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International Journal of Audiology Oct 2023The study investigated the relationship between the strength of the medial olivocochlear reflex (measured via contralateral inhibition of otoacoustic emissions) and... (Review)
Review
OBJECTIVE
The study investigated the relationship between the strength of the medial olivocochlear reflex (measured via contralateral inhibition of otoacoustic emissions) and speech perception in noise (obtained from behavioural identification task) through meta-analyses.
DESIGN
A systematic review and random-effects meta-analysis of studies investigating the relationship in neurotypical adults was performed.
STUDY SAMPLE
The systematic search (in PubMed, Scopus, Science Direct and Google Scholar databases) revealed 21 eligible studies, which were critically appraised using the NIH tool for Observational Cohort and Cross-Sectional Studies. Meta-analysis was performed on 17 studies (374 participants) with fair to good quality.
RESULTS
The results revealed that the medial olivocochlear reflex accounts for less than 1% of the variations in speech perception in noise in neurotypical individuals. Sub-group analyses conducted to address a few methodological differences also revealed no discernible association between the two variables.
CONCLUSIONS
The results reveal no modulatory effect of the medial olivocochlear reflex assessed using contralateral inhibition of otoacoustic emission on the ability to perceive speech in noise. However, more data utilising alternative measures of medial olivocochlear reflex strength is necessary before drawing any conclusions about the role of the medial olivocochlear bundle in speech perception in noise.
PubMed: 37791429
DOI: 10.1080/14992027.2023.2260951 -
Arthroscopy : the Journal of... Jan 2011Meniscal allograft transplantation (MAT) has become an accepted treatment option for patients undergoing meniscectomy with recalcitrant pain in the corresponding... (Review)
Review
PURPOSE
Meniscal allograft transplantation (MAT) has become an accepted treatment option for patients undergoing meniscectomy with recalcitrant pain in the corresponding compartment. Whether MAT can oppose cartilage degeneration is unclear. Our purpose was to perform a systematic review of available literature to answer the following: (1) Does MAT prevent advancing chondrosis? (2) Who is the ideal candidate for MAT? (3) What is the survival time for allograft in a stable knee? (4) Can MAT be successful when performed with concomitant procedures? (5) Is there an outcome difference between medial and lateral meniscal allograft transplants? (6) What is the expected function of a knee that has undergone MAT?
METHODS
Two authors performed a systematic review of the literature pertaining to MAT. Included in the review are studies with at least 2 years' follow-up, studies with validated outcome measures, and studies in which the allograft meniscal horns were secured with bony fixation.
RESULTS
We identified 14 clinical articles that satisfied our inclusion and exclusion criteria. Thirteen of the articles provided Level IV evidence, and one article provided Level III evidence.
CONCLUSIONS
MAT can result in alleviation of knee pain, improvement in knee function, and good patient satisfaction if performed in the optimal candidate. Improvements in both objective and subjective outcome measures were shown in relatively young patients without significant chondromalacia who underwent concomitant procedures for cartilage defects, limb malalignment, and/or knee instability. We detected no significant difference in outcomes when comparing medial and lateral meniscal allograft transplants. We detected no significant difference when comparing isolated MAT with MAT performed with concomitant procedures.
LEVEL OF EVIDENCE
Level IV, systematic review of Level III and IV studies.
Topics: Arthroscopy; Humans; Joint Instability; Knee Injuries; Menisci, Tibial; Pain, Postoperative; Recovery of Function; Transplantation, Homologous; Treatment Outcome
PubMed: 20884166
DOI: 10.1016/j.arthro.2010.05.019 -
Assistive Technology : the Official... Sep 2022Knee osteoarthritis is a disabling disease, causing pain and reduced function.Orthoses are used to manage this problem, including knee braces and lateral wedge insoles.... (Meta-Analysis)
Meta-Analysis Review
Knee osteoarthritis is a disabling disease, causing pain and reduced function.Orthoses are used to manage this problem, including knee braces and lateral wedge insoles. However, there is still controversy on which type of intervention is more effective. This systematic review and meta-analysis aimed toevaluate the effect of knee braces and lateral wedge insoles and compare their clinical outcomes onindividuals with medial knee osteoarthritis. We conducted the search strategy based on the population, intervention, comparison, andoutcome (PICO) method. We searched with PubMed, EMBASE, Web of Science, and Scopus databases for the related studies. The articles quality assessment was done based on the modified Downs and Black checklist. Totally, we chose 32 controlled trials, including 1.849 participants, for the final evaluation. Almosttwo-thirds of the studies had a moderate quality. The overall outcome suggested that both interventionshad improved pain and function. The difference between both interventions on pain reduction was not significant (standardized mean difference = 0.12, 95% confidence interval = 0.34 to 0.1) based on meta-analysis. Both knee brace and lateral wedge insole can improve pain and function in people with knee osteoarthritis. Using either separately or both of them together are effective.
Topics: Braces; Humans; Orthotic Devices; Osteoarthritis, Knee; Pain
PubMed: 33507124
DOI: 10.1080/10400435.2021.1880495 -
The Journal of Knee Surgery Oct 2016The medial patellofemoral ligament (MPFL) plays a key role in lateral patellofemoral stability, and there has been significant clinical and research interest in MPFL... (Review)
Review
The medial patellofemoral ligament (MPFL) plays a key role in lateral patellofemoral stability, and there has been significant clinical and research interest in MPFL reconstruction (MPFLR) in recent years. The primary objective of this systematic review of clinical studies is to investigate the reported indications for an isolated MPFLR and secondarily to examine some of the reasons reported for not performing an isolated MPFLR. A comprehensive search of the MEDLINE, EMBASE, PUBMED, and Cochrane databases was conducted to identify surgical studies investigating MPFLR. Study information including author, publication date, sample size, patient age, follow-up period, procedure performed, surgical indications and contraindications, and study design were extracted. The most common indication for isolated MPFLR was recurrent patellofemoral instability (82.1%). Common reasons given for not performing an isolated MPFLR included bony malalignment (51.8%), trochlear dysplasia (30.4%), and patella alta (23.2%). This systematic review identified recurrent patellofemoral instability as the primary indication for an isolated MPFLR; however, a large number of the studies did not provide clear criteria for when an isolated MPFLR should be performed. Similarly, there was significant variability in the reasons given for not performing an isolated MPFLR.
Topics: Humans; Joint Dislocations; Joint Instability; Ligaments, Articular; Patellofemoral Joint; Plastic Surgery Procedures
PubMed: 26516072
DOI: 10.1055/s-0035-1564730 -
Arthroscopy : the Journal of... Jul 2023To systematically review the clinical and radiologic outcomes of isolated medial opening-wedge high tibial osteotomies with different bone void filling materials and to... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
To systematically review the clinical and radiologic outcomes of isolated medial opening-wedge high tibial osteotomies with different bone void filling materials and to compare the outcomes by network meta-analysis.
METHODS
This systematic review and network meta-analysis included searches of Medline, Embase, Cochrane Library, Web of Science, and Scopus from inception to July 30, 2022, for clinical comparative studies comparing 2 or more bone void filling materials in patients undergoing medial opening-wedge high tibial osteotomies. We performed Bayesian random-effect network meta-analyses to summarize the evidence and applied the Grading of Recommendations Assessment, Development, and Evaluation frameworks to rate the certainty of evidence, calculate the absolute effects, and present the findings. Cochrane Risk of Bias Tool 2.0 and modified Newcastle-Ottawa Scale were used to assess the risk of bias.
RESULTS
In total, 2,755 citations were identified by our search, of which 25 eligible trials, including 10 randomized controlled trials and 15 nonrandomized comparative trials (NCTs) enrolled 1,420 participants and 6 different interventions (autografts, allografts, synthetic grafts, mixed grafts, xenografts, and without grafts). There were some concerns on the risk of bias assessment among randomized controlled trials, and the median Newcastle-Ottawa Scale score was 6 for NCTs. All fillers showed no significantly superior treatment effects when compared with unfilled group in final Knee Society Scoring, Western Ontario and McMasters Universities score, time to bone union (TBU), and loss of correction (LOC). Exceptionally, moderate-certainty evidence suggested that autograft would produce superior incidence of complete bone union (CBU) than the unfilled at postoperative 1 year (odds ratio [OR] 13.0, 95% confidence interval [CI] 1.60-95.6), whereas low- to very low-certainty evidence suggested allografts (OR 0.2, 95% CI 0.06-0.52) and synthetic grafts (OR 0.29, 95% CI 0.10-0.68) would result in inferior CBU. Low-certainty evidence suggested allografts would result in larger LOC angle than unfilled group (mean difference 1.1, 95% CI 0.1-2.3). As for TBU, low-certainty evidence suggested mixed grafts would take longer time to reach clinical bone union (mean difference -14.04, 95% CI -21.0 to -6.9).
CONCLUSIONS
There is a lack of efficacy for different bone void filling materials to result better outcomes in Knee Society Scoring, Western Ontario and McMasters Universities score, TBU, and LOC than without graft. Although applying the autografts would produce a superior possibility of radiologic CBU than other fillers, because of the inclusion of NCTs, the overall certainty of the evidence synthesis is low.
LEVEL OF EVIDENCE
Level Ⅲ, meta-analysis of Level I randomized controlled trials and Level Ⅱ-Ⅲ non-randomized comparative trials.
Topics: Humans; Network Meta-Analysis; Bayes Theorem; Osteotomy; Transplantation, Homologous; Transplantation, Autologous
PubMed: 36581002
DOI: 10.1016/j.arthro.2022.11.039 -
Orthopaedic Journal of Sports Medicine Nov 2021In cases of multiple ligaments or medial collateral ligament (MCL) reconstruction, restoring the native anatomy of the posterior oblique ligament (POL) to address... (Review)
Review
Midterm Outcomes, Complications, and Return to Sports After Medial Collateral Ligament and Posterior Oblique Ligament Reconstruction for Medial Knee Instability: A Systematic Review.
BACKGROUND
In cases of multiple ligaments or medial collateral ligament (MCL) reconstruction, restoring the native anatomy of the posterior oblique ligament (POL) to address chronic valgus instability has been attracting increased attention.
PURPOSE
To review the current literature on postoperative outcomes, complications, and return to sports after superficial MCL-POL (sMCL-POL) reconstruction to restore medial knee integrity.
STUDY DESIGN
Systematic review; Level of evidence, 4.
METHODS
A systematic review was conducted based on the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Two independent reviewers searched the PubMed, Scopus, Embase, and Cochrane Library databases using the terms "posterior oblique ligament," "posteromedial corner of the knee," and "reconstruction." Included were studies that reported postoperative clinical and functional outcomes in patients who had undergone a combined sMCL-POL reconstruction for medial knee instability. The authors evaluated surgical technique, rehabilitation protocol, postoperative outcomes (Lysholm, International Knee Documentation Committee [IKDC], and Tegner scores and valgus stress radiograph), and return to sports and complication rates across the included studies.
RESULTS
A total of 6 studies were reviewed. The cohort consisted of 199 patients (121 men and 78 women), with a mean age of 32.7 ± 3.9 years (range, 27.4-36.6 years). The Lysholm and IKDC scores improved from pre- to postoperatively (Lysholm, from 67.2 ± 20.4 to 89.4 ± 3; IKDC, from 45.8 ± 2.1 to 84.8 ± 7.5). The Tegner score produced satisfactory results, from a preoperative mean of 3.3 ± 2.4 to 6.3 ± 0.9 postoperatively. The medial joint opening on valgus stress radiographs ranged from 7.5 ± 1.1 mm preoperatively to 3 ± 3.1 mm postoperatively. After passing activity-specific functional and clinical tests, 88% to 91.3% of the patients were reported to have returned to recreational sports within 6 to 12 months postoperatively, whereas 10% of the patients developed postoperative complications.
CONCLUSION
Satisfactory clinical and functional outcomes, a high rate of return to recreational sports, and a low rate of postoperative complications were reported after an sMCL-POL reconstruction to restore medial knee integrity.
PubMed: 34888393
DOI: 10.1177/23259671211056070 -
Psychiatry Research. Neuroimaging Apr 2022Glutamate and N-acetylaspartate have been investigated in the neuropathology of chronic schizophrenia, with fewer studies focusing on early phase psychosis.... (Review)
Review
Glutamate and N-acetylaspartate have been investigated in the neuropathology of chronic schizophrenia, with fewer studies focusing on early phase psychosis. Additionally, there has been little review and synthesis of the literature focused on multiple brain regions. This systematic review aims to provide a clear report of the current state of research on glutamate and n-acetylaspartate concentrations in early phase psychosis (defined as the first five years following psychosis onset) in multiple brain regions. Existing literature was searched systematically to compile reports of glutamate/glutamate+glutamine (Glx) and n-acetylaspartate absolute levels and ratios in both male and female individuals with early phase psychosis. Reports on glutamate/Glx concentrations in the medial prefrontal region and thalamus were varied, but the majority of reports suggested no alterations in EPP. No studies reported glutamate alterations in the hippocampus or cerebellum. There was no evidence for n-acetylaspartate alterations in the caudate, basal ganglia, and medial prefrontal cortex, and minimal evidence for NAA reductions in the thalamus, anterior cingulate cortex, and hippocampus. Future research should focus on the regions that are less commonly reported, and should aim to explore possible confounds, such as medication status and substance use.
Topics: Aspartic Acid; Female; Glutamic Acid; Glutamine; Humans; Male; Proton Magnetic Resonance Spectroscopy; Psychotic Disorders
PubMed: 35183897
DOI: 10.1016/j.pscychresns.2022.111459 -
Arthroscopy : the Journal of... Nov 2015To systematically review reconstruction techniques of the medial collateral ligament (MCL) and associated medial structures of the knee (e.g., posterior oblique... (Review)
Review
PURPOSE
To systematically review reconstruction techniques of the medial collateral ligament (MCL) and associated medial structures of the knee (e.g., posterior oblique ligament).
METHODS
A systematic review of Medline/PubMed Database (1966 to November 2013), reference list scanning and citation searches of included articles, and manual searches of high-impact journals (2000 to July 2013) and conference proceedings (2009 to July 2013) were performed to identify publications describing MCL reconstruction techniques of the knee. Exclusion criteria included (1) MCL primary repair techniques or advancement procedures, (2) lack of clear description of MCL reconstruction technique, (3) animal models, (4) nonrelevant study design, (5) and foreign language articles without available translation.
RESULTS
After review of 4,600 references, 25 publications with 359 of 388 patients (92.5%) were isolated for analysis, including 18 single-bundle MCL and 10 double-bundle reconstruction techniques. Only 2 techniques were classified as anatomic reconstructions, and clinical and objective outcomes (n = 28; 100% <3 mm side-to-side difference [SSD]) were superior to those with nonanatomic reconstruction (n = 182; 79.1% <3 mm SSD) and tendon transfer techniques (n = 114; 52.6% <3 mm SSD).
CONCLUSIONS
This systematic review demonstrated that numerous medial reconstruction techniques have been used in the treatment of isolated and combined medial knee injuries in the existent literature. Many variations exist among reconstruction techniques and may differ by graft choices, method of fixation, number of bundles, tensioning protocol, and degree of anatomic restoration of medial and posteromedial corner knee restraints. Further studies are required to better ascertain the comparative clinical outcomes with anatomic, non-anatomic, and tendon transfer techniques for medial knee reconstruction.
LEVEL OF EVIDENCE
Level IV, systematic review of level IV studies and surgical techniques.
Topics: Humans; Joint Instability; Knee Injuries; Medial Collateral Ligament, Knee; Plastic Surgery Procedures; Tendon Transfer
PubMed: 26194939
DOI: 10.1016/j.arthro.2015.05.011 -
Arthroscopy, Sports Medicine, and... Apr 2020To systematically review the literature to better understand the technique, outcomes, and complications after percutaneous superficial medial collateral ligament (sMCL)... (Review)
Review
PURPOSE
To systematically review the literature to better understand the technique, outcomes, and complications after percutaneous superficial medial collateral ligament (sMCL) lengthening during knee arthroscopy to address isolated medial meniscal pathology.
METHODS
A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using a PRISMA checklist. The inclusion criteria consisted of English-language articles or articles with English-language translations documenting the use of percutaneous sMCL lengthening during arthroscopic knee surgery to treat isolated meniscal pathology (repair vs meniscectomy) with reported postoperative outcomes and complications.
RESULTS
Four studies met the inclusion criteria, consisting of a total of 192 patients undergoing percutaneous sMCL lengthening. No perioperative complications related to iatrogenic chondral damage, fracture, or additional meniscal injury were reported. Mild postoperative pain at the medial needle tract site lasting up to 15 days after surgery was reported in 52% of patients (46 of 88). At final follow-up, laxity on valgus stress testing showed a range from 0 to 1.1 mm with a range from -0.3° to 0.9° of radiographic medial joint space widening compared with preoperative radiographs. The length of follow-up ranged from 1.5 to 24 months.
CONCLUSIONS
The percutaneous "pie-crusting" technique remains the most commonly reported technique to lengthen the sMCL during arthroscopic meniscal surgery. Percutaneous lengthening represents a safe and effective method of increasing medial joint space visualization, with no reported perioperative or postoperative complications and with minimal, likely clinically insignificant residual joint laxity after surgery on valgus stress testing at final follow-up compared with preoperative values.
LEVEL OF EVIDENCE
Level IV, systematic review of Level IV studies.
PubMed: 32368752
DOI: 10.1016/j.asmr.2019.10.009 -
Knee Surgery, Sports Traumatology,... Dec 2022To systematically review and critically appraise the literature on double-level osteotomy (DLO) of the knee, and determine the indications, contraindications, targets... (Review)
Review
PURPOSE
To systematically review and critically appraise the literature on double-level osteotomy (DLO) of the knee, and determine the indications, contraindications, targets and outcomes.
MATERIALS AND METHODS
A systematic literature search was performed on PubMed, Embase®, and Cochrane for studies that reported on DLO by any technique or approach, including indications, contraindications, and targets for DLO, as well as patient-reported outcome measures (pROMS) and radiographic angles.
RESULTS
Twelve eligible studies were found: 9 case series and 3 studies that compared DLO to high-tibial osteotomy (HTO). In all studies, DLO was performed by medial opening-wedge tibial osteotomy and lateral closing-wedge femoral osteotomy. Seven specified that DLO was performed if simple HTO would exceed thresholds of postoperative medial proximal tibial angle (MPTA), lateral distal femoral angle (LDFA), and/or predicted wedge size. The targets were 88°-95° for MPTA, 84°-89° for LDFA, and 0°-4° for hip-knee-ankle (HKA) angle. The 3 comparative studies reported lower MPTA after DLO (89.6°-92.5°) than after HTO (91.5°-98.3°). All 3 reported similar postoperative HKA after DLO (0.2°-4.4°) as HTO (0.4°-4.8°); only 2 compared postoperative LDFA, which was lower after DLO (85.4° and 84.9°) than HTO (88.7° and 88.8°). Two comparative studies reported postoperative overall KOOS which was slightly lower after DLO (351-403) than HTO (368-410); only 1 study reported separate items of the KOOS.
CONCLUSION
There was relative consistency between studies on the indications, targets and techniques for DLO. Furthermore, while the comparative studies reported similar preoperative MPTA, LDFA and HKA, the postoperative MPTA and LDFA were lower after DLO than after HTO, though both treatments achieved equivalent postoperative HKA.
LEVEL OF EVIDENCE
IV, systematic review.
Topics: Humans; Knee Joint; Osteoarthritis, Knee; Osteotomy; Retrospective Studies; Tibia
PubMed: 35290484
DOI: 10.1007/s00167-022-06915-6