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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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Greater Quality of Life But Longer Operative Time With THA vs HA for Displaced Femoral Neck Fracture
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Synopsis:
Sixteen randomized controlled studies containing a total of 3084 patients were included in this meta-analysis including patients with displaced femoral neck fractures undergoing total hip arthroplasty (THA; n=1521) or hemiarthroplasty (HA; n=1563).Pooled outcomes of interest included the following: incidence of revision, functional outcomes (evaluated using the Harris hip score), incidence of mortality, health-related quality of life (QoL; evaluated using the EuroQol-5 Dimensions [EQ-5D] Index), incidence of periprosthetic fracture, incidence of dislocation, and operative time.Subgroup analyses was conducted by level of risk of bias.Revision surgery, incidence of mortality and dislocation were all analyzed at 12-60 months follow-up, where as the rest of the outcomes were assessed at 12-36 months.Pooled results revealed that health-related quality of life, evaluated using EQ-5D Index, was statistically significantly in favour of the THA group vs.HA (p=0.001).However, pooled operative time was statistically significantly shorter in the HA group vs THA (p=0.001). All other pooled...
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Author verified Level 1 Meta Analysis
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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...
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Level 1 RCT
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①
Synopsis:
One hundred five patients with clinically diagnosed knee osteoarthritis were randomized to receive a 6-week internet-based exercise and education program (n=48) or routine self-management care (n=57).The primary outcome of interest was change in self-reported knee pain using a numerical rating scale at 6 weeks.Secondary outcomes included physical function tests (30-second sit-to-stand, Timed Up-and-Go), WOMAC subscales (pain, stiffness, physical function), muscle strength, and quantitative sensory testing.Outcomes were assessed at baseline and 6 weeks.Overall, the results of the study revealed a significantly greater improvement in pain, function, and hamstring strength in the internet-based intervention group compared to usual care. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
One hundred forty-two patients with full-thickness small to large rotator cuff tears were randomized to receive either abduction brace immobilization (n=65) or sling immobilization (n=66) for 6 weeks following arthroscopic rotator cuff repair.The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) at 6 weeks postoperatively.Secondary outcomes included anxiety (Self-rating Anxiety Scale), pain levels, patient satisfaction, functional scores (ASES), and tendon healing assessed via ultrasonography at 6 weeks and 1 year.
Overall, the results of the study revealed that at 6 weeks, the sling group had significantly better sleep quality, less anxiety, less pain, and higher satisfaction compared to the brace group.However, no differences were found in any outcomes at 1 year, including tendon healing. These findings suggest...
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Level 1 RCT
3%
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
3%
①
Synopsis:
80 patients with distal radius fractures were randomized to receive either a 4-week (n=40) or a 6-week immobilization program.The primary outcome of interest was Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores at one year.Secondary outcomes of interest included QuickDASH scores at 3 and 6 months, incidence of adverse events, and range of motion in radial and ulnar deviation, dorsiflexion, and palmar flexion.All outcomes were comparable between the two groups at all time points. Therefore, a shorter...
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Level 1 RCT
3%
①
Synopsis:
One hundred and nineteen patients with insertional Achilles tendinopathy were randomized to received extracorporeal shockwave therapy with eccentric exercise (ESWT +EE) (n=58) or eccentric exercise (EE) and sham therapy (n=61).The primary outcome was function measured by the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A).Secondary outcomes of interest included pain scores, the Foot and Ankle Outcome Score (FAOS), the Short Form Health Survey (SF-12), recurrence and failure of treatment.Both groups demonstrated significant improvements from baseline.No differences in the VISA-A, FAOS or SF-12 were found at any time point between groups. The EWST+EE group...
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Level 1 RCT
3%
①
Synopsis:
58 elderly patients undergoing hip arthroplasty under spinal anesthesia were randomized to receive either 5 mg oral midodrine (n=29) or a placebo (n=29).The primary outcome of interest was intraoperative ephedrine consumption.Secondary outcomes included the incidence of post-spinal hypotension, bradycardia, hypertension, mean arterial pressure (MAP), and heart rate (HR).Outcomes were assessed throughout the duration of the surgery.Overall, the results of the study revealed that the midodrine group had significantly lower intraoperative ephedrine consumption and a reduced incidence of hypotension compared to the control group. The findings suggest...
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Level 1 RCT
3%
①
Synopsis:
12 randomized controlled trials (788 patients) comparing the use of a minimally invasive medial midvastus approach (MMV-TKA) versus the standard medial parapatellar total knee arthroplasty (MP-TKA) were included in this systematic review and meta-analysis.Outcomes of interest included the Knee Society Score (KSS), knee pain on a Visual Analog Scale (VAS), knee function on a Normalized Function Scale, knee range of motion (ROM), time to straight leg activity, incidence of loose outboard support belt use, operative time, length of stay, blood loss, and incidence of postoperative complications.KSS scores, VAS pain scores, and knee joint flexural activity at 3 months, and days of straight leg raises were significantly better in the MMV-TKA group.Operative time was significantly shorter in the MP-TKA group. All other outcomes...
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Level 1 Meta Analysis
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Improved Pain & Function With 8 Weeks of Electroacupunture or Manual Acupuncture vs Sham for Knee OA
①
Synopsis:
Four hundred and eighty patients diagnosed with knee osteoarthritis (OA) were randomized to receive electroacupuncture (EA; n=160) or manual acupuncture (MA; n=160) or sham (n=160) for a total of 8 weeks, 3 times/week.The primary outcome of interest was the response rate which consisted of patients improving at least 2 points on the numeric rating scale (NRS) for pain and 6 points on the WOMAC function subscale.Secondary outcomes of interest included the following: NRS pain at weeks 4, 16, and 26; WOMAC function at weeks 4, 16, and 26; WOMAC pain; WOMAC stiffness; quality of life using the 12-item Short Form (SF-12) health survey (i.e., mental health and physical health); incidence of paracetamol; and patient’s global assessment (PGA).WOMAC stiffness, SF-12 , and PGA scores were measured at 4, 8, 16, and 26 weeks follow-up.Also, incidence of adverse events were reported.Results revealed that the response rate, at 8 weeks, was statistically significantly higher in the EA compared to sham (n=0.023) but this was not observed when comparing MA to sham (n=0.051).Furthermore, the response rate at 4, 16, and 26 weeks follow-up was statistically significantly favored in the EA vs sham group but this was observed for MA vs sham only at weeks 16 and 26 (p<0.05).The total incidence of adverse events included 18, 22, and 17 patients in the EA, MA, and sham groups, respectively.NRS scores were statistically significantly improved in the EA vs Sham and MA vs sham groups for all timepoints.WOMAC function and pain were statistically significantly improved in the EA vs sham for all timepoints; yet, for WOMAC function, MA vs sham was only statistically significantly improved at 16 weeks follow-up (p<0.05).For WOMAC pain, a statistical significant improvement in scores was observed for weeks 8,16, and 26 (p<0.05).Moreover, WOMAC stiffness did not statistically significantly differ in MA vs sham groups for all timepoints, but EA vs sham was statistically improved at weeks 8 and 26 (p<0.05).For SF-12 physical health, a statistical significant improvement for EA and MA when compared to sham were observed only at 16 weeks follow-up (p=0.009 for EA vs sham; p=0.026 for MA vs sham).Finally, SF-12 mental health scores statistically significantly favored the EA compared to sham group only at week 26 (p=0.01) whereas MA was favored at both weeks 16 and 26 compared to sham (p=0.024; p=0.001, respectively). Finally, 4, 2...
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Level 1 RCT