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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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3%
①
Synopsis:
One hundred and six patients undergoing bilateral total knee arthroplasty (TKA) were randomized to receive either 20 mg of duloxetine (n=53) or a placebo (n=53) from preoperative day 2 to postoperative day 28.The primary outcome of interest was pain control, measured using the visual analogue scale (VAS) at rest (rVAS) and during mobilization (mVAS).Secondary outcomes included additional non-steroidal anti-inflammatory drug (NSAID) consumption, patient satisfaction, and safety profile assessment.Outcomes were assessed at 48 hours, 1 week, 2 weeks, 4 weeks, and 3 months postoperatively.Overall, the study revealed that duloxetine significantly reduced pain scores (rVAS and mVAS) and NSAID consumption during the first two postoperative weeks, with differences leveling off by the 4-week follow-up.Patient satisfaction was also higher in the duloxetine group, with a comparable safety profile. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Six studies involving 422 patients with chronic midportion Achilles tendinopathy were included in this systematic review and meta-analysis comparing PRP injections with nonoperative treatments.Pooled outcomes included VISA-A scores and maximal Achilles tendon (AT) thickness across three time points (3, 6, and 12 months).No significant differences were observed in functional outcomes (VISA-A score) or tendon thickness between PRP and control groups at any time point (e.g., short-term VISA-A, p = 0.29; intermediate-term AT thickness, p = 0.20). This review suggests...
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Level 1 Meta Analysis
3%
①
Synopsis:
Four randomized controlled trials (RCTs) including 423 elderly patients (aged ≥ 60 years) with displaced distal radius fractures (DRFs) were included in this systematic review and meta-analysis comparing volar locked plate (VLP) fixation versus closed reduction and casting (CRC).Pooled outcomes of interest included the Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, EuroQol 5 Dimension 5-level score (EQ-5D-5L), grip strength, and incidence of reoperation.VLP fixation was associated with statistically significant improvements in PRWE score, DASH score, and grip strength, but no significant differences in EQ-5D-5L scores or reoperation rates. Despite some functional...
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Level 1 Meta Analysis
2%
①
Synopsis:
Forty-three patients with displaced Lisfranc injuries were randomized to receive open reduction and internal fixation (ORIF, n=22) or primary arthrodesis (PA, n=21).The primary outcome was the Visual Analogue Scale Foot and Ankle (VAS-FA) score at 24 months.Secondary outcomes included subscales of the VAS-FA (pain, function, and complaints) and the American Orthopaedic Foot & Ankle Society (AOFAS) Midfoot Scale, assessed at 6, 12, and 24 months.Overall, the results revealed no significant differences in VAS-FA or AOFAS scores between the two groups across all follow-up points.Both ORIF and PA appear to be viable initial surgical methods for displaced Lisfranc injuries. However, the study...
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Level 1 RCT
2%
①
Synopsis:
Ninety patients with isolated meniscal tears requiring partial meniscectomy were randomized to receive either an intra-articular PRP injection immediately after surgery (n=45) or meniscectomy alone (n=45).The primary outcome was pain reduction assessed using the visual analog scale (VAS) at 30 days.Secondary outcomes included functional recovery measured by the International Knee Documentation Committee (IKDC) subjective score, Knee injury and Osteoarthritis Outcome Score (KOOS) subscales, Tegner score for activity level, and EuroQol-Visual Analog Scale (EQ-VAS) score.Outcomes were assessed at baseline and at 15, 30, 60, and 180 days postoperatively.Overall, the study found no significant differences between groups in pain relief, function, or return to sport.PRP injection led to earlier pain improvement at 15 days, but this advantage did not translate into superior long-term outcomes. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
One hundred thirty-nine patients with carpal tunnel syndrome undergoing carpal tunnel release were randomized to receive either lidocaine alone (n=67) or a combination of lidocaine and bupivacaine (n=72).The primary outcome was postoperative pain severity measured over 72 hours.Secondary outcomes included time to first analgesic use, quantity of analgesics consumed, and duration of postoperative finger numbness.Pain scores were significantly lower in the intervention group at 6 hours (2.3 vs.3.2, p<0.05) and 8 hours (2.9 vs.3.9, p<0.05).Patients receiving the combination anesthetic also delayed taking their first analgesic longer (5.2 vs.3.7 hours, p<0.05).However, this group experienced prolonged numbness at nearly all time points.Overall, the study revealed that the addition of bupivacaine modestly improved early postoperative pain control but at the cost of extended finger numbness. This suggests that...
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Level 1 RCT
2%
①
Synopsis:
Four randomized controlled trials (RCTs) comprising 244 patients with Rockwood type III acromioclavicular (AC) joint dislocation were included in this systematic review and meta-analysis comparing operative versus conservative treatment.The pooled outcomes of interest included Constant score (CS), coracoclavicular distance (CCD), pain levels, and complication rates.Results indicated no significant difference in long-term functional outcomes between the two treatment approaches.Operative treatment provided superior early pain relief at all follow-up points; however, it did not translate into better long-term functional outcomes and was associated with a higher incidence of posttraumatic osteoarthritis and hardware-related complications.Conservative treatment resulted in fewer complications and similar long-term results. These findings suggest...
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Level 1 Meta Analysis
2%
①
Synopsis:
Forty patients older than 50 years with chronic Achilles tendinopathy following Haglund deformity, who did not respond to conservative treatment, were randomized to receive either debridement and ostectomy alone (control group, n=20) or debridement and ostectomy with flexor hallucis longus (FHL) tendon transfer (FHL group, n=20).The primary outcome of interest was improvement in American Orthopaedic Foot & Ankle Society (AOFAS) ankle hindfoot scores and Victorian Institute of Sports Assessment Achilles (VISA-A) scores.Secondary outcomes included surgical complications and hallux function.Outcomes were assessed preoperatively and at one-year follow-up.Overall, the results indicated that while both groups showed significant improvements in AOFAS and VISA-A scores, the FHL group demonstrated greater improvements (P < .001), though the differences did not reach the minimal clinically important difference.There were no significant differences in surgical complications or hallux function between groups. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
Forty-eight patients with surgically repaired Achilles tendon ruptures were randomized to receive either standard loading (n=24) or delayed loading (n=24).The primary outcome of interest was the heel-rise height difference between the injured and uninjured sides at one year.Secondary outcomes included tendon length measured with MRI, muscle fascicle length and pennation angle of the gastrocnemius medialis, Doppler activity, Achilles tendon Total Rupture Score (ATRS), and isometric muscle strength.Outcomes were assessed for up to one year.Overall, the results of the study revealed no significant difference in heel-rise height deficit between the two groups.However, the delayed group had less Doppler activity at 12 weeks and a better ATRS at 52 weeks. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
Sixty-five patients with Achilles tendinopathy were randomized to receive active pulsed electromagnetic field (PEMF) therapy plus eccentric exercise (n=33) or sham PEMF therapy plus eccentric exercise (n=32).The primary outcome of interest was the Victorian Institute of Sports Assessment–Achilles (VISA-A) score.Secondary outcomes included numeric pain rating scale (NPRS) scores, tendon neovascularity measured by the Öhberg score, and time spent on sports per week.Outcomes were assessed at baseline and at 4, 8, and 12 weeks posttreatment.Overall, the results of the study revealed that while both groups showed significant improvements in VISA-A scores, NPRS scores, and tendon neovascularity over time, there were no significant differences between the PEMF and sham groups in any measured outcomes. This suggests that...
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Level 1 RCT