Evidence map›Paper›PMID 27515301›Full record

Trial reportKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016

Decreased flexion contracture after total knee arthroplasty using Botulinum toxin A: a randomized controlled trial.

Eric B Smith, Karim A Shafi, Ari C Greis, Mitchell G Maltenfort, Antonia F Chen

Abstract readRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
1.9field-weighted citation impact, top 14% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Article
  6. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Eric B SmithRothman Institute, 1118 West Baltimore Pike Health Center 4, 3rd Floor Media, Philadelphia, PA, 19063, USA. esmithdoc@yahoo.com.
Karim A ShafiSidney Kimmel Medical School at Thomas Jefferson University, Philadelphia, PA, USA.
Ari C GreisRothman Institute, 1118 West Baltimore Pike Health Center 4, 3rd Floor Media, Philadelphia, PA, 19063, USA.
Mitchell G MaltenfortRothman Institute, 1118 West Baltimore Pike Health Center 4, 3rd Floor Media, Philadelphia, PA, 19063, USA.
Antonia F ChenRothman Institute, 1118 West Baltimore Pike Health Center 4, 3rd Floor Media, Philadelphia, PA, 19063, USA.
Rothman Institute · USThomas Jefferson University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeFlexion contracture after total knee arthroplasty (TKA) can cause significant dissatisfaction. Botulinum toxin A has shown improved extension in patients with spastic flexion contractures after TKA. The purpose of this study was to evaluate whether Botulinum toxin A improves knee extension for any patient with flexion contractures following TKA.

methodsA prospective, double-blinded, randomized controlled trial was conducted. Fourteen patients (15 knees), with a flexion contracture (≥10°) one month postoperatively, were randomized to receive either Botulinum toxin A or saline placebo to the affected hamstrings. The subject, surgeon, and administering physiatrist were blinded to the treatment group throughout the study. Subject range of motion (ROM) was evaluated at 1, 6, and 12 months following injection. Differences were tested using mixed-effects regression to control for multiple measurements.

resultsThe initial post-operative flexion contracture averaged 19° ± 6° in the Botulinum toxin A group and 13° ± 3° in the saline group. Injections were performed 53 and 57 days after TKA in the Botulinum toxin A and saline groups, respectively. Post-injection extension improved to an average of 8, 5, and 1 degrees for BTX and 4, 2, and 1 degrees for SAL, at 1, 6, and 12 months, respectively, compared to pre-injection extension (p < 0.0001). Improvement in knee extension at 1 year improved 18° ± 7.5° for Botulinum toxin A and 12° ± 2° for saline (p = 0.04). No complications resulted from either injection.

conclusionPatients who received Botulinum toxin A or placebo were able to achieve near full extension one year after surgery. There was a statistically significant improvement in the amount of extension achieved at 1 year with Botulinum toxin A, but this may be of little clinical significance. Since achieving full extension is important for patient function and satisfaction, novel techniques to address this issue deserve special attention. LEVEL OF EVIDENCE: I.

Indexed as

Hamstring MusclesAgedAged, 80 and overArthroplasty, Replacement, KneeBotulinum Toxins, Type AContractureDouble-Blind MethodFemaleHumansInjections, IntramuscularKnee JointMaleMiddle AgedNeuromuscular AgentsProspective StudiesRange of Motion, ArticularBotulinum Toxins, Type ANeuromuscular AgentsArthrofibrosisBotulinum toxin AExtensionFlexion contractureStiffnessTotal knee arthroplasty

Identifiers

PMID27515301
OpenAlexW2514373869

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.