Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · Jan 2020
Review Meta AnalysisA comparison of aspirin against rivaroxaban for venous thromboembolism prophylaxis after hip or knee arthroplasty: A meta-analysis.
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) patients are at an elevated risk of post-operative venous thromboembolism (VTE). Newer thromboprophylactic agents such as rivaroxaban are increasingly used and effective in preventing thromboembolic events but may worsen bleeding risk. Recent studies have suggested that the more cost-effective aspirin may also be effective in preventing VTE. This systematic review and meta-analysis aimed to compare the efficacy of aspirin against rivaroxaban for the prevention of VTE following TKA and THA. ⋯ Aspirin was not significantly different to rivaroxaban for prevention of VTE or adverse events after TKA or THA. However, this study was limited by the significant heterogeneity of the included studies. More large randomized studies are needed to add to this body of evidence.
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J Orthop Surg (Hong Kong) · Jan 2020
Meta Analysis Comparative StudySuture versus screw fixation technique for tibial eminence fracture: A meta-analysis of laboratory studies.
The aim of this study was to compare the biomechanical properties between the suture fixation technique and the screw fixation technique for tibial eminence fracture (TEF). ⋯ The FiberWire suture fixation may be biomechanically superior to a single screw fixation in TEF treatment in mature knees regarding ultimate failure load, while no significant difference was found between the two fixations in terms of stiffness and displacement after the cyclic testing.
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J Orthop Surg (Hong Kong) · Jan 2020
Meta Analysis Comparative StudyConservative versus repair of medial patellofemoral ligament for the treatment of patients with acute primary patellar dislocations: A systematic review and meta-analysis.
The aim of this study was to perform a meta-analysis to compare the effects of repair of medial patellofemoral ligament (MPFL) and conservative treatment in patients with acute primary patellar dislocation (PPD). ⋯ Based on the available data, MPFL repair did not reduce the risk of redislocation nor did it produce any significantly better outcome based on the clinical manifestations, including anterior knee pain and knee activities. Only the Kujala score was improved by MPFL repair compared with conservative treatment.
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J Orthop Surg (Hong Kong) · Jan 2020
Outcome of nonoperative treatment for hip fractures in elderly patients: A systematic review of recent literature.
Many studies have shown that surgical management still leads to the best outcomes in elderly patients with hip fractures, with some studies showing non-inferiority of nonsurgical management as compared to surgery in fragility fractures. Evidence-based guidelines on whether to operate on these patients are lacking. A systematic literature search was conducted regarding outcomes of nonoperatively treated hip fractures in elderly patients with various comorbidities. ⋯ Of the 110 patients whose reported cause of death was nonoperative care, 44 (40%) was due to pneumonia. Patients with nonoperative treatment following hip fracture were associated with substantially higher complication and mortality compared with patients who were treated operatively. Our study will help health-care providers and caregivers to enable more informed decision-making for families and patients confronted with a hip fracture.
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J Orthop Surg (Hong Kong) · Jan 2020
Review Meta AnalysisPlatelet-rich plasma versus hyaluronic acid in knee osteoarthritis: A meta-analysis with the consistent ratio of injection.
Osteoarthritis (OA) is an extremely common form of chronic joint disease which can affect the knees and other joints of older adults, leading to debilitating disability in the knee and consequent reduction in quality of life. Intra-articular platelet-rich plasma (PRP) or hyaluronic acid (HA) injections are effective for maintaining long-term beneficial effects without increasing the risk of intra-articular infection. However, few studies have compared the relative value of HA and PRP for OA treatment. ⋯ However, the IKDC, WOMAC, and VAS scores differed significantly. Thus, based on the current evidence, PRP appears to be better than HA at achieving pain relief and self-reported functional improvement. Ia, meta-analyses of randomized clinical trials.