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You are viewing the most viewed ACE Reports by Orthopaedic Resident/Interns over the last 30 days in all specialties.
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6%
①
Synopsis:
1054 patients being treated for bone or joint infection at 26 UK centers were randomized in this non-inferiority trial to receive 6 weeks of oral antibiotic therapy (n=527) or 6 weeks of intravenous antibiotic therapy (n=527).The primary outcome of interest was the rate of definite treatment failure.Secondary outcomes of interest included the rate of treatment discontinuation, catheter complications, diarrhea caused by C.difficile, serious adverse events, length of hospitalization, and patient-reported outcomes (Oxford Hip and Knee Scores [OHS; OKS]; EuroQual-5Dimension scores [EQ-5D]).Outcomes were assessed at 6 weeks, 4 months, and 1 year follow-up.Oral antibiotics were found to be non-inferior to intravenous antibiotics with regards to the risk of definitive treatment failure.The incidence of early discontinuation of treatment and catheter complications, and length of hospitalization were significantly higher in the intravenous group, however, no differences in the incidence of diarrhea or serious adverse events were observed between the two groups. EQ-5D scores and...
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Level 1 RCT
6%
①
Synopsis:
Two hundred four patients with symptomatic and radiographic thumb base osteoarthritis were randomized to receive a 6-week combination of education, splinting, hand exercises, and topical diclofenac sodium 1% gel (n=102) or education alone (n=102).The primary outcomes were hand function (Functional Index for Hand Osteoarthritis, FIHOA) and thumb base pain (visual analog scale, VAS).Secondary outcomes included grip and pinch strength, quality of life, stiffness, global assessments, and responder rates.Outcomes were assessed at 2, 6, and 12 weeks, with additional follow-up at 6 months.Overall, the results of the study revealed that the combined intervention significantly improved hand function at both 6 weeks and 12 weeks and reduced pain at 12 weeks, though not at 6 weeks. This suggests the...
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Level 1 RCT
4%
①
Synopsis:
Two hundred sixty-five patients with osteoarthritis were randomized to receive either a stemless humeral implant (n=133) or a stemmed humeral implant (n=132) in anatomic total shoulder arthroplasty (aTSA).The primary outcomes were the American Shoulder and Elbow Surgeons (ASES) score at 2 years, the absence of device-related complications, and the absence of radiographic loosening.Secondary outcomes included range of motion, Single Assessment Numeric Evaluation (SANE) scores, and Constant scores, assessed at multiple time points over 2 years.Overall, the study found that the stemless implant was noninferior to the stemmed implant in all primary outcomes, with no significant differences in secondary outcomes between groups. These findings suggest...
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Level 1 RCT
4%
①
Synopsis:
Three hundred seventy-seven adults with knee osteoarthritis were randomized to receive high-intensity strength training (n=127), low-intensity strength training (n=126), or attention control (n=124).The primary outcomes were knee pain measured by the WOMAC scale and knee joint compressive force during walking.Secondary outcomes included physical function, 6-minute walk distance, joint space width, thigh muscle and fat volume, inflammatory markers, and muscle strength.Outcomes were assessed at 6 and 18 months.Overall, the results of the study revealed no statistically significant differences in primary outcomes between high-intensity training and either low-intensity or control groups. The findings suggest...
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Level 1 RCT
4%
①
Synopsis:
1,022 patients with primary knee osteoarthritis were randomized to receive either 2 grams of intrawound vancomycin powder (n=507) or no vancomycin (control, n=515) before arthrotomy closure.The primary outcome of interest was the incidence of periprosthetic joint infection (PJI) or surgical site infection (SSI).Secondary outcomes included rates of minor wound complications, reoperation rates, and nephrotoxicity incidence.Outcomes were assessed up to 12 months postoperatively.Overall, the study found no significant difference in PJI/SSI rates between the two groups. However, the vancomycin...
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Level 1 RCT
4%
①
Synopsis:
Ninety-six patients with primary hip osteoarthritis undergoing uncemented THA were randomized to receive either the largest possible metal head (36–44 mm) fitted in the thinnest available VEPE liner (n=48) or a standard 32-mm metal head with a thicker VEPE liner (n=48).The primary outcome was polyethylene wear, assessed as proximal head penetration using radiostereometric analysis (RSA).Secondary outcomes included periacetabular radiolucencies and patient-reported outcomes (PROMs) for hip function, quality of life, and activity levels.Follow-ups were conducted at 3 months, 1 year, 2 years, and 5 years.Overall, the study found no significant difference in polyethylene wear between groups.Rates of periacetabular radiolucencies and patient-reported hip function were similar, though the intervention group reported higher activity levels. The findings suggest...
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Level 1 RCT
4%
①
Synopsis:
Seventeen randomized controlled trials including 1,730 patients with distal radius fractures were included in this systematic review and meta-analysis comparing nonsurgical versus surgical treatment.Pooled outcomes of interest included DASH scores, grip strength, radial inclination, radial length, volar tilt, and wrist range of motion parameters.Surgical treatment significantly improved grip strength and reduced DASH scores compared with nonsurgical treatment.Additionally, surgical treatment resulted in better radial inclination and wrist pronation/supination but did not show significant differences in wrist flexion, extension, or ulnar deviation. These findings suggest...
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Level 1 Meta Analysis
4%
Synopsis:
Three hundred ninety-four patients with orthopedic trauma were randomized to receive either CEAA supplementation (n=XX) or a standard diet (n=XX).The primary outcome of interest was changes in fat-free mass (FFM).Secondary outcomes included complication rates, surgical site infections, unplanned reoperations, and mortality.Outcomes were assessed at baseline, 2, 6, and 12 weeks postoperatively, with complications monitored up to one year.Overall, the results revealed that patients with open fractures/polytrauma (OF/PT) experienced significant muscle loss at six weeks, while fragility fracture (FFx) patients lost muscle mass at 12 weeks.Patients with isolated fractures (IFx) gained muscle mass at 12 weeks.CEAA supplementation appeared to mitigate muscle loss in the OF/PT and FFx groups and was associated with a reduced risk of non-union, mortality, and total complications. These findings suggest...
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Conference Report
2%
①
Synopsis:
6 studies (363 patients) examining outcomes of surgical and nonsurgical treatments of undisplaced or minimally displaced scaphoid waist fractures were evaluated through pairwise meta-analysis.An additional 3 trials were also identified for inclusion in a network meta-analysis.Following assessments of fracture union, complications, range of motion, grip strength, and osteoarthritis between patients who underwent either surgical or non-surgical treatment, there was a non-significant trend to increased union with surgical treatment. However this method...
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Author verified Level 1 Meta Analysis
2%
①
Synopsis:
One hundred and thirteen patients who had undergone an elective primary hip or knee arthroplasty were randomized to receive the Mepilex Border Post-Op wound dressing or the Aquacel Surgical wound dressing.The primary outcome of interest was the incidence of wound dressing failure.Secondary outcomes of interest included the following: incidence of adverse events, incidence of investigator satisfaction with ease of applying of dressing, incidence of investigator satisfaction with ease of removal of dressing, patient satisfaction with wearing the dressing during rehabilitation training, overall satisfaction with the wound dressing, incidence of redness of the skin under the dressing, incidence of feeling itchy under the dressing, incidence of skin tears, incidence of systemic infections, incidence of blister formation, pain on a Visual Analogue Scale (VAS) before dressing removal, pain on VAS during dressing removal, incidence of wound exudate, incidence of serious adverse events.All outcomes were measured during surgery and four days post-operation.The results revealed that no statistically significant difference was observed between the two wound dressings for the incidence of wound dressing failure (p=0.8682). Investigator satisfaction in...
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Level 1 RCT