Medical reversals in family practice: a review

ConclusionWhile these practices were implemented because of sound biologic plausibility or encouraging observational data, well-done RCTs have failed to show evidence of effectiveness. These examples raise caution in introducing new clinical interventions into widespread clinical practice without sufficient high quality evidence demonstrating efficacy.
Source: Current Therapeutic Research - Category: Drugs & Pharmacology Source Type: research

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ConclusionThis study demonstrated that the AUC for the surgical treatment of knee OA can be applied easily in a clinical setting. Most of the treatments provided at our institution were appropriate and in agreement with the AUC recommendations. Additionally, the AUC had a web-based application that was easy to use and simple for identifying treatment recommendations.Level of evidenceRetrospective study, level IV.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Conclusions: Our short-term follow-up evaluation shows that hip arthroscopy for pediatric and adolescent hip disorder is a less invasive and safe procedure. It appears to be effective in improving functional impairment caused by femoroacetabular impingement between the deformed femoral head and acetabulum or intra-articular focal problems in pediatric and adolescent hip disorders. PMID: 32117544 [PubMed - in process]
Source: Clinics in Orthopedic Surgery - Category: Orthopaedics Tags: Clin Orthop Surg Source Type: research
Meniscus tears are a fairly common knee injury. Treatment typically involves complete or partial removal of the damaged meniscus. Without shock-absorbing role of the meniscus, however, patients are at risk for accelerated wear of the knee joint and o...
Source: Medgadget - Category: Medical Devices Authors: Tags: Exclusive Orthopedic Surgery Source Type: blogs
lle K Abstract Background and purpose - Few studies have evaluated the long- and mid-term outcomes after minimally invasive periacetabular osteotomy (PAO). We investigated: (1) the long-term hip survival rate after PAO; (2) the risk of complications and additional surgery after PAO; and (3) the hip function at different follow-up points.Patients and methods - We reviewed 1,385 hips (1,126 patients) who underwent PAO between January 2004 and December 2017. Through inquiry to the Danish National Patient Registry we identified conversions to total hip arthroplasty (THA) and complications after PAO. We evaluated the H...
Source: Acta Orthopaedica - Category: Orthopaedics Authors: Tags: Acta Orthop Source Type: research
Background: Open ankle arthrodesis (OAA) has traditionally been the gold standard for improving pain and function in ankle osteoarthritis patients. With advances in arthroscopic technology and improved instrumentation, arthroscopic ankle arthrodesis (AAA) has become more popular among orthopedic surgeons with equivalent or better outcomes compared with OAA. Recent studies have shown that, with increasing experience, AAA can even be suitable for large deformities, which has been traditional viewed as a relative contraindication. A review of literature and concepts with expert opinion. AAA has been shown in the literature ...
Source: Techniques in Foot and Ankle Surgery - Category: Orthopaedics Tags: Special Focus Source Type: research
ConclusionPoor preoperative WOMET scores, presence of cartilage lesions at the medial femoral condylus, meniscal degeneration, concomitant anterior cruciate ligament lesions as well as lateral meniscal tears are correlated with worse postoperative outcomes after arthroscopic partial meniscectomy. Patients with femoral bone marrow lesions femoral are more likely to gain benefit from arthroscopic partial meniscectomy in the middle term. Despite justified recent restrictions in indication, arthroscopic partial meniscectomy seems to effectively reduce pain and alleviate symptoms in carefully selected patients with degenerative...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
High tibial osteotomy for unilateral medial knee osteoarthritis unloads the osteoarthritic area, gives pain relief, and may prevent later osteoarthritis if performed for the ideal indications. The risk of conversion of high tibial osteotomy to total knee arthroplasty is higher if osteoarthritis has advanced too far and for overweight persons, cigarette smokers, older patients, female patients, patients with a high level of comorbidity, and patients with under-correction of the varus malalignment.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Editorial Commentary Source Type: research
ConclusionThe findings of this study partly confirm the hypotheses that pain and functional impairments after TKA without patellar resurfacing are associated with patellar shape. No association was revealed between postoperative patellar orientation and function nor pain. Quantitative consideration of patellar congruency could therefore prevent pain and improve function after TKA without patellar resurfacing.Level of evidenceRetrospective study, Level III.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Authors: Schmitz MR, Murtha AS, Clohisy JC, ANCHOR Study Group Abstract Developmental dysplasia of the hip (DDH) in adolescents and young adults can cause notable pain and dysfunction and is a leading cause of progressive hip osteoarthritis in affected patients. Recognition of the clinical symptoms and radiographic presentation of DDH in adolescents and young adults are paramount for early management. Plain radiographs are critical for making proper diagnosis, whereas three-dimensional imaging including MRI and/or CT detects intra-articular pathology and better characterizes hip morphology. Management of early, sym...
Source: The Journal of the American Academy of Orthopaedic Surgeons - Category: Orthopaedics Tags: J Am Acad Orthop Surg Source Type: research
J Knee Surg DOI: 10.1055/s-0039-1700978To improve the long-term outcomes of high tibial osteotomy (HTO) for gonarthritis, many cartilage repair procedures appeared, but their effects were controversial. To evaluate the efficacy of cartilage repair procedures during HTO for gonarthritis, we performed this update meta-analysis. We performed the system retrieval for clinical trials using various databases and then pooled the outcomes of the included studies. Fifteen studies were involved. The pooled results indicated that there were no significant differences in Kellgren and Lawrence (KL) scale (mean difference [MD] =&...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
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