1
|
Zhang B, Fang Z, Nian K, Sun B, Ji B. The effects of telemedicine on Rotator cuff-related shoulder function and pain symptoms: a meta-analysis of randomized clinical trials. J Orthop Surg Res 2024; 19:478. [PMID: 39143625 PMCID: PMC11323625 DOI: 10.1186/s13018-024-04986-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2024] [Accepted: 08/06/2024] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND The effectiveness of telemedicine in aiding rehabilitation exercises among patients with rotator cuff (RC) disorders remains unknown. Therefore, this meta-analysis aimed to assess the effectiveness of telemedicine in patients with RC disorders. METHODS Randomized clinical trials (RCTs) on the effectiveness of telemedicine in patients with RC disorders were summarized through a meta-analysis. A systematic search for these RCTs was conducted in PubMed, Cochrane, Embase, and Web of Science databases up to July 2024. Statistical analysis was performed using Stata 16. Publication bias was estimated with the funnel plot and Egger's test. RESULTS Ten studies involving 497 participants (telemedicine group = 248 and conventional group = 249) were enrolled, with follow-up durations ranging from 8 weeks to 48 weeks. Functional outcomes measured by the Constant-Murley score were markedly improved after treatment in the telemedicine group compared to the conventional group. Moreover, compared to conventional treatment, telemedicine significantly improved shoulder function evaluated by Quick Disabilities of the Arm, Shoulder, and Hand Score, relieved pain assessed by visual analog scale pain score, and improved range of motion after treatment and in the final follow-up period. CONCLUSION Telemedicine has demonstrated potential in alleviating pain and enhancing shoulder function and motion in patients with RC injuries. It may be a feasible intervention for rehabilitation exercises. Further research with a large sample size and standardized treatment is warranted to validate these findings.
Collapse
Affiliation(s)
- Boyi Zhang
- Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing, Zhejiang, 314000, China
- Department of Orthopedics, The First Hospital of Jiaxing, No. 1882 Zhonghuan South Road, Nanhu District, Jiaxing, Zhejiang, 314000, China
- Department of Orthopedics, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, 314000, China
| | - Zhihao Fang
- Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing, Zhejiang, 314000, China
| | - Kundang Nian
- Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing, Zhejiang, 314000, China
| | - Bing Sun
- Jiaxing University Master Degree Cultivation Base, Zhejiang Chinese Medical University, Jiaxing, Zhejiang, 314000, China
| | - Bin Ji
- Department of Orthopedics, The First Hospital of Jiaxing, No. 1882 Zhonghuan South Road, Nanhu District, Jiaxing, Zhejiang, 314000, China.
- Department of Orthopedics, Affiliated Hospital of Jiaxing University, Jiaxing, Zhejiang, 314000, China.
| |
Collapse
|
2
|
Marcano-Fernández F, Camara-Cabrera J, Madden K, Johal H, Nadeem IM, Kapoor R, Shehata M, Prada C. A Systematic Review of Outcome Measures in Orthopaedic Trauma Trials: What Are We Measuring? Indian J Orthop 2022; 56:1316-1326. [PMID: 35928659 PMCID: PMC9283598 DOI: 10.1007/s43465-022-00667-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/23/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE The objectives of this study are to describe the outcome measures used in orthopaedic fracture care trials, with a particular focus on patient-reported outcome measures (PROMs), and to determine which study characteristics are associated with number of citations. METHODS We retrieved randomized clinical trials on fracture care between 2012 and 2017 from Embase, Medline and CENTRAL databases. Data collected included study characteristics (e.g., region, design, setting, sample size) and outcome measures (e.g., primary variable, measurement perspective, use of PROMs, study results and number of citations). RESULTS We identified a total of 8,580 articles in the initial search. After title screening, abstract screening and full-text review, we included 416 articles for analysis. 58.4% (243) of the studies clearly defined a primary outcome measure and 56.3% (234) reported sample size justifications for outcome selection. The most common primary outcome reported was a visual analogue scale for pain; used in 21 of the 243 (8.6%) studies that defined a primary outcome. At least one PROM was used in 68.5% (285) of the papers included. CONCLUSIONS A large proportion of studies reporting on PROMs for orthopaedic trauma patients do not provide key information on the outcome selection process; a step of utmost importance in and the designing and reporting of RCTs. There is substantial heterogeneity in the selection of PROMs for fracture care trials, which limits the ability to compare and summarize across studies. Future research in fracture care should strive towards improving the reporting of informative PROMs, with rationale that demonstrates understating of the injury, intervention and patient values. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s43465-022-00667-8.
Collapse
Affiliation(s)
- Francesc Marcano-Fernández
- Orthopaedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc del Taulí, 1, 08208 Sabadell, Barcelona Spain
| | - Jaume Camara-Cabrera
- Orthopaedic Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Parc del Taulí, 1, 08208 Sabadell, Barcelona Spain
| | - Kim Madden
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7 Canada ,Department of Health Research Methods, Evidence, and Impact, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7 Canada
| | - Herman Johal
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7 Canada
| | | | - Raveena Kapoor
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7 Canada
| | - Michael Shehata
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7 Canada
| | - Carlos Prada
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7 Canada
| |
Collapse
|
3
|
Costa MT, Tejerina JFS, Silva CALD, Rêgo IEDQ, Bergamasco JMP, Marchi Neto ND. Avaliação da amplitude do movimento perna-pé. Qual método de aferição é mais fidedigno? Rev Bras Ortop 2022. [DOI: 10.1055/s-0042-1749620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Resumo
Objetivo Avaliar os métodos de mensuração do movimento perna-pé em tornozelos e pés normais comparando os resultados das medidas clínicas com a mensuração radiográfica e determinar qual é a amplitude do movimento perna-pé considerada normal.
Métodos O movimento perna-pé foi mensurado em 44 pacientes (60 pés) empregando um goniômetro tradicional, goniômetro digital, inclinômetro, aplicativo para smartphone, além da mensuração radiográfica (considerada padrão ouro). A dorsiflexão máxima foi alcançada pedindo ao paciente dar um passo à frente com o pé contralateral e realizar o máximo de dorsiflexão possível no tornozelo estudado sem retirar o calcanhar do solo. Já para a flexão plantar máxima, foi solicitado ao paciente para dar um passo para trás com pé contralateral e fazer o máximo de flexão plantar possível sem retirar o antepé estudado do solo.
Resultados Os valores obtidos na mensuração radiográfica foram maiores do que os obtidos com a mensuração clínica. Quando comparamos apenas os resultados da mensuração clínica, o goniômetro tradicional se mostrou impreciso. Segundo o método radiográfico, a média de amplitude do movimento perna-pé foi de 65,6 graus. Já a média da flexão plantar máxima foi de 34,9 graus, e a média da dorsiflexão máxima foi de 30,7 graus.
Conclusões O método mais adequado para a avaliação da amplitude do movimento perna-pé é o radiográfico. O goniômetro tradicional se mostrou o método clínico mais impreciso. A média de amplitude do movimento perna-pé em adultos jovens e saudáveis foi de 65 graus.
Collapse
Affiliation(s)
- Marco Túlio Costa
- Grupo do Pé e Tornozelo do Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Javier Felipe Salinas Tejerina
- Grupo do Pé e Tornozelo do Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Cesar Augusto Lima da Silva
- Grupo do Pé e Tornozelo do Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Itallo Epaminondas de Queiroz Rêgo
- Grupo do Pé e Tornozelo do Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Jordanna Maria Pereira Bergamasco
- Grupo do Pé e Tornozelo do Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
| | - Noé De Marchi Neto
- Grupo do Pé e Tornozelo do Departamento de Ortopedia e Traumatologia da Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brasil
| |
Collapse
|
4
|
Kvarda P, Heisler L, Krähenbühl N, Steiner CS, Ruiz R, Susdorf R, Sripanich Y, Barg A, Hintermann B. 3D Assessment in Posttraumatic Ankle Osteoarthritis. Foot Ankle Int 2021; 42:200-214. [PMID: 33073607 DOI: 10.1177/1071100720961315] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Auto-generated 3-dimensional (3D) measurements based on weightbearing cone-beam computed tomography (CT) scan technology may allow for a more accurate hind- and midfoot assessment. The current study evaluated the reliability and clinical relevance of such measurements in patients with posttraumatic end-stage ankle osteoarthritis. METHODS Seventy-two patients treated at our institution for posttraumatic end-stage ankle osteoarthritis, with available weightbearing conventional radiographs and a cone-beam CT scan, were analyzed. Twenty healthy individuals aged between 40 and 70 years served as controls. Seven variables were measured on weightbearing conventional radiographs (2D) and compared to 3D measurements that were based on reconstructions from weightbearing cone-beam CT scans. The reliability of each measurement was calculated and subgroups formed according to commonly observed deformities. RESULTS Inter- and intraobserver reliability was superior for 3D compared to 2D measurements. The accuracy of 3D measurements performed on osteoarthritic ankles was similar to 3D measurements performed on healthy individuals. Thirty-three of the 72 included patients (46%) evidenced an inframalleolar compensation of a supramalleolar/intra-articular ankle deformity (78% = varus compensation; 22% = valgus compensation), whereas 24 of those 72 patients (33%) showed no compensation or a further increase of a supramalleolar/intra-articular ankle deformity (67% = varus deformity; 33% = valgus deformity). CONCLUSION Auto-generated 3D measurements of the hind- and midfoot were found to be reliable in both healthy individuals and patients with posttraumatic end-stage ankle osteoarthritis. Such measurements may be crucial for a detailed understanding of the location and extent of hindfoot deformities, possibly impacting decision making in the treatment of end-stage ankle osteoarthritis. LEVEL OF EVIDENCE Level III, comparative study.
Collapse
Affiliation(s)
- Peter Kvarda
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Lukas Heisler
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Nicola Krähenbühl
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | | | - Roxa Ruiz
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Roman Susdorf
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Yantarat Sripanich
- Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Alexej Barg
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Beat Hintermann
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| |
Collapse
|
5
|
Ruiz R, Krähenbühl N, Susdorf R, Horn-Lang T, Barg A, Hintermann B. Ankle Range of Motion Following 3-Component Total Ankle Arthroplasty. Foot Ankle Int 2021; 42:31-37. [PMID: 32985282 DOI: 10.1177/1071100720955145] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Although surgeons have argued that preserving motion at the level of the ankle joint may be crucial for the long-term success in the treatment of end-stage ankle osteoarthritis, there is little evidence regarding the potential of total ankle arthroplasty (TAA) to increase ankle range of motion (ROM). In addition, the effect of a percutaneous heel cord lengthening (HCL) during TAA on ankle motion is poorly understood. METHODS A total of 357 primary TAAs treated with a 3-component device (336 patients, mean age 62.6 [24-85] years) performed between May 2003 and November 2017 were retrospectively analyzed. Sagittal ankle ROM was assessed according to a previously published protocol preoperatively (PreOP), 1 year postoperatively (PostOP), and at the last available follow-up (LastFU). Pain assessed on a visual analog scale (VAS) was assessed at the same time points. The effect of a percutaneous HCL on ankle ROM and VAS for pain was also evaluated. RESULTS Preoperative ankle ROM increased from mean 31.3 (0-69) to 33.9 (5-65) degrees 1 year postoperatively (P = .0002) and decreased to 31.9 (5-70) degrees at the LastFU (P = .007). Percutaneous HCL showed no effect on ankle ROM development after TAA (P = .141). Ankle ROM improvement after TAA (PreOP to LastFU) was higher in ankles with lower preoperative ankle motion (P < .0001). A lower ankle ROM at the last follow-up tended to be associated with a higher pain level (P = .056). CONCLUSION Although ankles with a lower preoperative sagittal ROM gained motion, the current data suggest that TAA has little potential to increase the preoperative available ankle motion. In some patients with a high preoperative ankle ROM, a slight decrease of ankle motion was observed postoperatively. Patients with limited ankle motion at long-term follow-up tended toward experiencing higher pain levels. The short- and long-term effect of a percutaneous HCL on ankle ROM following TAA was minimal. LEVEL OF EVIDENCE Level III, retrospective comparative series.
Collapse
Affiliation(s)
- Roxa Ruiz
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Nicola Krähenbühl
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Roman Susdorf
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Tamara Horn-Lang
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| | - Alexej Barg
- Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Orthopaedics, University of Utah, Salt Lake City, UT, USA
| | - Beat Hintermann
- Department of Orthopaedics, Kantonsspital Baselland, Liestal, Switzerland
| |
Collapse
|