Orthopedics (all articles)
SR | Diagnostic accuracy of tests for disc, sacroiliac, and facet joint origins in low back pain assessment
10 May, 2023 | 15:44h | UTC
ESTES recommendation on thoracolumbar spine fractures
10 May, 2023 | 15:40h | UTC
Position statement | Management of rotator cuff tears in adults
8 May, 2023 | 12:49h | UTCPosition statement: management of rotator cuff tears in adults – Canadian Journal of Surgery
SR | What Is the efficacy of intra-articular injections in the treatment of ankle osteoarthritis
8 May, 2023 | 12:48h | UTC
Treating long-lasting low back pain without surgery: the latest evidence
4 May, 2023 | 13:40h | UTCTreating long-lasting low back pain without surgery: the latest evidence – Evidently Cochrane
M-A | Efficacy of osteoporosis interventions on fracture prevention in postmenopausal women
3 May, 2023 | 15:37h | UTC
M-A | Efficacy of erector spinae plane block for postoperative analgesia lumbar surgery
26 Apr, 2023 | 13:53h | UTC
M-A | Surgical versus non-surgical treatment for sciatica
25 Apr, 2023 | 14:39h | UTCEditorial: Early surgery for sciatica – The BMJ
News Release: Surgery for sciatica reduces leg pain and disability, but benefits are short-lived – University of Oxford
Commentary on Twitter
Very low to low certainty evidence suggests that discectomy was superior to non-surgical treatment or epidural steroid injections in reducing leg pain and disability in people with sciatica with a surgical indication, but the benefits reduced over timehttps://t.co/kHL2HBNscF
— The BMJ (@bmj_latest) April 19, 2023
Pro-Con Debate | Peripheral nerve blockade should be provided routinely in extremity trauma
25 Apr, 2023 | 14:31h | UTCPro-Con Debate: Peripheral Nerve Blockade Should Be Provided Routinely in Extremity Trauma, Including in Patients At Risk for Acute Compartment Syndrome – Anesthesia & Analgesia (free for a limited period)
Consensus Paper | Management of pathological thoracolumbar vertebral fractures in patients with multiple myeloma
25 Apr, 2023 | 14:11h | UTC
Geriatric odontoid fractures: treatment algorithms based on expert consensus and a systematic review
25 Apr, 2023 | 14:08h | UTC
RCT | Stereotactic radiosurgery vs. conventional radiotherapy for localized vertebral metastases of the spine
24 Apr, 2023 | 13:37h | UTCStereotactic Radiosurgery vs Conventional Radiotherapy for Localized Vertebral Metastases of the Spine: Phase 3 Results of NRG Oncology/RTOG 0631 Randomized Clinical Trial – JAMA Oncology (link to abstract – $ for full-text)
Audio interview: Radiosurgery of Spine Metastasis—NRG/RTOG 0631 RCT Final Results – JAMA
Commentary on Twitter
Phase 3 rand trial of spinal radiosurgery vs. conventional external beam radiation therapy for pts w/spinal metastases showed radiosurgery did not significantly improve pain response at 3mo but showed feasibility that makes it widely used today. https://t.co/LvZY1nbUpS #RadOnc
— JAMA Oncology (@JAMAOnc) April 20, 2023
Low back pain of disc, sacroiliac joint, or facet joint origin: a diagnostic accuracy systematic review
12 Apr, 2023 | 13:17h | UTC
Pharmacological treatments for low back pain in adults: an overview of Cochrane Reviews
11 Apr, 2023 | 14:39h | UTCRelated:
SR | Nonopioid pharmacological management of acute low back pain
M-A | Limited evidence for analgesic effectiveness in acute low back pain treatment
M-A: Effectiveness of treatments for acute and subacute mechanical non-specific low back pain
Guideline Interventions for the management of acute and chronic low back pain.
M-A: Little benefit from muscle relaxants for adults with non-specific low back pain.
RCT | Effectiveness of nail bed repair in children with vs. without replacing the fingernail
4 Apr, 2023 | 13:33h | UTCNews Release: New approach to nail bed injury surgery could significantly cut NHS costs – University of Oxford
SR | Nonopioid pharmacological management of acute low back pain
31 Mar, 2023 | 13:27h | UTC
RCT | Drain usage may increase the length of hospital stay following lumbar arthrodesis
31 Mar, 2023 | 13:18h | UTCCommentary: Wound drains increase hospital los after lumbar surgery? – Orthopedics This Week
SR | Extracutaneous features and complications of the Ehlers-Danlos syndromes
30 Mar, 2023 | 13:41h | UTC
M-A | Limited evidence for analgesic effectiveness in acute low back pain treatment
29 Mar, 2023 | 13:32h | UTCSummary: The objective of this systematic review and network meta-analysis was to assess the effectiveness and safety of various analgesic medicines for treating acute non-specific low back pain. After examining 98 randomized controlled trials with over 15,000 participants, the study found that the quality of evidence for the effectiveness and safety of these medications is low or very low.
Some analgesic medicines showed potential in reducing pain intensity, but the evidence was limited due to trial risk of bias and imprecision in effect estimates. Furthermore, certain medications might increase the risk of adverse events during treatment, with evidence ranging from moderate to very low confidence.
Given the lack of high-quality evidence, clinicians and patients are advised to be cautious when using analgesic medicines for acute non-specific low back pain. More robust head-to-head comparison trials are needed to provide clearer guidance on the best course of treatment.
News Release: Study finds “considerable uncertainty” around effectiveness and safety of analgesics for low back pain – BMJ Newsroom
Commentary from the author on Twitter (thread – click for more)
Out today in @bmj_latest.
We found “considerable uncertainty” around the effectiveness and safety of analgesic medicines for adults with acute non-specific low back pain.
Available at https://t.co/PeOmEOeJyJ
Thread ? pic.twitter.com/T8YDNGhhME
— Michael Wewege (@mawewege) March 22, 2023
SR | Local corticosteroid injection versus placebo for carpal tunnel syndrome
29 Mar, 2023 | 13:00h | UTCLocal corticosteroid injection versus placebo for carpal tunnel syndrome – Cochrane Library
Summary: Local steroid injection for carpal tunnel syndrome – Cochrane Library
Commentary on Twitter
Local steroid injection for #CarpalTunnel syndrome @CochraneNMD systematic review looks at the evidence from 9 studies involving 639 people.
'Probably improves symptoms & function for up to six months.'
Read the full @CochraneLibrary review: https://t.co/4z5euxpQqE pic.twitter.com/VEy0VUNxV8
— Cochrane UK (@CochraneUK) February 4, 2023
Plasma D-Dimer may be useful in the diagnosis of periprosthetic joint infection
29 Mar, 2023 | 12:33h | UTCPlasma D-Dimer Is Noninferior to Serum C-Reactive Protein in the Diagnosis of Periprosthetic Joint Infection – The Journal of Bone and Joint Surgery (link to abstract – $ for full-text)
News Release: D-dimer blood test shows value in detecting prosthetic joint infections – Wolters Kluwer
Study reveals high rates of nonadherence to antimicrobial prophylaxis guidelines, often due to unnecessary vancomycin use
23 Mar, 2023 | 13:13h | UTCSummary: The study evaluated adherence to surgical antimicrobial prophylaxis guidelines in 825 US hospitals for elective surgeries from 2019-2020. The study found that 41% of surgical prophylaxis regimens were nonadherent to the American Society of Health-System Pharmacists guidelines.
Unnecessary vancomycin use was the most common reason for nonadherence to surgical antimicrobial prophylaxis guidelines, accounting for 77% of nonadherent regimens and occurring in 31% of all surgeries. It’s noteworthy that when vancomycin was used, it was often unnecessarily combined with cefazolin, and patients who received this combination had a 19% higher risk of acute kidney injury compared to those who received cefazolin alone.
The authors suggest that quality-improvement efforts aimed at reducing unnecessary vancomycin use and potential guideline revisions may offer impactful strategies for improving the risk-benefit profile of antimicrobial prophylaxis.
RCT | Short-term indwelling foley catheters do not reduce the risk of postoperative urinary retention in THA and TKA
22 Mar, 2023 | 13:14h | UTCShort-Term Indwelling Foley Catheters Do Not Reduce the Risk of Postoperative Urinary Retention in Uncomplicated Primary THA and TKA: A Randomized Controlled Trial – The Journal of Bone and Joint Surgery (link to abstract – $ for full-text)
RCT | Intermittent IV ibuprofen reduces morphine consumption and provides pain relief after surgery
20 Mar, 2023 | 13:39h | UTCSummary: The article describes a randomized, placebo-controlled, double-blind clinical trial to evaluate the efficacy and safety of different doses of intravenous ibuprofen (IVIB) in treating acute postoperative pain. The trial involved patients who underwent abdominal or orthopedic surgery and were randomized to placebo, IVIB 400 mg, or IVIB 800 mg. The first dose was given intravenously 30 minutes before surgery ended, followed by IV administration every 6 hours for a total of 8 doses.
The study found that IV administration of ibuprofen 400 mg or 800 mg significantly reduced morphine consumption and relieved pain without increasing the incidence of adverse events.
The study’s strengths were its multicenter, randomized, controlled, and prospective design. However, the extensive list of exclusion criteria suggests that the study was made in a relatively healthy population, making it difficult to extrapolate the safety results for more fragile patients.
M-A | Artificial intelligence for hip fracture detection and outcome prediction
20 Mar, 2023 | 13:13h | UTC