Die klinische Anwendbarkeit evidenzbasierter Orthopädie - Eine Querschnittsstudie der Qualität der Evidenz orthopädischer Studien

Vavken, Patrick; Culen, G.; Dorotka, Ronald

doi:10.1055/s-2007-965802

Cited by 13 publications

(9 citation statements)

References 8 publications

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“…Using the Jadad scale, the overall quality of the studies was measured at a mean of 2.6 (95% CI,1.8-3.4), which is good compared to a study by Vavken et al 25 of the average quality scores for orthopaedic studies.…”

Section: Resultsmentioning

confidence: 91%

Focused Extracorporeal Shock Wave Therapy in Calcifying Tendinitis of the Shoulder: A Meta-Analysis

Vavken

Holinka

Rompe³

et al. 2009

Sports Health: A Multidisciplinary Approach

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Background:The objective of this study is to assess the effectiveness of extracorporeal shock wave therapy in the management of calcifying tendinitis of the shoulder. Furthermore, a dose-response relationship was sought as a secondary confirmation of effectiveness.Hypothesis:Focused extracorporeal shock wave therapy has a high, dose-responsive effectiveness in the management of calcifying tendinitis of the shoulder.Study Design:Meta-analysis.Methods:Studies were identified from online databases (MEDLINE, EMBASE, and Cochrane Controlled Trials Register), manual searches, and personal communication with experts in the field. After assessment of heterogeneity, a random effects model was generated. The primary end points were identified as pain and function by using the visual analog scale and the Constant-Murley Score, respectively. These end points were pooled and the weighted mean differences and 95% confidence intervals were estimated. Odds ratios of the secondary end point deposit resorption were pooled.Results:In 14 studies, shock wave therapy led to a significantly higher reduction of pain (weighted mean difference, −2.8 points; 95% confidence interval, −4.2 to −1.5 points) and improvement of function (weighted mean difference, 19.8 points; 95% confidence interval, 13.4-26.3 points), compared to other treatments and placebo. High-energy treatment produced significantly better results than low-energy treatment for pain reduction (weighted mean difference, 1.7 points; 95% confidence interval, 0.7-2.6 points) and improvement of function (weighted mean difference, 10.7 points; 95% confidence interval, 7.2-14.1 points). These results are consistent with a dose-response relationship supporting the effectiveness of shock wave therapy.Conclusion:Shock wave therapy for calcifying tendinitis of the shoulder is effective in pain relief, function restoration, and deposit resorption; however, these conclusions are susceptible to bias arising from the limitations of the included studies.

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Section: Resultsmentioning

confidence: 91%

Focused Extracorporeal Shock Wave Therapy in Calcifying Tendinitis of the Shoulder: A Meta-Analysis

Vavken

Holinka

Rompe³

et al. 2009

Sports Health: A Multidisciplinary Approach

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“…There was one Level II study (33), 10 Level III studies (8, 17, 28, 30, 33, 35, 42, 43, 48, 55, 57), and 37 Level IV studies (Table 1). Most studies were longitudinal analyses of single cohorts without controls and without randomization; this situation is representative of the studied field (59). We categorized all studies by level of evidence to underscore the differences in the likelihood of bias of their respective results.…”

Section: Resultsmentioning

confidence: 99%

Treating Anterior Cruciate Ligament Tears in Skeletally Immature Patients

Vavken¹,

Murray²

2011

Arthroscopy: The Journal of Arthroscopic & Related Surgery

151

106

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Purpose To systematically review the current evidence for conservative and surgical treatment of anterior cruciate ligament (ACL) tears in skeletally immature patients. Methods A systematic search of PubMed, CINAHL, EMBASE, CCTR, and CDSR was performed for surgical and/or conservative treatment of complete ACL tears in immature individuals. Studies with less than six months of follow-up were excluded. Study quality was assessed and data were collected on clinical outcome, growth disturbance, and secondary joint damage. Results We identified 48 studies meeting the inclusion criteria. Conservative treatment was found to result in poor clinical outcomes and a high incidence of secondary defects, including meniscal and cartilage injury. Surgical treatment had only very weak evidence for growth disturbance, yet strong evidence of good postoperative stability and function. No specific surgical treatment showed clearly superior outcomes, yet the studies using physeal-sparing techniques had no reported growth disturbances at all. Conclusions The current best evidence suggests that surgical stabilization should be considered the preferred treatment in immature patients with complete ACL tears. While physeal-sparing techniques are not associated with a risk of growth disturbance, transphyseal reconstruction is an alternative with a beneficial safety profile and a minimal risk of growth disturbance. Conservative treatment commonly leads to meniscal damage and cartilage destruction and should be considered a last resort. Level of Evidence Level IV, systematic review of Level II, III, and IV studies.

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“…1). Der mittlere Jadad-Score dieser Studien war 2,1 ± 0,9, und lag damit im üblichen Bereich für orthopädische Studien [29]. Dutton [23 -28].…”

Section: Suchergebnisse Und Eingeschlossene Studienunclassified

Ergebnisse nach minimalinvasivem Knieersatz – eine Metaanalyse

Vavken

Gruber²,

Dorotka³

2008

Z Orthop Unfall

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Die klinische Anwendbarkeit evidenzbasierter Orthopädie - Eine Querschnittsstudie der Qualität der Evidenz orthopädischer Studien

Cited by 13 publications

References 8 publications

Focused Extracorporeal Shock Wave Therapy in Calcifying Tendinitis of the Shoulder: A Meta-Analysis

Focused Extracorporeal Shock Wave Therapy in Calcifying Tendinitis of the Shoulder: A Meta-Analysis

Treating Anterior Cruciate Ligament Tears in Skeletally Immature Patients

Ergebnisse nach minimalinvasivem Knieersatz – eine Metaanalyse

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