Bmc Musculoskel Dis
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Bmc Musculoskel Dis · May 2019
Meta Analysis Comparative StudyTotal hip arthroplasty versus hemiarthroplasty for independently mobile older adults with intracapsular hip fractures.
Displaced intracapsular hip fractures are typically treated with hemiarthroplasty (HA) or total hip arthroplasty (THA). A number of professional bodies recommend considering THA for patients that were independently mobile and cognitively intact before injury. The aim of this study was to compare the outcomes between HA and THA for independently mobile older adults with hip fractures. ⋯ National clinical registries can provide important context when interpreting RCT data, which may alone be inadequate for comparing the safety profile of surgical interventions. These data suggest that THA is at significantly higher risk of dislocation but lower risk of revision within 12 months. The finding from both RCT and clinical registry data that THA is associated with lower 12-month mortality amongst the fittest patients with hip fractures requires urgent further study to determine whether or not this can be replicated in other balanced populations.
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Bmc Musculoskel Dis · May 2019
Randomized Controlled TrialGreen exercise and mg-ca-SO4 thermal balneotherapy for the treatment of non-specific chronic low back pain: a randomized controlled clinical trial.
Non-specific chronic low back pain (nscLBP) has a high socio-economic relevance due to its high incidence, prevalence and associated costs. Therefore, it is essential to evaluate effective therapeutic strategies. This study examines the effects of moderate mountain exercise and spa therapy on orthopedic and psychophysiological parameters. Based on a three-armed randomized controlled trial, guided mountain hiking tours and balneotherapy in thermal water were compared to a control group. ⋯ The results of this study confirmed a benefit of mountain hiking combined with Mg-Ca-SO4 spa therapy as a multimodal treatment of patients with nscLBP. Further studies should focus on long-term-effects of this therapeutic approach.
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Bmc Musculoskel Dis · May 2019
Clinical outcome and concomitant injuries in operatively treated fractures of the lateral process of the talus.
The aim of this study was to review the patient rated outcome (PROM) of surgically treated fractures to the lateral process of the talus (LPTF) and identify factors influencing the outcome. ⋯ Level III.
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Bmc Musculoskel Dis · May 2019
Randomized Controlled TrialTelephone cognitive behavioural therapy to prevent the development of chronic widespread pain: a qualitative study of patient perspectives and treatment acceptability.
Telephone cognitive behavioural therapy (tCBT) is an acceptable and effective treatment for patients with chronic widespread pain (CWP). Preventing the onset of CWP offers considerable benefits to the individual and society and the MAmMOTH study is the first aimed at CWP prevention. The study is a two-arm randomised trial testing a course of tCBT against usual care for prevention of CWP. This nested qualitative study explores patients' treatment experiences, with a view to understanding their potential influences on acceptability of the intervention. ⋯ This study extends our understanding of the acceptability and suitability of preventative interventions for chronic widespread pain and provides further evidence for the acceptability of tCBT.
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Bmc Musculoskel Dis · May 2019
Femoral fracture classification in the Swedish Fracture Register - a validity study.
A total of more than 270,000 fractures are registered in the Swedish Fracture Register (SFR), a national quality register. Fractures are classified following the AO/OTA classification, commonly by a junior doctor. As a step in the process of validating the data in the SFR, several studies of the accuracy of the fracture classification have already been published. The aim of this study was to evaluate the accuracy of femoral fracture classification in the SFR. ⋯ The classification of femoral fractures in the Swedish Fracture Register is substantial (AO/OTA group) to almost perfect (AO/OTA type) and as accurate as in previous studies. The present study also shows that the agreement between the SFR classification and a gold standard classification is in the same range of agreement as between experienced raters. In contrast to previous studies, the classifications in the SFR are made by an unselected group of mostly inexperienced classifiers. The results indicate that the fracture classification in a national quality register can be accurate enough to permit the evaluation of fracture treatment in specific groups of fractures.