Background: Among the leading causes of work-related disability, musculoskeletal diseases (MSDs) profoundly affect productivity and quality of life. Workplace changes, equipment adjustments, and training courses, among other ergonomic interventions, seek to lower the frequency and degree of MSDs. This systematic review and meta-analysis evaluated whether ergonomic interventions help prevent and control MSDs in various workplace environments. Methods: A systematic search was conducted in PubMed, Scopus, Embase, Web of Science, and Cochrane Library to identify relevant studies. Inclusion criteria included randomized controlled trials (RCTs) that evaluated ergonomic interventions against conventional conditions. Effect sizes were computed using mean differences and pooled using a random-effects model in case of heterogeneity. A uniform Excel sheet was used for data extraction. Revman software (Cochrane Collaboration, Copenhagen, Denmark) was used for statistical analysis. Results: This meta-analysis included 24 RCTs with 4086 workers with different occupations. A meta-analysis of 10 included studies demonstrated lower pain intensity with a mean difference in VAS score between ergonomic interventions and the control group of −0.28 (95%CI: −0.43, −0.14, p = 0.0001). Also, there was a significant reduction in reported MSD-related pain in the lower back with ergonomic interventions with an OR 0.53 (95%CI: 0.40–0.70, p < 0.00001). Moreover, there were statistically significant results for ergonomic interventions in the upper back, ankles, wrists, and neck. In contrast, there were no significant improvements in the thighs, arms, knees, shoulders, and elbows. Conclusions: Our findings support implementing ergonomic strategies as a practical approach to reducing work-related MSDs. However, further research is needed to improve intervention design and long-term effectiveness.

Introduction: Robotic surgery in total hip arthroplasty (THA) has emerged as a promising approach for improving precision and reducing errors. This meta-analysis aimed to compare the efficacy and safety of robot-assisted MAKO total hip arthroplasty. Studies were searched using four databases. Meta-analysis was performed using Review Manager 5.4. Efficacy was assessed radiologically, and functional scores and complications were recorded. Twelve studies (1224 hips) were analyzed. The MAKO group achieved greater cup anteversion (MD 1.53, 95%CI 1.04–2.03) and a higher percentage of components within safe inclination and anteversion ranges (p > 0.05). Harris Hip Scores did not differ significantly (MD 0.61, 95%CI -0.22–1.45) but the forgotten joint scores favored MAKO (MD 5.99, 95% CI 4.10–7.88), although not exceeding the minimally clinically significant difference. No differences in intraoperative complications emerged (OR 0.96, 95%CI 0.51–1.79) but preoperative plans significantly mismatched the final cup placement after MAKO (p < 0.05). The use of the MAKO robot in THA improves radiological outcomes by enhancing safe prosthesis placement. However, no significant differences were observed in terms of complications. Longer follow-up studies are required to assess the clinical impact of improved radiological results. Level IV metaanalysis of nonrandomized clinical trials. CRD42023433733

Although open surgery is the conventional option for ankle arthritis, there are some reports in the literature regarding the use of the arthroscopy procedure with outstanding results. The primary purpose of this systematic review and meta-analysis was to analyze the effect of the surgery technique (open-ankle arthrodesis vs. arthroscopy) in patients with ankle osteoarthritis. Three electronic databases (PubMed, Web of Science, and Scopus) were searched until 10 April 2023. The Cochrane Collaboration’s risk-of-bias tool was used to assess the risk of bias and grading of the recommendations assessment, development, and evaluation system for each outcome. The between-study variance was estimated using a random-effects model. A total of 13 studies (including n = 994 participants) met the inclusion criteria. The meta-analysis results revealed a nom-significant (p = 0.072) odds ratio (OR) of 0.54 (0.28–1.07) for the fusion rate. Regarding operation time, a non-significant difference (p = 0.573) among both surgical techniques was found (mean differences (MD) = 3.40 min [−11.08 to 17.88]). However, hospital length stay and overall complications revealed significant differences (MD = 2.29 days [0.63 to 3.95], p = 0.017 and OR = 0.47 [0.26 to 0.83], p = 0.016), respectively. Our findings showed a non-statistically significant fusion rate. On the other hand, operation time was similar among both surgical techniques, without significant differences. Nevertheless, lower hospital stay was found in patients that were operated on with arthroscopy. Finally, for the outcome of overall complications, the ankle arthroscopy technique was a protective factor in comparison with open surgery.

Background: Recurrent disc herniation is a common condition that often results in months of disabling symptoms and additional costs. Objective: The objective of this study was to investigate the incidence of recurrent disc herniation in patients treated surgically. Materials and Methods: Clinical trials and prospective studies involving patients treated with different techniques, such as open, percutaneous, or microendoscopic discectomy, were included. The incidence of recurrence as well as the level and the time until the recurrent disc herniation was collected. Results: Thirteen studies were included. Recurrence of disc herniation ranged from 0% to 14% of patients. Most recurrences occurred at the same level of herniation and on the same side. The time to recurrence of disc herniation ranged from 1 to 5 years. Conclusion: This study answers the question of how much, when, and where in lumbar recurrent disc herniation.

Introduction: Distal chevron osteotomy is commonly used for the operative treatment of hallux valgus (HV). However, there are several operative procedures that can be used to treat HV. The aim of this meta-analysis was to compare the efficacy of distal chevron osteotomy with different operative procedures. Materials and methods: A systematic search was conducted using the MEDLINE and EMBASE databases to identify randomized clinical trials (RCTs). The variables were radiological (hallux metatarsal phalangeal angle [HVA] and intermetatarsal angle [IMA]) and clinical (American Orthopaedic Foot & Ankle Society Score [AOFAS]). Heterogeneity was assessed with chi² and I² statistics. A random effects model was used for significant heterogeneity. Publication bias was evaluated with funnel plots. Results: Ten studies involving 985 patients were evaluated in the meta-analysis. Distal chevron osteotomy was associated with a mean IMA correction 2.18° greater than the scarf procedure (MD − 2.18; 95% CI − 3.67, − 0.69; p = 0.004; I² = 0%). In addition, the proximal chevron was associated with a mean IMA correction 1.08° greater than the distal chevron (MD − 1.08; 95% CI − 1.86, − 0.29; p = 0.007; I² = 0%). The AOFAS assessment showed an overall advantage of 3.2 points in favor of the Lingdren group compared with distal chevron osteotomy (MD 3.20; 95% CI 0.37, 6.04; p = 0.03; I² = 0%). Conclusions: Our findings indicate that distal chevron osteotomy provides a greater HVA correction than scarf osteotomy, and proximal chevron provides a larger IMA correction than distal chevron osteotomy. Lingdren osteotomy provides a greater AOFAS correction than distal chevron osteotomy. Level of evidence: Level I, meta-analysis.