RESUMO
OBJECTIVES: This systematic review and meta-analysis investigated the mobility of the median nerve (MN) in carpal tunnel syndrome (CTS) patients compared to healthy people. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was followed and the electronic databases including PubMed, Scopus, EMBASE, and Cochrane Library were searched up to April 2022. All published observational studies comparing the excursion of MN between participants with and without CTS were included. The quality of research was assessed by the Newcastle-Ottawa Scale tool. The primary outcome was the excursion of the MN under dynamic examination, representing nerve mobility quantified by the standardized mean difference (SMD) for random effect meta-analysis. RESULTS: Fourteen studies were included in the qualitative review, and twelve entered the meta-analysis involving a total of 375 CTS patients and 296 healthy controls. The forest plot revealed that the mobility of the MN significantly decreased in the CTS group compared to the non-CTS control (SMD = -1.47, 95% CI: -1.91, -1.03, p < 0.001, heterogeneity 82%). In subgroup analysis, both transverse and longitudinal methods for nerve excursion showed less nerve mobility in CTS than in non-CTS. CONCLUSIONS: This meta-analysis showed that the patients with CTS exhibited less mobility of the MN than those without CTS, suggesting MN mobility as a potential CTS marker. KEY POINTS: ⢠The patients with CTS revealed less mobility of the median nerve than those without CTS. ⢠The mobility of the median nerve could be regarded as a potential CTS marker.
Assuntos
Síndrome do Túnel Carpal , Nervo Mediano , Humanos , Bibliometria , Bases de Dados FactuaisRESUMO
OBJECTIVE: The aim of this study was to investigate the effectiveness of platelet-rich plasma (PRP) injection after arthrocentesis or arthroscopy in patients with temporomandibular joint osteoarthritis. STUDY DESIGN: Electronic databases (PubMed, EMBASE, Scopus, and Cochrane Library) were searched for reports up to July 30, 2018. We included all published or unpublished randomized controlled trials (RCTs). The primary outcome was pain reduction, and the secondary outcome was the improvement of maximal mouth opening. Weighted mean differences were utilized for random-effect meta-analysis. RESULTS: Five RCTs were enrolled in the meta-analysis, comparing PRP injection to placebo (hyaluronic acid [HA] injection, saline injection, or no injection). The results revealed that PRP injection was more effective than placebo in pain reduction, but no in the improvement of maximal mouth opening, in the long term. In the subgroup analysis, PRP injection yielded better outcome only in pain reduction comparing to HA injection (Weighted mean difference 1.34, 95% confidence interval [CI] 0.95-1.73). CONCLUSIONS: This meta-analysis demonstrated that PRP injection provided adjuvant efficacy to arthrocentesis or arthroscopy in pain reduction for temporomandibular joint osteoarthritis in the long term. Furthermore, PRP injection significantly reduced pain better compared with HA injection, saline injection, or no injection.