LOGIN
PeerView
You are viewing the most viewed ACE Reports by Orthopaedic Resident/Interns over the last 30 days in all specialties.
Displaying
100%
7%
①
Synopsis:
The PREPARE Trial was a cluster-randomized, crossover trial part of the PREP-IT program, which compared alcohol-based anti-septic solutions of iodine povacrylex vs.chlorhexidine gluconate in operative fracture patients.THE PREPARE Trial included a total of 8485 patients who underwent fracture fixation: 1700 patients with open limb fractures and 6785 with closed lower-limb or pelvic fractures.Randomization occurred at the hospital level.The primary outcome of interest was the incidence of surgical-site infection, which included superficial incisional infections within 30 days and deep incisional or organ-space infections within 60 days post-surgery.Secondary outcomes included unplanned fracture-related reoperations and serious adverse events.The iodone povacrylex group (77/3205; 2.4%) had a lower incidence of surgical site infections compared to chlorhexidine (108/3272; 3.3%) in closed-fracture patients [OR, 0.74; 95% CI, 0.55 to 1.00; p=0.049].The rates were similar in open-fracture patients between the iodine (54/3272; 6.5%) and chlorhexidine (60/3272; 7.3%) [OR, 0.86; 95% CI, 0.58 to 1.27; p=0.45].In the closed-fracture group, 5.5% in the iodine group and 5.9% in the chlorhexidine group underwent unplanned reoperations [OR, 0.96; 95% CI, 0.77 to 1.20].In the open-fracture group, the figures were 16.1% for iodine and 14.5% for chlorhexidine [OR, 1.16; 95% CI, 0.87 to 1.54]. The results of...
Read More »
Level 1 RCT
5%
①
Synopsis:
Three randomized controlled trials with 267 patients who had acute ankle fractures or isolated syndesmotic injuries were included in this systematic review and meta-analysis comparing those undergoing routine removal of the screw and those receiving on-demand removal.Pooled outcomes included the Olerud-Molander Ankle Score (OMAS), American Orthopedic Foot and Ankle Hindfoot Score (AOFAS), dorsiflexion, pain scores, range of motion, and complication rates.The results showed no significant difference in OMAS, AOFAS, dorsiflexion, pain scores, or range of motion between groups at one year. However, routine removal...
Read More »
Level 1 Meta Analysis
3%
①
Synopsis:
Ninety patients with acceptably reduced intra-articular distal radius fractures were randomized to receive surgical fixation with a volar plate (n=44) or nonoperative cast immobilization (n=46).The primary outcome was patient reported function at 12 month follow-up utilizing the Patient-Rated Wrist Evaluation (PRWE) score.Secondary outcome measures included the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, the Short Form-36 (SF-36) questionnaire, pain scores, range of motion, grip strength, radiographic parameters and complications.The operative group had significantly better PRWE and DASH scores at 12 month follow-up.No differences in ROM, grip strength or pain scores existed at 12 month follow-up.No differences existed in overall complications. However, 13 (28%)...
Read More »
Level 1 RCT
3%
Micro-fragmented Adipose Tissue Versus Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis
①
Synopsis:
One hundred and eighteen patients with symptomatic knee osteoarthritis were randomized to receive either intra-articular micro-fragmented adipose tissue injections (MF-AT; n=59) or platelet-rich plasma injections (PRP; n=59).The primary outcome of this trial was the change in International Knee Documentation Committee (IKDC) scores and pain subscale of the Knee Osteoarthritis Outcome Score (KOOS) from baseline to 6 months.Other outcomes such as KOOS subscales for functional improvement, EuroQol visual analog scale (EQ-VAS), EuroQol 5 Dimensions (EQ-5D), and Visual Analog Scale (VAS) for pain at 3, 6, 12, and 24 months.MRI findings using the Whole-Organ Magnetic Resonance Imaging (WORMS) score was also assessed.Statistically significant improvements in all clinical scores were apparent in the MF-AT group, except for EQ-VAS scores. IKDC and KOOS...
Read More »
Level 1 RCT
3%
①
Synopsis:
12,211 patients from 21 trauma centers in the United States and Canada were included in this non-inferiority randomized trial comparing aspirin (n=6,101) and low molecular-weight heparin (n=6110).The primary outcome of interest was death by any cause at 90 days.Secondary outcomes of interest included the risk of thromboembolic events (pulmonary embolism; deep-vein thrombosis), cause-specific death, bleeding & wound complications, and the rate of infection.Aspirin was found to be non-inferior to low molecular-weight heparin with respect to the primary outcome of death by any cause. No differences in...
Read More »
Level 1 RCT
3%
①
Synopsis:
141 patients undergoing total knee arthroplasty were randomized to receive either a cementless implant (n=76) or a cemented implant (n=65).Outcomes of interest included Oxford Knee Score (OKS), Knee Society Function Score, Forgotten Joint Score (FJS), percentage of normal knee, patient satisfaction, incidence of revision, and the incidence of reoperation.Outcomes were assessed at 2 and 6 years post-operation.There were no differences in all outcomes at 2 and 6 years except for patient satisfaction which was significantly better in the cementless group. The rate of...
Read More »
Level 1 RCT
3%
①
Synopsis:
A total of 127 patients with primary osteoarthritis were randomized to receive either a vitamin E-diffused polyethylene acetabular liner with 32 and 36mm diameter (vE-PE; n=26 & n=30, respectively) or a cross-linked polyethylene acetabular liner with 32 and 36mm diameter (XLPE; n=33 & n=38, respectively).The primary outcome of interest was femoral head component wear measured by head penetration after 10 years.Secondary outcomes included acetabular component migration and patient-reported outcome measures (PROMs) such as the EuroQol five-dimension questionnaire (EQ-5D), 36-Item Short-Form Health Survey (SF-36), Harris Hip Score (HHS), and University of California, Los Angeles Activity Scale (UCLA).Outcomes were assessed up to ten years.Overall, the results of the study revealed that head penetration was significantly lower in the vitamin E-diffused polyethylene liner groups compared to the cross-linked polyethylene liner groups, with no significant difference between head sizes.There were no significant differences in outcomes related to head size or in most PROMs, except for the UCLA Activity Scale. This suggests that...
Read More »
Level 1 RCT
3%
①
Synopsis:
108 patients undergoing ankle fracture fixation were randomized to receive either a splint (n=54) or no splint (n=54).The primary outcomes of interest were ankle edema, pain on a Visual Analog Scale (VAS), and the American Orthopaedic Foot & Ankle Society (AOFAS) scores.Secondary outcomes of interest were patient satisfaction, length of stay, and the incidence of complications.Patient satisfaction at 3 and 6 weeks, and the incidence of unplanned ER visits were significantly better in the no splint group compared to the splint group.All other outcomes were similar between the two groups. The use of...
Read More »
Level 1 RCT
1%
②
Synopsis:
144 patients with primary complete Achilles tendon rupture were randomized to be treated with either a surgical repair and accelerated functional rehabilitation or with only the accelerated functional rehabilitation. Over the course of a two year follow up, it was observed that Achilles tendon rupture led to clinically similar results between the two treatment groups.
Read More »
Level 2 RCT
1%
②
Synopsis:
60 patients with dominant-hand thumb carpometacarpal osteoarthritis (OA) were randomized into two groups to measure the effects of either radial nerve mobilization treatment or a nontherapeutic placebo treatment on pain sensitivity and pinch strength. At 2 months follow-up, patients who underwent radial nerve mobilization experienced a decrease in pain sensitivity in the trapeziometacarpal joint and an increase in tip and tripod pinch strength.
Read More »
Author verified Level 2 RCT