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You are viewing the most viewed ACE Reports by Orthopaedic Surgeons over the last 30 days in all specialties.
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Synopsis:
Fifty-seven patients with displaced type II distal clavicle fractures were randomized to receive either operative treatment (n=27) or non-operative treatment (n=30).The primary outcome of interest was the Disabilities of the Arm, Shoulder, and Hand (DASH) score at two years.Secondary outcomes included union rates, re-operation rates, satisfaction with shoulder appearance, and return to activities.Outcomes were assessed at one and two years.Overall, the results revealed no significant difference in DASH scores between the two groups at two years, indicating excellent function in both groups.However, 48% of the operative group required hardware removal, while 20% of the non-operative group required surgical intervention due to non-union.Union rates were comparable at two years. These findings suggest...
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Conference Report
3%
Synopsis:
Seventy patients with isolated, closed humeral shaft fractures were randomized to receive either open reduction and plate fixation (n=36) or functional bracing (n=34).The primary outcome of interest was the DASH score at three months.Secondary outcomes included health-related quality of life (HRQoL), pain scores, shoulder/elbow range of motion, complications, and return to activity over one year.Overall, the results revealed that surgery led to superior functional outcomes at three months (mean DASH 24.5 vs.39.4; MD 15.0, p=0.006) and improved HRQoL and pain scores over the first six months.Surgery also resulted in better shoulder and elbow mobility and a higher rate of return to sport.However, by one year, there were no significant differences between groups. These findings suggest...
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Conference Report
3%
①
Synopsis:
One hundred twenty-four patients with postoperative stiffness after primary TKA due to osteoarthritis were randomized to receive either MUA with PT alone (n=58) or MUA with PT plus one dose of pre-MUA intravenous dexamethasone (8 mg) and 14 days of oral celecoxib (200 mg) (n=66).The primary outcome of interest was knee ROM at 6 weeks after MUA.Secondary outcomes included knee ROM at 1 year and clinical outcome measures at both time points.Outcomes were assessed immediately after MUA, at 6 weeks, and at 1 year.Overall, the results revealed that while MUA significantly improved ROM immediately by 46°, there was no statistically significant difference between the treatment and control groups at 6 weeks or at 1 year.Clinical outcomes were also similar between groups. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
This systematic review and meta-analysis included 24 randomized controlled trials with 1711 participants diagnosed with sciatica due to lumbar disc herniation.It compared surgical treatment, primarily discectomy, to non-surgical treatments and epidural steroid injections.The primary outcomes assessed were leg pain and disability, while secondary outcomes included adverse events, back pain, quality of life, and treatment satisfaction.The pooled results indicated that discectomy provided moderate reductions in leg pain in the short term, with diminishing benefits over time.Effects on disability were smaller, showing only minor improvements.The long-term outcomes revealed no significant differences between surgical and non-surgical treatments. These findings suggest...
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Level 1 Meta Analysis
2%
①
Synopsis:
One hundred thirty patients undergoing primary total knee arthroplasty (TKA) for knee osteoarthritis were randomized to receive surgery with a tourniquet (n=65) or without a tourniquet (n=65).The primary outcome was quadriceps thickness.Secondary outcomes included quadriceps stiffness, operation time, intraoperative blood loss, postoperative blood loss, total blood loss, transfusion rate, thigh circumference, pain scores (VAS), D-Dimer and CRP levels, knee function scores, patient satisfaction, and complications.Outcomes were assessed up to two years postoperatively.Overall, the results revealed that the tourniquet group had significantly less total blood loss and intraoperative blood loss but greater postoperative blood loss and a higher D-Dimer level on postoperative day 3.Other clinical parameters, including quadriceps thickness, stiffness, pain scores, function scores, and complications, showed no significant differences between groups. These findings suggest...
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Level 1 RCT
2%
Synopsis:
Ninety-four patients with periprosthetic distal femur fractures (PPDFs) were randomized to receive locked plating (LP; n=53) or retrograde intramedullary nailing (RIMN; n=41).The primary outcome of interest was the Timed Up and Go (TUG) test at 3 months.Secondary outcomes included the Knee Society Score (KSS), rates of nonunion, malunion, reoperation, and mortality.Outcomes were assessed at 2 weeks, 6 weeks, 3 months, 6 months, 12 months, and 24 months.Overall, the results of the study revealed no significant differences between the two fixation strategies in terms of functional outcomes, including TUG and KSS scores, at any time point.However, malunion was significantly more common in the RIMN group (36.1%) compared to the LP group (9.3%) (p=0.003).Although nonunion and reoperation occurred more frequently in the LP group, these differences were not statistically significant. The findings suggest...
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Conference Report
2%
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%
Progressive Stepped Exercise Program in Patients With Knee Osteoarthritis for Pain and Functionality
①
Synopsis:
Three hundred forty-five patients with symptomatic knee osteoarthritis were randomized to receive either a stepped exercise program (STEP-KOA) (n=230) or an arthritis education (AE) control intervention (n=115).The STEP-KOA intervention involved a progressive three-step approach: an internet-based exercise program (step 1), followed by biweekly physical activity coaching (step 2) for non-responders, and in-person physical therapy (step 3) for those still not meeting response criteria.The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, with secondary outcomes including objective physical function tests and self-reported physical activity.Outcomes were assessed at 3, 6, and 9 months.Overall, the study found that at 9 months, the STEP-KOA group demonstrated a greater improvement in WOMAC scores compared to the AE group, but there were no significant differences in objective physical function tests or self-reported physical activity. The findings suggest...
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Level 1 RCT
2%
①
Synopsis:
Two hundred ten patients with shoulder impingement syndrome were randomized to receive either arthroscopic subacromial decompression (ASD) (n=59), diagnostic arthroscopy (n=63), or exercise therapy (n=71).The primary outcomes of interest were shoulder pain at rest and on arm activity, measured using a Visual Analogue Scale (VAS).Secondary outcomes included Constant-Murley score, Simple Shoulder Test score, SF-36, and 15D health-related quality of life measures.Outcomes were assessed over five years.Overall, the results of the study revealed no clinically significant differences between ASD and diagnostic arthroscopy, nor between ASD and exercise therapy, in reducing shoulder pain or improving function. The study suggests...
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Level 1 RCT
2%
①
Synopsis:
Ninety-seven patients with symptomatic acetabular labral tears and limited osteoarthritis (Tönnis grades 0-2) were randomized to receive either hip arthroscopy with postoperative physical therapy (SPT) (n=52) or physical therapy alone (PTA) (n=45).Patients in the PTA group who experienced unsatisfactory improvement were allowed to cross over to surgery after completing at least 14 weeks of PT (CO group, n=32).The primary outcomes were the International Hip Outcome Tool-33 (iHOT-33) and the modified Harris Hip Score (mHHS) at 24 months.Secondary outcomes included additional patient-reported outcome measures (PROMs) and pain scores.Overall, the results demonstrated that SPT led to superior improvements in functional outcomes and pain reduction compared to PTA in both the intention-to-treat and modified as-treated analyses.Additionally, patients who crossed over to surgery experienced similar postoperative outcomes to those who underwent initial surgery. These findings suggest...
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Level 1 RCT