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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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5%
①
Synopsis:
One hundred patients with chronic midportion Achilles tendinopathy were randomized to receive either exercise therapy combined with ultrasonography-guided corticosteroid injection (n=48) or exercise therapy with placebo injection (n=52).The primary outcome was improvement in the Victorian Institute of Sport Assessment–Achilles (VISA-A) score at 6 months.Secondary outcomes included tendon thickness, pain during activity and in the morning (measured by VAS), and global assessment of treatment response.Outcomes were assessed at baseline and 1, 2, 3, 6, 12, and 24 months.Overall, the results revealed that the corticosteroid group showed a significantly greater improvement in VISA-A scores at 6 months, accompanied by improved tendon morphology and early symptom relief, with no increase in adverse events. These findings suggest...
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Level 1 RCT
5%
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
4%
①
Synopsis:
One hundred twenty-eight patients with sciatica lasting 4 to 12 months due to lumbar disc herniation were randomized to receive either microdiscectomy (n=64) or 6 months of standardized nonoperative care (n=64).The primary outcome was leg pain intensity at 6 months.Secondary outcomes included back pain, Oswestry Disability Index (ODI), SF-36 quality-of-life scores, employment status, and treatment satisfaction, assessed at multiple time points up to 12 months.Overall, the results of the study revealed that microdiscectomy led to a significantly greater reduction in leg pain at 6 months and consistent improvements in secondary outcomes. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Three hundred twenty-one patients with degenerative meniscal tears were randomized to receive arthroscopic partial meniscectomy (n=159) or exercise-based physical therapy (n=162).The primary outcome of interest was patient-reported knee function assessed by the International Knee Documentation Committee (IKDC) questionnaire.Secondary outcomes included radiographic progression of knee osteoarthritis, symptomatic OA, pain during activities, physical functioning (KOOS-PS), and quality of life.Outcomes were assessed at multiple time points up to 5 years.Overall, the results of the study revealed that physical therapy was noninferior to surgery for knee function, with no clinically meaningful differences in OA progression or other secondary outcomes. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Forty patients aged age 18 to 25 years old with a first episode of anterior shoulder dislocation were randomized to receive arthroscopic Bankart repair (n=20) or nonoperative management (n=20). The primary outcome of interest was recurrence of instability at two year follow-up.Secondary outcomes of interest included range of motion, return to sport, Disabilities of the Arm, Shoulder and Hand (DASH) score, the Walch-Duplay score, and the Western Ontario Shoulder Instability Index (WOSI).At two year follow-up, recurrence of instability was significantly lower in the group undergoing arthroscopic Bankart repair.The Walch-Duplay score and WOSI scores were significantly better in the surgical group.Patients had a higher return to sport in the surgical group at two years follow-up. No surgical complications...
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Author verified Level 1 RCT
3%
①
Synopsis:
One hundred fifty-three patients with severe knee osteoarthritis undergoing primary total knee arthroplasty (TKA) were randomized to receive medialized anatomic (MA) (n=47), medialized dome (MD) (n=44), or Gaussian dome (GD) (n=48) patellar components.The primary outcome of interest was the postoperative Kujala score at two years.Secondary outcomes included the Knee Society Scores (KSKS and KSFS), Hospital for Special Surgery (HSS) score, Western Ontario and McMaster Universities Arthritis Index (WOMAC), range of motion, and radiographic parameters such as patellar tilt angle (PTA) and Blackburne-Peel ratio.Outcomes were assessed at 1 month, 3 months, 1 year, and 2 years postoperatively.Overall, the results revealed no significant differences in clinical scores, complications, or range of motion between the three groups.However, the GD group had a higher proportion of outliers in PTA, but this was not clinically significant. The findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Twenty randomized controlled trials including 1875 patients undergoing orthopedic surgery were included in this systematic review and meta-analysis comparing perioperative ERAS vs.conventional care.Pooled outcomes of interest included wound infection rates, postoperative complications, and length of hospital stay.The pooled results demonstrated that ERAS significantly reduced wound infection rates, postoperative complications, and hospital length of stay. The main findings...
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Level 1 Meta Analysis
2%
②
Synopsis:
159 patients scheduled for total knee or total hip arthroplasty were randomized to patient education via an automated text messaging service (StreaMD; SMS bot group) or standard preoperative clinic appointment and perioperative instructions (control group).The purpose of this study was to determine if the SMS bot group demonstrated greater daily postoperative exercise compared to the control group over the first 6 weeks after surgery.Results demonstrated a statistically significant longer duration of daily exercise in the SMS bot group compared to the control group. In addition, significant...
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Level 2 RCT
2%
①
Synopsis:
One hundred patients with isolated traumatic meniscal tears were randomized to receive either arthroscopic partial meniscectomy (n=49) or standardized physical therapy (n=51), with the option for delayed arthroscopic partial meniscectomy after three months.The primary outcome was the IKDC score at 24 months, which assesses knee symptoms, function, and ability to participate in sports.Secondary outcomes included KOOS, NRS pain, Lysholm, WOMET, Tegner activity level, and satisfaction with knee function.Follow-up assessments were conducted at multiple time points up to 24 months.Overall, both groups demonstrated clinically relevant improvements in IKDC scores, but there was no significant difference between the groups at 24 months. The study suggests...
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Level 1 RCT
2%
①
Synopsis:
Five hundred three patients with unilateral primary frozen shoulder were randomized to receive manipulation under anaesthesia with steroid injection (n=201), arthroscopic capsular release with or without steroid injection (n=203), or early structured physiotherapy with steroid injection (n=99).The primary outcome was the Oxford Shoulder Score (OSS) at 12 months.Secondary outcomes included the QuickDASH, pain intensity (Numeric Rating Scale), perceived extent of recovery, and quality of life (EQ-5D-5L).Outcomes were assessed at baseline, 3, 6, and 12 months.Overall, the results revealed that all three treatments resulted in substantial improvements in OSS, but none were clinically superior.Arthroscopic capsular release had slightly higher OSS at 12 months but also more adverse events and higher costs.Manipulation under anaesthesia was the most cost-effective. These findings suggest...
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Level 1 RCT