Editorial Commentary: Network Geometry of Nonoperative Management of Patellar Tendinopathy-Can the Shape of the Evidence Inform Practice?
Cote, Mark P;
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association2019Vol. 35pp. 3132-3134
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cote2019editorialarthroscopy
Abstract
Recent research has examined the comparative effectiveness of nonoperative treatments for patellar tendinopathy using a network meta-analysis method. This method allows analysis of a network of clinical trials individually studying different treatment options in comparison to an eccentric exercise control; however, most treatments have not been compared head to head. Although leukocyte-rich platelet-rich plasma is statistically ranked as the treatment with the highest improvements in pain and function, concerns over the assumption of transitivity (on which network meta-analysis is based) and the lack of connection or comparisons among treatments suggest that future studies comparing treatments head to head are needed.