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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:
In this meta-analysis, fifteen randomized controlled trials were included to compare operative (ORIF with locked plates, locked IMN, cemented, uncemented, nonmodular or modular hemiarthroplasty, and reverse shoulder arthroplasty) versus non-operative treatment for proximal humeral fractures.Outcomes of interest were normalized function, pain on the Visual Analog Scale (VAS), and the incidence of reoperation.In the pooled analysis comparing operative treatment with nonoperative treatment, no differences were found between all outcomes. When comparing ORIF...
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Level 1 Meta Analysis
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Synopsis:
Thirty patients with partial-thickness tears of the supraspinatus tendon were randomized to receive a platelet-rich plasma injection (n=15) or corticosteroid injection (n=15).The primary outcome of interest was tear size.The secondary outcome of interest was functional outcomes, measured with the American Shoulder and Elbow Surgeons (ASES) score and the Constant Murley (CM) score.Outcomes were measured at 6 months post-injection.The improvement from baseline in tear size at 6 months in the coronal and sagittal views was significantly greater in the platelet-rich plasma group. Similarly, ASES and...
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Level 1 RCT
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Synopsis:
5 randomized controlled trials with a total of 268 patients with low back pain were included in this systematic review and meta-analysis assessing the effectiveness of visceral osteopathy manipulation.Pooled outcomes of interest included pain, disability and physical function.The results of all primary outcome analyses found no benefit of visceral osteopathy for pain, disability, and physical function vs.control.In the subgroup analysis by intervention, visceral osteopathy in isolation provided a significant benefit in pain, but there was a limited number of studies and an imbalance in sample sizes between the included groups. More studies are...
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Level 1 Meta Analysis
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Synopsis:
92 patients with mild-moderate carpal tunnel syndrome were randomized to receive neural mobilization plus 4 weeks of extracorporeal shockwave therapy (n=47) or neural mobilization alone (n=45).Outcomes of interest included clinical efficacy, symptom improvement, and pain scores, median nerve electrophysiological examination, upper limb function, and symptom scores as measured by the Boston Carpal Tunnel Questionnaire (BCTQ), the activity of daily living mobility, and adverse events. The results of...
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Level 1 RCT
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Synopsis:
52 elderly knee osteoarthritis patients who underwent a unilateral primary total knee replacement were randomized to receive 4 months of exergaming rehabilitation (videogame-based rehabilitation; n=25) or standard home-based exercise (n=27).The primary outcomes of interest were knee-related function and pain, and mobility.Secondary outcomes of interest included knee pain on a Visual Analog Scale (VAS), walking speed, lower extremity performance, muscle strength, knee range of motion, and satisfaction, assessed up to 4 months follow-up. The study revealed...
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Level 1 RCT
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Synopsis:
40 patients with chronic lateral ankle instability undergoing a modified Brostrom-Gould procedure were randomized to receive conventional post-operative management only (n=20) or in addition to 3 post-operative injections of leukocyte-rich platelet-rich plasma injections (PRP; n=20).Outcomes of interest included pain on a Visual Analog Scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) scores, and total ankle range of motion, assessed up to 6 months post-operation (3 months for range of motion).PRP injections did not provide any significant benefit with respect to the improvement in pain or functional scores compared to the control group. However, the change...
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Level 1 RCT
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Synopsis:
Forty patients with knee osteoarthritis were randomized to receive either low-level laser therapy (LLLT; n=20) or pulsed electromagnetic field therapy (PEMFT; n=20).Outcomes of interest were pain at rest, during walking, during sitting to stand, and while walking upstairs, all measured using the Visual Analog Scale (VAS).The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to measure pain, stiffness, and function.Additionally, the Timed Up and Go (TUG) test and 10-m walking test were also assessed after 3 weeks.Between-group comparisons for VAS at rest, rising to stand, stairs, and WOMAC total score, pain, and function were all significantly better after 3 weeks in the PEMFT group. TUG scores were...
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Level 1 RCT
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Synopsis:
100 patients with anterior cruciate ligament (ACL) tears were randomized to receive an ACL reconstruction using an average-sized graft combined with a lateral extra-articular tenodesis (LET) procedure, or an ACL reconstruction with a large-size graft.Outcomes of interest included graft failure, pivot shift results, and the International Knee Documentation Committee score (IKDC).The follow-up was 2 years post-operation.Patients who received an average-sized graft with LET reported lower rates of graft failure and lower rates of rotational instability (as measured by the pivot shift) compared to ACL reconstruction with a large graft. No difference in...
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Level 1 RCT
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Synopsis:
200 patients scheduled for unilateral arthroscopic anterior cruciate ligament (ACL) reconstruction were randomized to receive a tourniquet (n=100) or no tourniquet (n=100) during the procedure.Primary outcomes of interest included intraoperative visualization, operative time, and sterile saline consumption.Secondary outcomes of interest included blood loss, pain, opioid consumption, limb swelling, functional scores, and graft healing.Outcomes were assessed up to 12 months post-operation.Results revealed significantly better intra-operative visualization, less intra-operative blood loss, shorter operative time, and less sterile saline consumption in the tourniquet group. No differences in...
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Level 1 RCT
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Synopsis:
34 geriatric patients with distal femoral fractures were randomized to receive double plating fixation (n=18) or distal femoral replacement (n=16).Outcomes of interest included functional, radiological, and safety outcomes measured up to 12 months.Range of motion at 1 month was better in the replacement group.However, KSS knee scores and range of motion at 12 months were significantly better in the double-plating group compared to the replacement group. No differences in...
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Level 1 RCT