Ballepatterson4652

Background The guidelines for pilot and feasibility studies were published in 2016. Little is known about the guideline adherence of TCM (traditional Chinese medicine) pilot trials or whether the guidelines can significantly enhance the quality of implementation and reporting of TCM pilot trials. We aimed to investigate the guideline adherence, assess the impact of guidelines on TCM pilot trials, and discuss potential challenges specific to TCM pilot trials, by conducting a literature review. Methods We systematically searched MEDLINE, EMBASE, and CNKI to retrieve TCM pilot trials. We randomly chose 50 pilot trials from the eligible studies for analyses. The CONSORT extension to pilot and feasibility studies was used as a framework to assess the methodology and reporting quality of the studies. Results The included studies had a guideline adherence level ranging from 4 to 96%, where the lowest adherence was found in the item 6c (prespecified criteria used to judge progression to future definitive trial). The guidance published in 2016 seemed to exert minimal effect on guideline adherence in TCM pilot trials. The unidentified issues related to TCM pilot trials from the guidelines included blinding, lack of standard formula of interventions, difficulty in comparison for effect assessment of interventions, and difficulty in bias control. Conclusions The current practice in TCM pilot trials required substantial improvement in the literature. Further endeavors are needed for training and dissemination of guideline adherence, and development of more detailed methodology in the field of TCM pilot trials. © The Author(s) 2020.Ischiofemoral space (IFS) is a radiological parameter employed for diagnosing ischiofemoral impingement (IFI). Aminoguanidine hydrochloride chemical structure The mean IFS value measured with the leg in natural resting position has been reported as 23.0 mm in males and 18.6 mm in females in a patients-based Western population. The normal value of IFS for an Asian population is unknown. This study therefore aimed to investigate whether the IFS value in Japanese hip joints equals that of the Western population. We retrospectively examined 89 consecutive Japanese individuals (178 hips) (46 male subjects with 92 hips, 43 female subjects with 86 hips; mean age 58.7 ± 15.7 years, range 17-84 years) who had undergone computed tomography (CT) for conditions unrelated to hip disorders and ordered by other departments at our institution. All CT scans were performed in a standardized fashion patient in a flat spine position, hips and knees in extension, and the leg in its natural resting position. IFS was evaluated on axial images as the shortest distance between the ischium and the lesser trochanter. The mean IFSs of this Japanese patient-based population were 20.5 ± 7.3 mm [95% confidence interval (CI) 19.0-22.0] in the male cohort and 13.9 ± 6.5 mm (95% CI 12.6-15.3) in the female cohort. The IFS value was significantly smaller in female subjects than in male subjects. Taking the lower limit of 95% CI into consideration, the IFSs measured in natural leg-resting position in the Japanese male and female groups were significantly smaller than those of the Western populations. © The Author(s) 2019. Published by Oxford University Press.The purpose of this study was to determine the influence of prior lower extremity surgery on patient reported outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Consecutive patients who underwent hip arthroscopy for FAIS and a prior history of ipsilateral lower extremity surgery were identified and matched 21 by age, gender, and body mass index (BMI) to controls without a history of lower extremity surgery. The minimal clinically important difference (MCID) and patient acceptable symptomatic state (PASS) were calculated for HOS-ADL, HOS-SS, and mHHS. Preoperative and 2-year postoperative patient reported outcomes of both groups were compared, and logistic regression was performed to determine whether lower extremity surgery influenced achieving MCID and PASS. A total of 102 patients (24.94%) with prior history of ipsilateral lower extremity surgery were identified. Ipsilateral orthopaedic knee surgery accounted for more than half (53.92%) of all prior surgeries. Patients with a history of ipsilateral lower extremity surgery had significant lower 2-year PROs, satisfaction, and greater pain when compared to patients without lower extremity surgery (P less then 0.001 all). A history of ipsilateral lower extremity surgery was a negative predictor of achieving MCID for HOS-ADL and HOS-SS, as well as PASS for HOS-ADL, HOS-SS, and mHHS (P less then 0.001 all). In conclusion, patients with prior lower extremity surgery were found to have inferior outcome scores and a lower likelihood of achieving clinically significant outcome improvement compared to patients without a history of lower extremity surgery at two years postoperatively. © The Author(s) 2019. Published by Oxford University Press.In the presence of severe acetabular cartilage defects, the benefits of labral reconstruction (RECON) versus labral resection (RESEC) have not been determined. Prospectively collected data between October 2008 and December 2016 were retrospectively reviewed. Inclusion criteria were hip arthroscopy, acetabular Outerbridge grade III/IV, irreparable labral tears that underwent RECON or RESEC, and minimum 2-year postoperative measures for the modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score-Sports Specific Subscale, International Hip Outcome Tool, Patient Satisfaction and Visual Analogue Scale for pain. Exclusion criteria included Tönnis grade >1, previous hip conditions or previous ipsilateral hip surgeries. A 11 matched-pair analysis was performed based on age ±5 years, sex, body mass index ±5 kg/m2, Tönnis grade, acetabular microfracture, femoral Outerbridge grade (0 or I compared with II, III or IV). Relative risk (RR) and conversion rate to total hip arthroplasty (THA) were calculated. A total of 38 RECON hips were successfully matched. Both groups demonstrated significant improvements in patient-reported outcomes (PROs). THA conversion was 5.3% and 21.1% for the RECON and RESEC groups, respectively (P = 0.04). RECON was four times less likely to require THA conversion than the RESEC group (RR=4.0; 95% CI 0.91-17.63). In the setting of primary arthroscopic management of femoroacetabular impingement, irreparable labral tears and acetabular chondral lesions of Outerbridge III/IV, patients that underwent RECON and RESEC experienced significant improvement in PROs at minimum 2-year follow-up, and these functional scores were comparable when groups were matched. However, RR and rate to THA conversion were significantly higher in the RESEC group. © The Author(s) 2019. Published by Oxford University Press.