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Synopsis: One hundred and two patients with acute tibia and femur fractures were included in this Phase II screening randomized trial comparing the effect of high loading dose Vitamin D3 supplementation (n=27), high daily dose supplementation (n=24), low daily dose supplementation (n=24) and placebo (n=27) on the improvement of fracture healing.Primary outcomes of interest were clinical fracture healing (as assessed by the Function IndeX for Trauma [FIX-IT]) and radiographic fracture healing (as assessed by the Radiographic Union Score for Tibial fractures [RUST]).High dose Vitamin D3 supplementation (loading or daily) was found to provide modest benefits in clinical fracture healing compared to placebo at 3 and 12 months. However, the effectiveness... Read More »
Level 1 RCT
6%
Synopsis: Five studies involving 339 patients with carpal tunnel syndrome were included in this systematic review and meta-analysis comparing distal and proximal approaches to corticosteroid injection.Pooled outcomes of interest included the Boston Carpal Tunnel Questionnaire (BCTQ), pain on a Visual Analog Scale (VAS), electrophysiological outcomes, pain on injection, duration of injection, and adverse events.Results revealed no differences in pooled BCTQ function or symptom scores between the two approaches.No difference in pain intensity or the risk of adverse events was observed either.However, a distal approach was found to take significantly less time to perform and resulted in a better sensory nerve action potential amplitude vs. Read More »
Level 1 Meta Analysis
6%
Synopsis: 375 new foot and ankle patients arriving at clinic for visit were randomized to receive a scripted viewing and discussion of patient-reported outcome measures (PROMs) (n=130) or control (no viewing of PROMs; n=145).The outcomes of interest were patient satisfaction and experience, patient activation, and surgeon and sociodemographic factors linked with those associations.All patients rated their surgeons highly.No differences in patient satisfaction or activation were observed between the two groups. In patients who... Read More »
Conference Report
3%
Synopsis: 110 patients (ages of 17-70 years) after undergoing a surgical repair for Achilles tendon rupture were kept non-weight-bearing for the first two weeks after surgery.Subsequently, they were randomized to be kept either weight-bearing or non-weight-bearing for an additional four weeks. Early weight-bearing at... Read More »
Author verified Level 2 RCT
3%
Synopsis: 50 patients with primary osteoarthritis were randomized to undergo total hip arthroplasty with either the removal or retention of the subchondral bone plate during cemented cup fixation in the original radiostereometric analysis (RSA) study.This study aimed to compare outcomes between removal and retention at a 10-year follow-up.Results indicated greater stability in proximal migration and change of inclination of the cup in the removal group compared to the retention group.Significantly less development of radiolucent lines was observed in the cement-bone interface of patients in the removal group as well. Clinical outcomes were... Read More »
Conference Report
3%
Synopsis: 204 patients with an unstable intertrochanteric hip fracture were randomized to undergo fixation using either an intramedullary implant or extramedullary implant.The purpose of this study was to compare clinical outcomes, including the lower extremity measure (LEM), functional independence measure (FIM), timed "up and go" tests (TUG), and a timed two-minute walk test, and radiographical outcomes, including tip-apex distance and femoral neck shortening, between groups.Follow-up was performed over a 12-month period postoperatively.Results demonstrated no significant differences between groups in any of the clinical/functional outcomes measured. Intramedullary nails demonstrated... Read More »
Author verified Level 2 RCT
3%
Synopsis: 27 randomized and quasi-randomized trials that investigated safety outcomes in patients undergoing either endoscopic or open carpal tunnel release for carpal tunnel syndrome were included in this meta-analysis.The study was conducted to determine whether earlier concerns regarding the safety of endoscopic release in comparison to an open approach were still applicable presently.The study found that previous drawbacks of an endoscopic release such as high reoccurrence and reoperation rates have been gradually lessened to where they are now comparable with rates in an open approach.Total and major complications are also comparable between groups, whereas minor occurrences were significantly less frequent following endoscopic release. Return to activity... Read More »
Author verified Level 1 Meta Analysis
3%
Synopsis: 40 patients scheduled for arthroscopic anterior cruciate ligament reconstruction with a semitendinosus graft or semitendinosus and gracilis graft, were randomized to have the tibial insertion of the graft preserved or resected.The purpose of this study was to evaluate graft ligamentization and integration on MRI at 6 months, as well as clinical outcome measures up to 2 years postoperatively.Grading of graft ligamentization at 6 months favoured the group which received preservation of the tibial insertion.Clinical outcome results appeared similar between groups after 2 years. Read More »
Level 2 RCT
3%
Synopsis: 68 patients with a proximal humerus fracture were randomized to fixation with either an intramedullary nail (Locking Blade Nail; Marquard) or a locking plate (Proximal Humerus Interlocking Osteosynthesis [PHILOS] system; DePuy Synthes).Patients were assessed for outcome related to function and complications over 1-year follow-up.Results for the primary outcome measure of the Constant score, as well as secondary outcomes for pain and range of motion demonstrated no significant differences between groups at 3 months, 6 months or 1 year.The Disabilities of the Arm, Shoulder, and Hand score demonstrated a significant between-group difference in favour of the nail group at 1 year, but not at 3 or 6 months. Overall rate of... Read More »
Level 2 RCT
3%
Synopsis: 15 studies (839 patients) were included in this meta-analysis comparing plate fixation to intramedullary nailing for the treatment of humeral shaft fractures.Outcomes of interest included the American Shoulder and Elbow Surgeons (ASES) score, operative time, blood loss, and the incidence of non-union, nerve injury, post-operative infection, re-operation delayed union and shoulder and elbow joint restriction.A sub-group analyses was performed for each type of plate fixation.Pooled results found significantly favourable blood loss and incidence of post-operative infection with intramedullary nailing compared to plate fixation. The subgroup analyses... Read More »
Level 2 Meta Analysis