ABSTRACT
Objective: This study aimed to investigate the efficacy of electroacupuncture (EA) combined with growth hormone in alleviating quadriceps atrophy and enhancing knee function following anterior cruciate ligament reconstruction. Methods: A prospective study was conducted, and a total of 90 patients exhibiting quadriceps atrophy after anterior cruciate ligament reconstruction were recruited between July 2020 and July 2022 from Shenzhen Pingle Orthopedic Hospital. They were randomly assigned to either the control group or the observation group , with 45 patients in each. The control group received routine rehabilitation training along with growth hormone treatment, while the observation group received routine rehabilitation training in addition to EA and growth hormone treatment. The study assessed the visual analogue score (VAS) for postoperative pain, knee function, and clinical outcomes in both groups. Results: The total effective rate in the observation group was significantly higher compared to the control group, with a statistically significant difference (P < .05). Initially, there were no significant differences between the two groups in peri-thigh atrophy index, VAS score, Lysholm score, knee swelling, knee stability, and range of motion (ROM) score (P > .05). However, after 3 and 6 months of treatment, significant reductions were observed in peri-thigh atrophy index, VAS score, knee swelling, and ROM score in the observation group compared to the control group (P < .05). Moreover, Lysholm score and knee stability significantly increased in the observation group (P < .05), with changes significantly higher than those in the control group (P < .05). Conclusions: EA combined with growth hormone treatment significantly reduces quadriceps atrophy and knee joint function in patients undergoing anterior cruciate ligament reconstruction. This combination therapy holds promise for enhancing rehabilitation outcomes in this patient population.
ABSTRACT
BACKGROUND: The biological mechanisms underlying the use of platelet-rich plasma (PRP), as well as the efficacy and possible adverse effects of PRP, have not yet been fully elucidated. Prior studies have evaluated PRP for cutaneous ulceration. However, the benefits from PRP still remain controversial and few have assessed the effects of ulceration etiologies. The purpose of our study is to determine the efficacy and safety of PRP and which kind of ulcer is more suitable for PRP by analyzing the effects of PRP on ulcers with different causes. METHODS: A comprehensive search was performed to identify randomized controlled trials (RCTs) regarding the application of PRP from PubMed, EMBASE, Scopus, and the Cochrane Library. The data were analyzed using Review Manager 5.3. RESULTS: A total of nineteen RCTs (909 patients) were included. In contrast with conventional treatments, PRP achieved higher healing rate, higher percentage of area reduction, and smaller final area in vascular ulcers. However, the advantage disappeared in diabetic and pressure ulcers. Concerning adverse events, PRP showed lower incidence in the short term, but higher in the long term. No significant differences were found in ulcer closure velocity and healing time. CONCLUSION: Platelet-rich plasma effectiveness and safety in treating cutaneous ulceration depend on what is the ulceration etiology. For diabetic ulcers, PRP showed no satisfactory results suggesting that PRP may not be suitable for diabetic patients. However, PRP could be efficient and more beneficial for vascular ulcers and effects on pressure ulcers remain unclear. Thus, PRP option should be carefully considered for each patient in accordance with their ulceration etiologies.
Subject(s)
Diabetic Foot/therapy , Platelet-Rich Plasma , Skin Ulcer/therapy , Wound Healing , Humans , Randomized Controlled Trials as Topic , Skin Ulcer/etiology , Time Factors , Treatment OutcomeABSTRACT
BACKGROUND: The use of less-invasive techniques in the treatment of displaced intra-articular calcaneal fractures (DIACFs) remains controversial. No prior meta-analysis has considered the influence of differences in the fracture type. Thus, our meta-analysis aimed to investigate the efficacy and safety of minimally invasive (MI) in Sanders type II and III fractures. MATERIALS AND METHODS: A comprehensive search was performed to identify RCTs comparing MI using sinus tarsi approach (STA) or percutaneous reduction (PR) to open reduction (OR) via extensile lateral approach (ELA) from the Cochrane Library, PubMed, Embase and CNKI. Dichotomous and continuous data were pooled using risk ratio (RR) and mean difference (MD), respectively, with 95% confidence intervals (CIs). The data were analysed using Review Manager 5.3. RESULTS: Eight RCTs (495 participants) were selected in our meta-analysis. Based on the American Orthopaedic Foot and Ankle Society score (AOFAS), both general pooled data and subgroup analysis of Sanders type II fractures indicated that MI improves functional outcomes, while in the Sanders type III subgroup, the advantage disappeared. Additionally, the pooled results showed that MI reduces the rate of wound complications; lowers the VAS score; and shortens the time to surgery, duration of surgery and length of hospital stay. There was no statistical significance with respect to recovery of calcaneus length and width or improvement of Gissane's angle and Bohler's angle. CONCLUSION: Our meta-analysis suggests that MI and ELA are equally effective treating Sanders type II and III fractures. However, MI is effective in improving the AOFAS score (Sanders type II); reducing the rate of wound complications; and shortening the time to surgery, duration of surgery and length of hospital stay.