BACKGROUND: Return to work (RTW) is an important outcome in Total Knee Arthroplasty (TKA). At pre... more BACKGROUND: Return to work (RTW) is an important outcome in Total Knee Arthroplasty (TKA). At present, 70–80%of TKA patients return to work within three to six months. OBJECTIVE: What are patients’ perspectives regarding beneficial and limiting factors in RTW after TKA? METHODS: Focus groups were formed in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Three major topics were explored: 1. What was beneficial for RTW after TKA; 2. What was limiting for RTW after TKA; and 3. What additional care would benefit RTW after TKA? RESULTS: Data saturation was reached after four focus groups, comprising 17 participants—nine men and eight women (median age 58, range 52–65). The focus group study identified four main themes that contributed to a successful RTW namely rehabilitation (medical) like post-operative physical therapy, patient characteristics (personal), like motivation to RTW, occupational characteristics (work-related) like build-up i...
Cryotherapy is applied in Total Knee Arthroplasty (TKA) to improve functional outcome. The aim of... more Cryotherapy is applied in Total Knee Arthroplasty (TKA) to improve functional outcome. The aim of this study is to investigate whether an advanced cryotherapy device does not increase the risk of complications and improves knee function or decreases swelling. A prospective cohort of TKA patients was formed by a cryotherapy group and a control group. The primary outcome was complication ratio. Our secondary outcomes were functional results and swelling. No significant differences were found in complication ratio between 31 patients in the cryotherapy group and 31 patients in the control group. The cryotherapy group showed a significant better knee flexion and less swelling in the early rehabilitation phase. No differences were found at the other follow-up moments or in the other outcomes. This advanced cryotherapy device is safe in respect of postoperative complications, improves knee function and decreases swelling in the early rehabilitation phase. However, it is questionable if an...
Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Scaffold-Based Therapies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each...
Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Conservative Management and Biological Treatment Strategies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed ...
Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Diagnosis: History, Physical Examination, Imaging, and Arthroscopy” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was per...
Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle is based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Fixation Techniques” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each state...
The evidence supporting best practice guidelines in the field of cartilage repair of the ankle ar... more The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on "Debridement, Curettage and Bone Marrow Stimulation" developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available ev...
We conducted a meta-analysis and systematic review with the primary objective to determine the ov... more We conducted a meta-analysis and systematic review with the primary objective to determine the overall incidence of radial head prosthesis removal or revision. Our secondary objectives addressed the incidence of removal or revision based on the type of prosthesis fixation (cemented, uncemented smooth stem, uncemented press-fit), material (metal, Vitallium, titanium, pyrocarbon), and design (short vs long stem and monopolar vs bipolar), and the reasons for prosthetic removal or revision. We included 30 studies with a total of 1,017 patients out of whom 77 prostheses were removed and 45 prostheses were revised. The pooled rate of radial head prosthesis removal or revision was 10.0% (95% confidence interval, 7.3%-13.6%) with a mean follow-up of 38 months. Subgroup analysis showed that the incidence of removal/revision was lowest with the cemented fixation, longer-stem, Vitallium material, and bipolar prosthesis. More than half of the prostheses were removed/revised for excision of the ...
The purpose of this study was to compare the observer participation and satisfaction as well as i... more The purpose of this study was to compare the observer participation and satisfaction as well as interobserver reliability between two online platforms, Science of Variation Group (SOVG) and Traumaplatform Study Collaborative, for the evaluation of complex tibial plateau fractures using computed tomography in MPEG4 and DICOM format. A total of 143 observers started with the online evaluation of 15 complex tibial plateau fractures via either the SOVG or Traumaplatform Study Collaborative websites using MPEG4 videos or a DICOM viewer, respectively. Observers were asked to indicate the absence or presence of four tibial plateau fracture characteristics and to rate their satisfaction with the evaluation as provided by the respective online platforms. The observer participation rate was significantly higher in the SOVG (MPEG4 video) group compared to that in the Traumaplatform Study Collaborative (DICOM viewer) group (75 and 43%, respectively; P < 0.001). The median observer satisfacti...
Eponymous terms are used frequently in daily patient care and scientific literature. They remind ... more Eponymous terms are used frequently in daily patient care and scientific literature. They remind us of our predecessors in surgery. It is debatable whether eponymous terms are reliable in case of information transfer. The aim of our study was to investigate whether the original meaning of eponymous terms in shoulder and elbow surgery has been preserved in its use in contemporary literature. To evaluate whether eponymous terms were used correctly, we analysed the use of frequently encountered eponymous terms from January to December 2014. By means of a PubMed search, articles with eponymous terms were identified and analysed for the way an eponymous term was used, and we compared it with the original description. The original description was traced back to the index publication. The use of the eponymous term was scored as similar, divergent or undefined. In the search for eponymous terms, we included those eponymous terms that were used more than 10 times in the English, German and D...
Introduction. Chondrosarcomas are malignant bone tumors that are characterized by the production ... more Introduction. Chondrosarcomas are malignant bone tumors that are characterized by the production of chondroid tissue. Since radiation therapy and chemotherapy have limited effect on chondrosarcoma, treatment of most patients depends on surgical resection. We conducted this study to identify independent predictive factors and survival characteristics for conventional central chondrosarcoma and dedifferentiated central chondrosarcoma.Methods. A systematic literature review was performed in September 2014 using the Pubmed, Embase, and Cochrane databases. Subsequent to a beforehand-composed selection procedure we included 13 studies, comprising a total of 1114 patients.Results. The prognosis of central chondrosarcoma is generally good for the histologically low-grade tumors. Prognosis for the high-grade chondrosarcoma and the dedifferentiated chondrosarcoma is poor with lower survival rates. Poor prognostic factors in conventional chondrosarcoma for overall survival are high-grade tumor...
Radial head fractures are commonly interpreted as isolated injuries, and it is assumed that the e... more Radial head fractures are commonly interpreted as isolated injuries, and it is assumed that the energy transferred during trauma has its influence on the risk on associated ipsilateral upper limb injuries. However, relationships between Mason classification, mechanism of injury, and associated injuries have been reported only once before in a relatively small population. The purpose of this study was to define whether trauma mechanism and patient related factors are of influence on the type of radial head fracture and associated injuries to the ipsilateral upper limb in 440 patients. The radiographs and medical records of 440 patients that presented with a fracture of the radial head were retrospectively analyzed. The medical records of all patients were searched for (1) the trauma mechanism and (2) associated injuries of the ipsilateral upper limb. The mechanism of injury was classified as being low-energy trauma (LET) or high-energy trauma (HET). Associated injuries to the ipsilat...
The British journal of general practice : the journal of the Royal College of General Practitioners, 2001
Lateral epicondylitis (tennis elbow) is af requently reported condition. A wide variety of treatm... more Lateral epicondylitis (tennis elbow) is af requently reported condition. A wide variety of treatment strategies has been described. Asy et, no optimal strategy has been identified. The aim of this review was to assess the effectiveness of orthotic devices for treatment of tennis elbow. An electronic database search was conducted using MEDLINE, EMBASE, CINAHL, the Cochrane Controlled Trial Register Current Contents, and reference listsf rom all retrieved articles. Experts on the subjects were approachedfor additional trials. All randomised controlled trials (RCTs) descrbiing individuals with diagnosed lateral epicondylitis and assessing the use of an orthotic device as a treatment strategy were evaluatedfor inclusion. Two reviewers independently assessed the validity of the included trials and extracted data on relevant outcome measures. Dichotomous outcomes were expressed as relative risks and continuous outcomes as standardised mean differences, both with corresponding 95% confiden...
... 28] preventie van recidieven De belangrijkste risicofactor voor het verzwikken van de enkel i... more ... 28] preventie van recidieven De belangrijkste risicofactor voor het verzwikken van de enkel is een eer-der inversietrauma. Het voorkomen van recidiverend verzwikken van de enkel is belang-rijk om twee redenen. Ten eerste ...
Patellofemoral pain syndrome is a frequently reported condition in active adults. A wide variety ... more Patellofemoral pain syndrome is a frequently reported condition in active adults. A wide variety of conservative treatment strategies have been described. As yet, no optimal strategy has been identified. Application of orthotic devices e.g. knee braces, knee straps, forms of taping of the knee, active training devices, knee sleeves and in-shoe orthotics to support the foot have been advocated to treat this condition. To assess the effectiveness of foot and knee orthotics for treatment of patellofemoral pain syndrome. We searched the Cochrane Musculoskeletal Injuries Group specialised register (December 2001), the Cochrane Controlled Trials register (Issue 2, 2000), MEDLINE (January 1966 to March 2000; EMBASE (January 1988 to March 2000); CINAHL (January 1982 to March 2000) and PEDro (up to March 2000). Relevant orthotic companies were contacted. All randomised and quasi-randomised trials comparing the effectiveness of knee or foot orthotics for treatment of patellofemoral pain syndrome were selected. Trials describing the use of orthotic devices in conjunction with operative treatment were excluded. Three reviewers independently assessed methodological quality of the identified trials by use of a modified version of the Cochrane Musculoskeletal Injuries Group assessment tool, consisting 11 items. Two reviewers extracted data without blinding. Trialists were contacted to obtain missing data. Five trials involving 362 participants were included in this review. Five other trials await possible inclusion if further information can be obtained and one awaits further assessment. Due to clinical heterogeneity, we refrained from statistical pooling and conducted analysis by grading the strength of scientific evidence. The level of obtained research-based evidence was graded as limited as all trials were of low methodological quality. This limited research-based evidence showed the Protonics orthosis at six week follow-up was significantly more effective for decrease in pain (weighted mean difference (WMD) between groups 3.2; 95% confidence interval (CI) 2.8 to 3.6), functional improvement on the Kujala score (WMD 45.6; 95% CI 43.4 to 47.7) and change in patellofemoral congruence angle (WMD 17.2; 95% CI 14.1 to 20.3) when compared to no treatment. A comprehensive programme including tape application was significantly superior to a monitored exercise programme without tape application for decrease in worst pain (WMD 1.6; 95% CI 0.4 to 2.8) and usual pain (WMD 1.2; 95% CI 0.2 to 2.1), and clinical change and functional improvement questionnaire scores (WMD 10, 95% CI 2.07 to 17.93) at four weeks follow-up. The trials reported statistically significant differences in patient satisfaction after applied therapy (WMD 3.3; 95% CI 0.5 to 6.1) in favour of the McConnell regimen compared with the Coumans bandage at six weeks follow-up. The evidence from randomised controlled trials is currently too limited to draw definitive conclusions about the use of knee and foot orthotics for the treatment of patellofemoral pain. Future high quality trials in this field are warranted.
BACKGROUND: Return to work (RTW) is an important outcome in Total Knee Arthroplasty (TKA). At pre... more BACKGROUND: Return to work (RTW) is an important outcome in Total Knee Arthroplasty (TKA). At present, 70–80%of TKA patients return to work within three to six months. OBJECTIVE: What are patients’ perspectives regarding beneficial and limiting factors in RTW after TKA? METHODS: Focus groups were formed in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist. Three major topics were explored: 1. What was beneficial for RTW after TKA; 2. What was limiting for RTW after TKA; and 3. What additional care would benefit RTW after TKA? RESULTS: Data saturation was reached after four focus groups, comprising 17 participants—nine men and eight women (median age 58, range 52–65). The focus group study identified four main themes that contributed to a successful RTW namely rehabilitation (medical) like post-operative physical therapy, patient characteristics (personal), like motivation to RTW, occupational characteristics (work-related) like build-up i...
Cryotherapy is applied in Total Knee Arthroplasty (TKA) to improve functional outcome. The aim of... more Cryotherapy is applied in Total Knee Arthroplasty (TKA) to improve functional outcome. The aim of this study is to investigate whether an advanced cryotherapy device does not increase the risk of complications and improves knee function or decreases swelling. A prospective cohort of TKA patients was formed by a cryotherapy group and a control group. The primary outcome was complication ratio. Our secondary outcomes were functional results and swelling. No significant differences were found in complication ratio between 31 patients in the cryotherapy group and 31 patients in the control group. The cryotherapy group showed a significant better knee flexion and less swelling in the early rehabilitation phase. No differences were found at the other follow-up moments or in the other outcomes. This advanced cryotherapy device is safe in respect of postoperative complications, improves knee function and decreases swelling in the early rehabilitation phase. However, it is questionable if an...
Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Scaffold-Based Therapies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each...
Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Conservative Management and Biological Treatment Strategies” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed ...
Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Diagnosis: History, Physical Examination, Imaging, and Arthroscopy” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was per...
Background: The evidence supporting best practice guidelines in the field of cartilage repair of ... more Background: The evidence supporting best practice guidelines in the field of cartilage repair of the ankle is based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on “Fixation Techniques” developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Methods: Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each state...
The evidence supporting best practice guidelines in the field of cartilage repair of the ankle ar... more The evidence supporting best practice guidelines in the field of cartilage repair of the ankle are based on both low quality and low levels of evidence. Therefore, an international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to report the consensus statements on "Debridement, Curettage and Bone Marrow Stimulation" developed at the 2017 International Consensus Meeting on Cartilage Repair of the Ankle. Seventy-five international experts in cartilage repair of the ankle representing 25 countries and 1 territory were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 11 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available ev...
We conducted a meta-analysis and systematic review with the primary objective to determine the ov... more We conducted a meta-analysis and systematic review with the primary objective to determine the overall incidence of radial head prosthesis removal or revision. Our secondary objectives addressed the incidence of removal or revision based on the type of prosthesis fixation (cemented, uncemented smooth stem, uncemented press-fit), material (metal, Vitallium, titanium, pyrocarbon), and design (short vs long stem and monopolar vs bipolar), and the reasons for prosthetic removal or revision. We included 30 studies with a total of 1,017 patients out of whom 77 prostheses were removed and 45 prostheses were revised. The pooled rate of radial head prosthesis removal or revision was 10.0% (95% confidence interval, 7.3%-13.6%) with a mean follow-up of 38 months. Subgroup analysis showed that the incidence of removal/revision was lowest with the cemented fixation, longer-stem, Vitallium material, and bipolar prosthesis. More than half of the prostheses were removed/revised for excision of the ...
The purpose of this study was to compare the observer participation and satisfaction as well as i... more The purpose of this study was to compare the observer participation and satisfaction as well as interobserver reliability between two online platforms, Science of Variation Group (SOVG) and Traumaplatform Study Collaborative, for the evaluation of complex tibial plateau fractures using computed tomography in MPEG4 and DICOM format. A total of 143 observers started with the online evaluation of 15 complex tibial plateau fractures via either the SOVG or Traumaplatform Study Collaborative websites using MPEG4 videos or a DICOM viewer, respectively. Observers were asked to indicate the absence or presence of four tibial plateau fracture characteristics and to rate their satisfaction with the evaluation as provided by the respective online platforms. The observer participation rate was significantly higher in the SOVG (MPEG4 video) group compared to that in the Traumaplatform Study Collaborative (DICOM viewer) group (75 and 43%, respectively; P < 0.001). The median observer satisfacti...
Eponymous terms are used frequently in daily patient care and scientific literature. They remind ... more Eponymous terms are used frequently in daily patient care and scientific literature. They remind us of our predecessors in surgery. It is debatable whether eponymous terms are reliable in case of information transfer. The aim of our study was to investigate whether the original meaning of eponymous terms in shoulder and elbow surgery has been preserved in its use in contemporary literature. To evaluate whether eponymous terms were used correctly, we analysed the use of frequently encountered eponymous terms from January to December 2014. By means of a PubMed search, articles with eponymous terms were identified and analysed for the way an eponymous term was used, and we compared it with the original description. The original description was traced back to the index publication. The use of the eponymous term was scored as similar, divergent or undefined. In the search for eponymous terms, we included those eponymous terms that were used more than 10 times in the English, German and D...
Introduction. Chondrosarcomas are malignant bone tumors that are characterized by the production ... more Introduction. Chondrosarcomas are malignant bone tumors that are characterized by the production of chondroid tissue. Since radiation therapy and chemotherapy have limited effect on chondrosarcoma, treatment of most patients depends on surgical resection. We conducted this study to identify independent predictive factors and survival characteristics for conventional central chondrosarcoma and dedifferentiated central chondrosarcoma.Methods. A systematic literature review was performed in September 2014 using the Pubmed, Embase, and Cochrane databases. Subsequent to a beforehand-composed selection procedure we included 13 studies, comprising a total of 1114 patients.Results. The prognosis of central chondrosarcoma is generally good for the histologically low-grade tumors. Prognosis for the high-grade chondrosarcoma and the dedifferentiated chondrosarcoma is poor with lower survival rates. Poor prognostic factors in conventional chondrosarcoma for overall survival are high-grade tumor...
Radial head fractures are commonly interpreted as isolated injuries, and it is assumed that the e... more Radial head fractures are commonly interpreted as isolated injuries, and it is assumed that the energy transferred during trauma has its influence on the risk on associated ipsilateral upper limb injuries. However, relationships between Mason classification, mechanism of injury, and associated injuries have been reported only once before in a relatively small population. The purpose of this study was to define whether trauma mechanism and patient related factors are of influence on the type of radial head fracture and associated injuries to the ipsilateral upper limb in 440 patients. The radiographs and medical records of 440 patients that presented with a fracture of the radial head were retrospectively analyzed. The medical records of all patients were searched for (1) the trauma mechanism and (2) associated injuries of the ipsilateral upper limb. The mechanism of injury was classified as being low-energy trauma (LET) or high-energy trauma (HET). Associated injuries to the ipsilat...
The British journal of general practice : the journal of the Royal College of General Practitioners, 2001
Lateral epicondylitis (tennis elbow) is af requently reported condition. A wide variety of treatm... more Lateral epicondylitis (tennis elbow) is af requently reported condition. A wide variety of treatment strategies has been described. Asy et, no optimal strategy has been identified. The aim of this review was to assess the effectiveness of orthotic devices for treatment of tennis elbow. An electronic database search was conducted using MEDLINE, EMBASE, CINAHL, the Cochrane Controlled Trial Register Current Contents, and reference listsf rom all retrieved articles. Experts on the subjects were approachedfor additional trials. All randomised controlled trials (RCTs) descrbiing individuals with diagnosed lateral epicondylitis and assessing the use of an orthotic device as a treatment strategy were evaluatedfor inclusion. Two reviewers independently assessed the validity of the included trials and extracted data on relevant outcome measures. Dichotomous outcomes were expressed as relative risks and continuous outcomes as standardised mean differences, both with corresponding 95% confiden...
... 28] preventie van recidieven De belangrijkste risicofactor voor het verzwikken van de enkel i... more ... 28] preventie van recidieven De belangrijkste risicofactor voor het verzwikken van de enkel is een eer-der inversietrauma. Het voorkomen van recidiverend verzwikken van de enkel is belang-rijk om twee redenen. Ten eerste ...
Patellofemoral pain syndrome is a frequently reported condition in active adults. A wide variety ... more Patellofemoral pain syndrome is a frequently reported condition in active adults. A wide variety of conservative treatment strategies have been described. As yet, no optimal strategy has been identified. Application of orthotic devices e.g. knee braces, knee straps, forms of taping of the knee, active training devices, knee sleeves and in-shoe orthotics to support the foot have been advocated to treat this condition. To assess the effectiveness of foot and knee orthotics for treatment of patellofemoral pain syndrome. We searched the Cochrane Musculoskeletal Injuries Group specialised register (December 2001), the Cochrane Controlled Trials register (Issue 2, 2000), MEDLINE (January 1966 to March 2000; EMBASE (January 1988 to March 2000); CINAHL (January 1982 to March 2000) and PEDro (up to March 2000). Relevant orthotic companies were contacted. All randomised and quasi-randomised trials comparing the effectiveness of knee or foot orthotics for treatment of patellofemoral pain syndrome were selected. Trials describing the use of orthotic devices in conjunction with operative treatment were excluded. Three reviewers independently assessed methodological quality of the identified trials by use of a modified version of the Cochrane Musculoskeletal Injuries Group assessment tool, consisting 11 items. Two reviewers extracted data without blinding. Trialists were contacted to obtain missing data. Five trials involving 362 participants were included in this review. Five other trials await possible inclusion if further information can be obtained and one awaits further assessment. Due to clinical heterogeneity, we refrained from statistical pooling and conducted analysis by grading the strength of scientific evidence. The level of obtained research-based evidence was graded as limited as all trials were of low methodological quality. This limited research-based evidence showed the Protonics orthosis at six week follow-up was significantly more effective for decrease in pain (weighted mean difference (WMD) between groups 3.2; 95% confidence interval (CI) 2.8 to 3.6), functional improvement on the Kujala score (WMD 45.6; 95% CI 43.4 to 47.7) and change in patellofemoral congruence angle (WMD 17.2; 95% CI 14.1 to 20.3) when compared to no treatment. A comprehensive programme including tape application was significantly superior to a monitored exercise programme without tape application for decrease in worst pain (WMD 1.6; 95% CI 0.4 to 2.8) and usual pain (WMD 1.2; 95% CI 0.2 to 2.1), and clinical change and functional improvement questionnaire scores (WMD 10, 95% CI 2.07 to 17.93) at four weeks follow-up. The trials reported statistically significant differences in patient satisfaction after applied therapy (WMD 3.3; 95% CI 0.5 to 6.1) in favour of the McConnell regimen compared with the Coumans bandage at six weeks follow-up. The evidence from randomised controlled trials is currently too limited to draw definitive conclusions about the use of knee and foot orthotics for the treatment of patellofemoral pain. Future high quality trials in this field are warranted.
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