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Knee osteoarthritis is currently one of the most common joint diseases worldwide. Pulsed electromagnetic field therapy has become popular among patients with knee osteoarthritis in recent years. However, the efficacy of this therapy on joint pain, joint stiffness and physical function is regarded as controversial in published clinical trials and systematic reviews. Several new randomized controlled studies on this subject have been published recently. The aim of this systematic review and metaanalysis is therefore to assess the efficacy of classical pulsed electromagnetic field therapy on patients with knee osteoarthritis, according to the methodology set out in the Cochrane Handbook for Systematic Reviews of Interventions. The results show that, despite showing no advantage in the management of pain and stiffness, pulsed electromagnetic field therapy is beneficial for improving clinical symptoms, such as physical function of the knee joint; thus it may be recommended as a supplementary therapy option for knee osteoarthritis. This review provides some evidence to help resolve current controversies about the efficacy of pulsed electromagnetic field therapy for knee osteoarthritis. Objective: To evaluate the efficacy of classical pulsed electromagnetic field therapy on patients with knee osteoarthritis. Methods: The databases PubMed, EMBASE, Web of Science and Cochrane Library were searched for relevant studies. Randomized controlled trials comparing classical pulsed electromagnetic field with placebo for patients with knee osteoarthritis were included. Data for primary outcomes, including pain, stiffness and physical function, were extracted. Data from 8 randomized controlled trials involving 421 patients were pooled. Results: Pulsed electromagnetic field therapy had an effect on improving physical function (weighted mean difference; WMD = −5.28, 95% confidence interval; 95% CI −9.45 to −1.11, p = 0.01), but showed no advantage in the reduction of Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (WMD = −7.80, 95% CI −16.08 to 0.47, p = 0.06), WOMAC pain score (WMD = −1.06, 95% CI −2.30 to 0.17, p = 0.09), visual analogue scale pain score (WMD=−0.88, 95% CI −2.06 to 0.31, p = 0.15) or WOMAC stiffness score (WMD = −0.50, 95% CI −1.09 to 0.09, p = 0.1). Conclusion: Pulsed electromagnetic field therapy is beneficial for improving physical function despite having no advantage in treating pain and stiffness. Further randomized controlled trials are needed to confirm these findings and determine the optimal parameters and treatment regimen for pulsed electromagnetic field therapy.

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V, therapeutic study.

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Background To systematically review the literature and provide a comprehensive understanding of the preemptive effects of oral pregabalin on perioperative pain management in lower limb orthopedic surgery. Method We searched three electronic databases for randomized controlled trials comparing the results of preoperative pregabalin and placebo in patients undergoing lower limb orthopedic surgery. Data analyses were conducted using RevMan 5.4. Results Twenty-one randomized controlled trials met our inclusion criteria. The cumulative opioid consumption within 24 and 48 h postoperatively in the pregabalin group was significantly less than that in the placebo group. The pooled static pain intensity at all time points within the first day was significantly lower in the pregabalin group than in the placebo group. Lower dynamic pain intensity at 48 h was detected in the pregabalin group than in the placebo group. Meanwhile, pregabalin led to a lower incidence of nausea but appeared to be associated with a higher incidence of dizziness and sedation. Subgroup analyses showed that no difference was detected between subgroups stratified by dosing regimen or pregabalin dose in the results of opioid consumption, pain intensity and incidence of complications. Conclusion This meta-analysis supports the use of pregabalin preoperatively in patients undergoing lower limb orthopedic surgery. However, it was wary of the resulting increase in dizziness and sedation. There is no evidence to support the continued use of pregabalin postoperatively or using more than 150 mg of pregabalin per day. Trial registration: This study was registered on 09 November 2021 with INPLASY (registration number: INPLASY2021110031).

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Background Recently, some studies on the efficacy of the femoral neck system (FNS) in treating femoral neck fractures (FNFs) have been published. Therefore, a systematic review was performed to clarify the efficacy and safety of FNS versus cannulated screws (CS) for the treatment of FNFs. Method The PubMed, EMBASE, and Cochrane databases were systematically searched for studies comparing FNS and CS fixations in FNFs. Intraoperative indicators, postoperative clinical indicators, postoperative complications, and postoperative scores were compared between the implants. Results A total of eight studies were included in the study, involving 448 FNFs patients. The results showed that patients in FNS group were significantly lower than the CS group in the number of X-ray exposures (WMD = -10.16; 95% CI, -11.44 to -8.88; P < 0.001; I2 = 0%), fracture healing time (WMD = -1.54; 95% CI, -2.38 to -0.70; P < 0.001; I2 = 92%), length of femoral neck shortening (WMD = -2.01; 95% CI, -3.11 to -0.91; P < 0.001; I2 = 0%), femoral head necrosis (OR = 0.27; 95% CI, 0.08 to 0.83; P = 0.02; I2 = 0%), implant failure/cutout (OR = 0.28; 95% CI, 0.10 to 0.82; P = 0.02; I2 = 0%), and Visual Analog Scale Score (WMD = -1.27; 95% CI, -2.51 to -0.04; P = 0.04; I2 = 91%). And the Harris Score was significantly higher in the FNS group than in the CS group (WMD = 4.15; 95% CI, 1.00 to 7.30; P = 0.01; I2 = 89%). Conclusions Based on this meta-analysis, FNS shows better clinical efficacy and safety in treating FNFs compared to CS. However, due to the limited quality and number of included studies and the high heterogeneity of the meta-analysis; large samples and multicenter RCTs are needed to confirm this conclusion in the future. Level of evidence II, Systematic review and Meta-analysis. Trial registration PROSPERO CRD42021283646.