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Don’t use post-operative splinting of the wrist after carpal tunnel release for long-term relief.
Choosing Wisely Canada
Canadian Orthopaedic Association -Canadian Medical Association - University of Toronto
Routine post-operative splinting of the wrist after the carpal tunnel release procedure showed no benefit in grip or lateral pinch strength or bowstringing. In addition, the research showed no effect in complication rates, subjective outcomes or patient satisfaction. Clinicians may wish to provide protection for the wrist in a working environment or for temporary protection. However, objective criteria for their appropriate use do not exist. Clinicians should be aware of the detrimental effects ...
ver más ... 2014Don’t use lateral wedge insoles to treat patients with symptomatic medial compartment osteoarthritis of the knee.
Choosing Wisely Canada
Canadian Orthopaedic Association -Canadian Medical Association - University of Toronto
In patients with symptomatic osteoarthritis of the knee, the use of lateral wedge or neutral insoles does not improve pain or functional outcomes. Comparisons between lateral and neutral heel wedges were investigated, as were comparisons between lateral wedged insoles and lateral wedged insoles with subtalar strapping. The systematic review concludes that there is only limited evidence for the effectiveness of lateral heel wedges and related orthoses. In addition, the possibility exists that ...
ver más ... 2014Don’t use glucosamine and chondroitin to treat patients with symptomatic osteoarthritis of the knee.
Choosing Wisely Canada
Canadian Orthopaedic Association -Canadian Medical Association - University of Toronto
Both glucosamine and chondroitin sulfate do not provide relief for patients with symptomatic osteoarthritis of the knee.
ver más ... 2014Don’t use needle lavage to treat patients with symptomatic osteoarthritis of the knee for long-term relief.
Choosing Wisely Canada
Canadian Orthopaedic Association -Canadian Medical Association - University of Toronto
The use of needle lavage in patients with symptomatic osteoarthritis of the knee does not lead to measurable improvements in pain, function, 50-foot walking time, stiffness, tenderness or swelling.
ver más ... 2014Avoid performing routine post-operative deep vein thrombosis ultrasonography screening in patients who undergo elective hip or knee arthroplasty.
Choosing Wisely Canada
Canadian Orthopaedic Association -Canadian Medical Association - University of Toronto
Since ultrasound is not effective at diagnosing unsuspected deep vein thrombosis (DVT) and appropriate alternative screening tests do not exist, if there is no change in the patient’s clinical status, routine post-operative screening for DVT after hip or knee arthroplasty does not change outcomes or clinical management.
ver más ... 2014