The Journal of bone and joint surgery. American volume
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J Bone Joint Surg Am · Sep 2008
Randomized Controlled Trial Multicenter StudyLumbar discectomy outcomes vary by herniation level in the Spine Patient Outcomes Research Trial.
The Spine Patient Outcomes Research Trial showed an overall advantage for operative compared with nonoperative treatment of lumbar disc herniations. Because a recent randomized trial showed no benefit for operative treatment of a disc at the lumbosacral junction (L5-S1), we reviewed subgroups within the Spine Patient Outcomes Research Trial to assess the effect of herniation level on outcomes of operative and nonoperative care. ⋯ The advantage of operative compared with nonoperative treatment varied by herniation level, with the smallest treatment effects at L5-S1, intermediate effects at L4-L5, and the largest effects at L2-L3 and L3-L4. This difference in effect was mainly a result of less improvement in patients with upper lumbar herniations after nonoperative treatment.
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J Bone Joint Surg Am · Sep 2008
Randomized Controlled Trial Comparative StudyThe influence of early weight-bearing compared with non-weight-bearing after surgical repair of the Achilles tendon.
The optimal rehabilitation protocol after surgical repair of an Achilles tendon rupture has not been well defined. The objective of this randomized study was to compare the effect of early weight-bearing with that of non-weight-bearing on early postoperative recovery following repair of an acutely ruptured Achilles tendon. ⋯ Early weight-bearing after surgical repair of an acute Achilles tendon rupture improves health-related quality of life in the early postoperative period and has no detrimental effect on recovery.