1. NICE Guidance:
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2. New and Updated Cochrane Systematic Reviews:
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Potential benefits of cryotherapy on blood loss, postoperative pain, and range of motion may be too small to justify its use, and the quality of the evidence was very low or low for all main outcomes. This needs to be balanced against potential inconveniences and expenses of using cryotherapy. Well designed randomised trials are required to improve the quality of the evidence.
Adie S, Kwan A, Naylor JM, Harris IA, Mittal R. Cryotherapy following total knee replacement. Cochrane Database of Systematic Reviews 2012, Issue 9.
Authors’ conclusions: Although statistically significant, the differences between disc replacement and conventional fusion surgery for degenerative disc disease were not beyond the generally accepted clinical important differences with respect to short-term pain relief, disability and Quality of Life. Moreover, these analyses only represent a highly selected population. The primary goal of prevention of adjacent level disease and facet joint degeneration by using total disc replacement, as noted by the manufacturers and distributors, was not properly assessed and not a research question at all. Unfortunately, evidence from observational studies could not be used because of the high risk of bias, while these could have improved external validity assessment of complications in less selected patient groups. Non-randomised studies should however be very clear about patient selection and should incorporate independent, blinded outcome assessment, which was not the case in the excluded studies. Therefore, because we believe that harm and complications may occur after years, we believe that the spine surgery community should be prudent about adopting this technology on a large scale, despite the fact that total disc replacement seems to be effective in treating low-back pain in selected patients, and in the short term is at least equivalent to fusion surgery.
Jacobs W, Van der Gaag NA, Tuschel A, de Kleuver M, Peul W, Verbout AJ, Oner FC. Total disc replacement for chronic back pain in the presence of disc degeneration. Cochrane Database of Systematic Reviews 2012, Issue 9.
Authors’ conclusions: Topical NSAIDs can provide good levels of pain relief; topical diclofenac solution is equivalent to that of oral NSAIDs in knee and hand osteoarthritis, but there is no evidence for other chronic painful conditions. Formulation can influence efficacy. The incidence of local adverse events is increased with topical NSAIDs, but gastrointestinal adverse events are reduced compared with oral NSAIDs.
Derry S, Moore RA, Rabbie R. Topical NSAIDs for chronic musculoskeletal pain in adults. Cochrane Database of Systematic Reviews 2012, Issue 9.
3. Systematic Reviews:
For abstracts of the articles below please click on the titles. There may be a link to full text in the top right hand corner of the webpage. You may have to log in using your NHS Athens username and password, if you don’t have one go to Register for Athens and register for free.
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4. Economic Evaluations:
For abstracts of the economic evaluations below please click on the titles. There may be a link to full text in the top right hand corner of the webpage. You may have to log in using your NHS Athens username and password, if you don’t have one go to Register for Athens and register for free.
If full text is not available then please contact us to request a copy. This is a free service but you will need to complete our Article Request Form. Or you may email us directly quoting the number(s) of the articles you would like.
5. Latest Journal Table of Contents:
If you would like full text of any of the articles listed in the below journals then please contact us to request a copy. This is a free service but you will need to complete our Article Request Form. Or you may email us directly quoting the number(s) of the articles you would like.
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