Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis
Abstract Background Achilles tendon ruptures are a common injury and are increasing in incidence. Several management strategies exist for both non-operative and operative care, with each strategy offering unique risks and benefits. Traditional pairwise meta-analyses have been performed to compare ma...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | Systematic Reviews |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13643-018-0912-5 |
| _version_ | 1818109634729213952 |
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| author | Brad Meulenkamp Dawn Stacey Dean Fergusson Brian Hutton Risa Shorr MLIS Ian D. Graham |
| author_facet | Brad Meulenkamp Dawn Stacey Dean Fergusson Brian Hutton Risa Shorr MLIS Ian D. Graham |
| author_sort | Brad Meulenkamp |
| collection | DOAJ |
| description | Abstract Background Achilles tendon ruptures are a common injury and are increasing in incidence. Several management strategies exist for both non-operative and operative care, with each strategy offering unique risks and benefits. Traditional pairwise meta-analyses have been performed to compare management strategies; however, all treatment options have never been integrated in a single analysis. Network meta-analysis (NMA) is a generalization of pairwise meta-analysis, which allows for the comparison of multiple interventions based on all available direct and indirect evidence. The objectives of this review are to synthesize the evidence on the management options for acute Achilles tendon rupture and identify which treatment gives the best functional outcomes. Methods A systematic review with NMA is planned. An electronic literature search will be performed in conjunction with an experienced information specialist in MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of Controlled Trials. We will include randomized controlled trials with a minimum 6-month follow-up. Two independent reviewers will screen citations for eligibility, extract study data, and perform risk of bias assessments. The primary outcome will be disease-specific functional outcome scores (AOFAS, Leppilahti, modified Leppilahti) at 1 year. Secondary outcomes will include complications (re-rupture, sural nerve injury, wound complications, deep infection, secondary surgeries), strength, range of motion, return to work, return to sport, and quality-of-life measures (including the SF-36 questionnaire). Traditional pairwise meta-analyses will be performed for all direct comparisons where evidence is available, and NMAs will subsequently be performed where possible to compare all management strategies. Discussion The data generated from this review will provide health-care providers with a clear evidence synthesis of all Achilles tendon rupture management strategies. Additionally, these data will be incorporated into the development of a patient decision aid to assist patients and clinicians in making a preference-based decision when faced with an Achilles tendon rupture. Systematic review registration PROSPERO CRD42018093033. |
| first_indexed | 2024-12-11T02:34:23Z |
| format | Article |
| id | doaj.art-5982e8fefd4d4ecab9440d177ae5c237 |
| institution | Directory Open Access Journal |
| issn | 2046-4053 |
| language | English |
| last_indexed | 2024-12-11T02:34:23Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Systematic Reviews |
| spelling | doaj.art-5982e8fefd4d4ecab9440d177ae5c2372022-12-22T01:23:45ZengBMCSystematic Reviews2046-40532018-12-01711710.1186/s13643-018-0912-5Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysisBrad Meulenkamp0Dawn Stacey1Dean Fergusson2Brian Hutton3Risa Shorr MLIS4Ian D. Graham5Faculty of Medicine, University of OttawaFaculty of Health Sciences, Centre for Practice-Changing Research, The Ottawa Hospital Research Institute, University of OttawaDepartment of Medicine, Centre for Practice-Changing Research Clinical Epidemiology Program, The Ottawa Hospital Research Institute, University of OttawaClinical Epidemiology Program, Centre for Practice-Changing Research, The Ottawa Hospital Research InstituteThe Ottawa HospitalSchool of Epidemiology and Public Health; Clinical Epidemiology Program, Centre for Practice-Changing, The Ottawa Hospital Research Institute Research, University of OttawaAbstract Background Achilles tendon ruptures are a common injury and are increasing in incidence. Several management strategies exist for both non-operative and operative care, with each strategy offering unique risks and benefits. Traditional pairwise meta-analyses have been performed to compare management strategies; however, all treatment options have never been integrated in a single analysis. Network meta-analysis (NMA) is a generalization of pairwise meta-analysis, which allows for the comparison of multiple interventions based on all available direct and indirect evidence. The objectives of this review are to synthesize the evidence on the management options for acute Achilles tendon rupture and identify which treatment gives the best functional outcomes. Methods A systematic review with NMA is planned. An electronic literature search will be performed in conjunction with an experienced information specialist in MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of Controlled Trials. We will include randomized controlled trials with a minimum 6-month follow-up. Two independent reviewers will screen citations for eligibility, extract study data, and perform risk of bias assessments. The primary outcome will be disease-specific functional outcome scores (AOFAS, Leppilahti, modified Leppilahti) at 1 year. Secondary outcomes will include complications (re-rupture, sural nerve injury, wound complications, deep infection, secondary surgeries), strength, range of motion, return to work, return to sport, and quality-of-life measures (including the SF-36 questionnaire). Traditional pairwise meta-analyses will be performed for all direct comparisons where evidence is available, and NMAs will subsequently be performed where possible to compare all management strategies. Discussion The data generated from this review will provide health-care providers with a clear evidence synthesis of all Achilles tendon rupture management strategies. Additionally, these data will be incorporated into the development of a patient decision aid to assist patients and clinicians in making a preference-based decision when faced with an Achilles tendon rupture. Systematic review registration PROSPERO CRD42018093033.http://link.springer.com/article/10.1186/s13643-018-0912-5Achilles tendon ruptureSystematic reviewNetwork meta-analysisOrthopedicsSurgeryPhysiotherapy |
| spellingShingle | Brad Meulenkamp Dawn Stacey Dean Fergusson Brian Hutton Risa Shorr MLIS Ian D. Graham Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis Systematic Reviews Achilles tendon rupture Systematic review Network meta-analysis Orthopedics Surgery Physiotherapy |
| title | Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis |
| title_full | Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis |
| title_fullStr | Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis |
| title_full_unstemmed | Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis |
| title_short | Protocol for treatment of Achilles tendon ruptures; a systematic review with network meta-analysis |
| title_sort | protocol for treatment of achilles tendon ruptures a systematic review with network meta analysis |
| topic | Achilles tendon rupture Systematic review Network meta-analysis Orthopedics Surgery Physiotherapy |
| url | http://link.springer.com/article/10.1186/s13643-018-0912-5 |
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