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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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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%
Synopsis:
One hundred twenty-seven patients undergoing outpatient total hip arthroplasty with the direct anterior (DA) approach were prospectively randomized and compared to fifty-one patients undergoing outpatient total hip arthroplasty with the direct lateral (DL) approach.The primary outcome of interest was the overall cost from a Canadian healthcare payer perspective.Secondary outcomes included costs from a societal perspective, encompassing patient-incurred costs, productivity losses, and informal care.Cost data were collected during hospitalization and via patient-reported diaries after discharge.Overall, the results of the study revealed no significant differences in healthcare payer costs (DA: $7910.19 vs DL: $7847.17, p=0.80) or societal costs (DA: $14657.21 vs DL: $14581.21, p=0.96). These findings suggest...
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Conference Report
5%
COA 2025: Greater Kinematic Alignment Following Unicompartmental Compared to Total Knee Arthroplasty
Synopsis:
Thirty patients with knee osteoarthritis were randomized to receive either unicompartmental knee arthroplasty (UKA; n=12) or total knee arthroplasty (TKA; n=18).The primary outcome of interest was gait biomechanics, including sagittal and coronal knee angle metrics during walking.Secondary outcomes of interest included the Oxford Knee Score (OKS) and the WOMAC sub-scores for pain, stiffness, and physical function.Outcomes were assessed pre-operatively and at one year post-operatively.Overall, the results of the study revealed that UKA was associated with gait patterns more closely resembling native knee biomechanics, including greater sagittal knee angle correlation and lower coronal knee angle RMSE (F4,25, P=0.010), while PROMs improved similarly in both groups (p<0.001). These findings suggest...
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Conference Report
5%
Functional brace improves early function and is more cost-effective than casting in Achilles rupture
①
Synopsis:
High quality evidence has revealed that non-operative management of acute Achilles tendon rupture achieves optimal outcomes in most patients.Among non-operative treatment options, the most commonly used are functional bracing (walking boot with heel wedges) and casting in equinus position.There has been a recent move towards early mobilization and more use of functional bracing over casts in a number of different areas, and it is unclear if there is a benefit in favour of either strategy in the context of Achilles tendon ruptures.In this study, the authors randomized patients to plaster cast versus functional bracing, and performed an accompanying economic evaluation.They found that patients treated with functional brace had significantly better functional scores at eight weeks, and that bracing was dominant from a cost-effectiveness perspective, with modest savings and slightly better utility. There was no...
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Level 1 RCT
3%
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
3%
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
2%
①
Synopsis:
Seventy-nine patients with greater trochanteric pain syndrome unresponsive to conservative treatment were randomized to receive a single ultrasound-guided injection of leukocyte-rich platelet-rich plasma (n=39) or saline placebo (n=40).The primary outcome of interest was the iHOT-12 score.Secondary outcomes included VAS for pain, EQ-5D index, EQ-5D VAS, and mHHS scores.Outcomes were assessed at 3, 6, and 12 months.Overall, the results of the study revealed no significant differences in any outcome measures between the PRP and placebo groups at any follow-up point. This suggests that...
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Level 1 RCT
2%
Comparison of Ligament Z-Plasty and Conventional Surgery for the Treatment of Carpal Tunnel Syndrome
①
Synopsis:
One hundred nine patients with moderate to severe carpal tunnel syndrome were randomized to receive either ligament Z-plasty (n=55) or conventional surgery (n=54).The primary outcome was the incidence of pillar pain at 3 weeks and 6 months postoperatively.Secondary outcomes included changes in grip strength, pinch strength, and Boston Carpal Tunnel Questionnaire (BCTQ) scores.Follow-up assessments occurred at 3 weeks and 6 months.Overall, the results showed a significantly lower incidence of pillar pain at 3 weeks and greater improvements in pinch strength at 3 weeks and grip and pinch strength at 6 months in the Z-plasty group. The findings suggest...
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Level 1 RCT
2%
①
Synopsis:
Two hundred thirty-six patients undergoing orthopedic, gynecologic, thoracic, general, colorectal, vascular, plastic, or urological surgery were randomized to receive either an infection prevention bundle (n=106) or usual care (n=130).The primary outcome was the incidence and number of S.aureus transmission events.Secondary outcomes included incidence of surgical site infections (SSIs), association between transmission and SSI, and impact of feedback intervention.Outcomes were assessed up to 60 days postoperatively.Overall, the results revealed that the infection prevention bundle significantly reduced S.aureus transmission and the incidence of SSIs. This suggests that...
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Level 1 RCT
2%
Synopsis:
Ninety-eight patients undergoing unilateral knee arthroplasty were randomized to receive either standard care (n=47) or a multicomponent intervention for opioid-free pain control (OFPC) (n=51).The primary outcome of interest was the rate of OFPC at eight weeks.Secondary outcomes included pain levels, patient satisfaction, recruitment and adherence rates, and feasibility metrics such as follow-up and retention.Outcomes were assessed at 3, 6, 9, and 12 months.Overall, the results of the study revealed that 67% of patients in the intervention group achieved OFPC at eight weeks, with high adherence to most components of the intervention and follow-up exceeding 90% at 12 months. These findings suggest...
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Conference Report