Identifying Musculoskeletal Interventions with Low or Limited Levels of Efficacy – 2016

The COA Executive has requested and received two reports from OrthoEvidence to identify orthopaedic interventions for which evidence of efficacy and cost-effectiveness is lacking.

Both of these reports evaluate the strong evidence, randomized controlled trials and meta-analyses of RCTs in the orthopaedic literature to identify treatments currently in use that may be ineffective in comparison to conventional methods or have low levels of efficacy. With respect to the management of degenerative pathologies of the knee, the following interventions are discussed in “Identifying Musculoskeletal Interventions with Low Levels of Efficacy in the Knee“:

  • Arthroscopic debridement of degenerative meniscal tears
  • Patient-specific instrumentation and computer navigation in TKA
  • High flexion, mobile-bearing and posterior cruciate retaining TKA prostheses
  • Gender-specific instrumentation in TKA
  • Tourniquet use in TKA

The following interventions with respect to the shoulder and elbow are discussed in “Identifying Musculoskeletal Interventions with Limited Levels of Efficacy in the Shoulder & Elbow“:

  • Operative management of displaced humeral fractures in the elderly
  • Operative mangement of shoulder impingement syndrome
  • Platelet-rich plasma injections and acromioplasty in rotator cuff repair
  • Efficacy of treatment for adhesive capsulitis and lateral epicondylitis
  • Immobilization in external rotation following shoulder dislocation

Feedback may be directed to Trinity Wittman: policy@canorth.org at the COA Office.