If you are a surgeon, anaesthetist, haematologist or physiotherapist involved in the perioperative care of haemophilic patients undergoing lower limb arthroplasty you'll want to read these clinical practice recommendations. @HaemoSocUK@haemophilia_jnl
https://t.co/3A9JUI3ip5
Largest systematic review and network meta-analysis to date on de Quervain's tenosynovitis and clinical practice recommendations based on the highest level of evidence available. Great team effort as always!
Managing de Quervain’s tenosynovitis in the clinic remains challenging. This systematic review and network meta-analysis recommends corticosteroid followed by immobilization as first-line treatment. https://t.co/pxp4ktopg7 @dchalloumas@tendonglasgow@UofGSii
@GregLehman@jon_alessi@AdamMeakins@KThorborg@TendonGlasgow@Seth0Neill And this is because no other interventions (as monotherapies or with exercise) have produced results of strong enough evidence (i.e., moderate or high strength of evidence) to justify a clinical practice recommendation for their use. This may well come in the future though.
@GregLehman@jon_alessi@AdamMeakins@KThorborg@TendonGlasgow@Seth0Neill We never said our recommendations are strong, please read the article. In fact we highlight a few times that the network results are based on low strength of evidence and we recommend exercise, which is safe, cost-effective and will help most people based on widespread evidence.
@GregLehman@AdamMeakins@KThorborg@TendonGlasgow@Seth0Neill Researchers choose to add other therapies to exercise and not vice versa, as the only intervention with a repeatedly proven track record is exercise. There is therefore no evidence to answer your question.
We are not saying it's the best, only that it should be tried first.
The addition of PRP, steroid injections, acupuncture, shockwave, and another adjunct therapies does NOT significantly improve the effects of exercise on lower limb tendinopathies! Good work @DChalloumas@TendonGlasgow@Seth0Neill https://t.co/QsvWJFf2sy
@GregLehman@mgibsonphysio@RodWhiteley@carlespedret@Seth0Neill@TendonGlasgow We say conclusions on the effectiveness of these adjuncts "as monotherapies" cannot be made as they have predominantly been assessed alongside exercise in RCTs. That's why we recommend that they are all used with exercise, if exercise alone fails, and never as monotherapies.
And here we go again!!
Another big systematic review and network metaanalysis in Effectiveness of Exercise Treatments with or without Adjuncts for Common Lower Limb #tendinopathies
Kudos to the myths @DChalloumas@Seth0Neill@TendonGlasgow
FREE FULL TEXT!
https://t.co/v68C60Cy3T
I had the opportunity to be one of the reviewers of this great paper. Now, once published, I can highly recommend its lecture (and it's FREE FULL TEXT)
Neurogenic inflamation and #tendinopathy@TendonGlasgow @DChalloumas88
https://t.co/PYuF0wuoxY