Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisTherapeutic ultrasound for osteoarthritis of the knee or hip.
Osteoarthritis is the most common form of joint disease and the leading cause of pain and physical disability in the elderly. Therapeutic ultrasound is one of several physical therapy modalities suggested for the management of pain and loss of function due to osteoarthritis (OA). ⋯ In contrast to the previous version of this review, our results suggest that therapeutic ultrasound may be beneficial for patients with osteoarthritis of the knee. Because of the low quality of the evidence, we are uncertain about the magnitude of the effects on pain relief and function, however. Therapeutic ultrasound is widely used for its potential benefits on both knee pain and function, which may be clinically relevant. Appropriately designed trials of adequate power are therefore warranted.
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisInterventions for replacing missing teeth: maintaining and recovering soft tissue health around dental implants.
It is important to institute an effective supportive therapy to maintain or recover soft tissue health around dental implants. Different maintenance regimens have been suggested, however it is unclear which are the most effective. ⋯ There was only low quality evidence for which are the most effective interventions for maintaining or recovering health of peri-implant soft tissues. The included RCTs had short follow-up periods and few subjects and although overall the risk of bias of the studies was either low or unclear, only single trials were available for each outcome. There was no reliable evidence as to which regimens are most effective for long term maintenance. This should not be interpreted as meaning that current maintenance regimens are ineffective. There was weak evidence that antibacterial mouthrinses are effective in reducing plaque and marginal bleeding around implants. More RCTs should be conducted in this area. In particular, there is a definite need for trials powered to find possible differences, using primary outcome measures and with much longer follow up. Such trials should be reported according to the CONSORT guidelines (www.consort-statement.org/).
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Cochrane Db Syst Rev · Jan 2010
Review Meta AnalysisEpidural blood patching for preventing and treating post-dural puncture headache.
This is an update of a Cochrane Review first published in Issue 2, 2002. Dural puncture is a common procedure, but leakage of cerebrospinal fluid (CSF) from the resulting dural defect may cause post-dural puncture headache (PDPH) after the procedure, and this can be disabling. Injecting an epidural blood patch around the site of the defect may stop this leakage. ⋯ The review authors do not recommend prophylactic epidural blood patch over other treatments because there are too few trial participants to allow reliable conclusions to be drawn. However, therapeutic epidural blood patch showed a benefit over conservative treatment, based on the limited available evidence.
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Bell's palsy or idiopathic facial palsy is an acute facial paralysis due to inflammation of the facial nerve. A number of studies published in China have suggested acupuncture is beneficial for facial palsy. ⋯ The quality of the included trials was inadequate to allow any conclusion about the efficacy of acupuncture. More research with high quality trials is needed.
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Cochrane Db Syst Rev · Jan 2010
ReviewInterventions for treating proximal humeral fractures in adults.
Proximal humeral fractures are common injuries. The management, including surgical intervention, of these fractures varies widely. ⋯ There is insufficient evidence to inform the management of these fractures. Early physiotherapy, without immobilisation, may be sufficient for some types of undisplaced fractures. It is unclear whether surgery, even for specific fracture types, will produce consistently better long term outcomes.