Blog

Proximal hamstring repair

Dr Dwyer was recently asked to comment on a randomized trial for surgery versus no surgery for proximal hamstring tears, which found no difference in outcomes between the two treatment groups. It is important to note that patients ranged in age between 30 and 70, and that there was in fact a significant difference in return to sport, favoring surgery.

Dr Dwyer agrees that many proximal hamstring tears can and should be treated without surgery. However, if sport is important to you, and you wish to return to running / sprinting, surgery should be considered in the acute setting.

Link to this article: https://pubmed.ncbi.nlm.nih.gov/39023393/

PRP versus hyaluronic acid for knee osteoarthritis

A systematic review of 18 level 1 studies demonstrate significant improvements in pain and function in patients with knee osteoarthritis treated with PRP versus HA. There was also evidence of improved function with leukocyte poor PRP versus leukocyte rich PRP.

Link to this article: https://pubmed.ncbi.nlm.nih.gov/32302218/

PRP for knee osteoarthritis

A randomized trial has demonstrated that multiple PRP injections are superior at reducing pain for 12 months compared to a single PRP injections

Link to this article: https://pubmed.ncbi.nlm.nih.gov/34705072/

PRP for hip osteoarthritis

A recently published randomized trial compared the injections of hyaluronic acid to PRP for 105 patients with hip osteoarthritis. At six months post injection, patients with PRP injections had both longer lasting and superior pain relief.

Link to this article: https://pubmed.ncbi.nlm.nih.gov/36096771/

IL1-Ra injections for knee osteoarthritis

A systematic review of the use of PRP in rotator cuff repair looked at 18 randomized trials involving over a thousand patients.  This paper, by Hurley et al. in the American Journal of Sports Medicine, demonstrated improved tendon healing in those patients treated with rotator cuff repair combined with PRP.

Link to this article: https://www.ncbi.nlm.nih.gov/pubmed/29466688

Hip arthroscopy

A randomized study published in the Lancet by Griffin et al. has demonstrated superior outcomes of hip arthroscopy to physiotherapy in patients with FAI and no osteoarthritis.

Link to this article:  Hip Arthroscopy RCT

ACL reconstruction

A meta-analysis of Bone-Patellar-Tendon-Bone versus Hamstring graft for ACL reconstruction by Samuelsen et al in CORR in 2017 looked at over 47,000 patients.  The failure rate for BPTB was 2.8% versus 2.84% for hamstring grafts, indicating that both grafts are excellent options for patients.

Link to this article: https://www.ncbi.nlm.nih.gov/pubmed/28205075

Rotator cuff tears

A study in the Journal of Bone and Joint Surgery America has examined the natural history study of patients with full thickness tears of the rotator cuff who did not have pain or other symptoms. Over a three year period, 18/50 patients (36%) developed symptoms, usually with an increase in the size of the tear by 1 cm.

Link to this article: https://www.ncbi.nlm.nih.gov/pubmed/23864172 h

PRP for knee osteoarthritis

More research continues to emerge with regards to injections for the treatment of patients with knee osteoarthritis. The use of platelet-rich plasma or PRP has been studied extensively in this regard, with a systematic review of six randomized trials involving 739 patients demonstrating that PRP was superior to hyaluronic acid and controls at up to 12 months

Link to this article: https://www.ncbi.nlm.nih.gov/pubmed/26432430