult spinal deformity; however, there are few studies evaluating the influence of PI-LL on surgical outcomes after short-segment fusion. In this study, we have examined the effects of PI-LL mismatch on surgical outcomes of short-segment lumbar intervertebral fusion for lumbar degenerative diseases. ⋯ This study is the first to find that PI-LL mismatch influences post-operative residual symptoms, such as LBP, lower extremity pain and numbness. Among the three types of LBP examined in the detailed VAS, LBP while standing was most strongly related to PI-LL mismatch. The importance of maintaining spinopelvic alignment is emphasized, particularly when treating patients with adult spinal deformity using long-segment fusion surgery. However, our results indicate that surgeons should pay attention to sagittal spinopelvic alignment and avoid post-operative PI-LL mismatch even when treating patients with short-segment lumbar interbody fusion.
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Bmc Musculoskel Dis · Aug 2015
Clinical TrialEvaluation of a disease specific rheumatoid arthritis self-management education program, a single group repeated measures study.
Rheumatoid Arthritis is a progressive and disabling disease, predicted to increase in prevalence over the next 50 years. Self-management is acknowledged as an integral part in the management of chronic disease. The rheumatoid arthritis specific self-management program delivered by health professionals was developed by Arthritis Western Australia in 2006. The purpose of this study was to determine whether this program would achieve early benefits in health related outcomes, and whether these improvements would be maintained for 12 months. ⋯ Participants in the program recorded significant improvements in depression and mental health post-intervention, which were maintained to 12 months follow up.
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Bmc Musculoskel Dis · Aug 2015
Randomized Controlled TrialSpecific exercise training for reducing neck and shoulder pain among military helicopter pilots and crew members: a randomized controlled trial protocol.
Flight-related neck/shoulder pain is frequent among military helicopter pilots and crew members. With a lifetime prevalence of 81% for pilots and 84% for crew members, the prevalence of neck pain is considered high compared to the general population. The aim of this study was to investigate whether a specifically tailored exercise intervention would reduce the prevalence and incidence rate of neck/shoulder pain among helicopter pilots and crew members. ⋯ In spite of the high prevalence of flight related neck/shoulder pain among military helicopter pilots and crew members there are currently no evidence based guidelines for the prevention or clinical handling of neck pain among these occupational groups. Results from this study may therefore be beneficial for future establishment of such guidelines.