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9%
Synopsis: One hundred and forty hips scheduled for a total hip arthroplasty were randomized to receive a metal-on-polyethylene bearing (n=69 hips) or a ceramic-on-ceramic bearing (n=71 hips).Outcomes of interest included aseptic revision rate, rate of component loosening, rate of periarticular osteolysis, the Western Ontario and McMaster University (WOMAC) osteoarthritis scores, the incidence of ceramic fracture, and implant survivorship.The minimum follow-up time was 20 years.Results revealed significantly greater survivorship, lower aseptic revision rate, lower rate of periarticular osteolysis, and greater functional scores in the ceramic-on-ceramic group compared to the metal-on-polyethylene group (p<0.05 for all). No cases of... Read More »
Conference Report
6%
Synopsis: Eight randomized controlled trials were included in this meta-analysis which comparing negative pressure wound therapy and conventional dressings in wound management following open fracture. Pooled analysis demonstrated a significantly lower rate of infection among groups treated with negative pressure wound therapy compared to groups treated with conventional dressings. Read More »
Level 2 Meta Analysis
4%
Synopsis: 19 patients who underwent total hip arthroplasty were randomized to postoperative wound treatment using either the current standard of care or negative pressure wound treatment (NPWT) to determine its effects on post-operative seromas and wound healing. Results at 10 days indicated superior wound healing and a reduction in the occurrence of seromas, with only 44% of the NPWT group developing seroma compared to 90% of the standard dressing group. Read More »
Level 2 RCT
4%
Synopsis: 160 patients scheduled for a total joint arthroplasty (hip/knee) were randomized to receive either a closed incision negative pressure wound therapy (ciNPWT; PREVENA) device or a standard-of-care silver-impregnated occlusive wound dressing.The primary outcome of interest was the incidence of wound complications.Secondary outcomes included the rates or re-admission and re-operation.Follow up was performed at 2 weeks, 4 weeks, and 12 weeks post-surgery.Results revealed a significantly favourable rate of wound complications in the ciNPWT group compared to the control group at 2 weeks and overall.The rate of re-operation was significantly in favour of the ciNPWT group at 12 weeks and overall compared to the control group.Two cases of infection were reported in the ciNPWT group, whilst 8 cases were reported in the control group. No differences were... Read More »
Level 2 RCT
1%
Synopsis: 2551 patients with an open fracture of the extremity were included in this randomized, 2 by 3 factorial design trial to investigate the effects of irrigation pressure and solution on reoperation rates.The patients were randomized to receive irrigation with either soap or saline at high, low, or very low pressure.After a 12 month follow-up period, the results indicated that the use of saline was superior to the use of soap for the irrigation of open fractures.Additionally, there were no differences between the different pressures, establishing very low pressure as a low-cost alternative in the irrigation of open fractures.The analysis indicated that there was no interaction between irrigation solution and pressure. Read More »
Author verified Level 1 RCT
1%
Synopsis: 13 ACE reports (4 reviews/ meta-analyses, 9 RCTs) were included from the OrthoEvidence database that compared operative versus nonoperative or operative versus operative treatments for displaced midshaft clavicle fractures.The findings of this review demonstrated that surgical procedures led to a lower rate of nonunion and malunion with better functional outcome when compared to nonoperative treatment. Comparisons of operative treatments indicated that an optimal surgical procedure - between plate fixation, nailing, and pin fixation - could not be determined based on union rates or functional outcome. The results of... Read More »
ACE Review
1%
Synopsis: 8 ACE Reports (all randomized controlled trials) from the OrthoEvidence database were included in this review/meta-analysis examining the effect of arthroscopic surgery and physical therapy in the treatment of degenerative tears of the meniscus and knee osteoarthritis.The purpose of this review was to determine if any differences in outcome were demonstrated between arthroscopy followed by physical therapy versus physical therapy alone, regarding pain, function, satisfaction, adverse events, or osteoarthritis progression.Pain results were pooled at 3 different time point: 2-3 months, 6 months, and 12-24 months postintervention.At short-term (2-3 months) and long-term (12-24 months) follow-up, pain was similar between groups, with no significant difference observed.There tended to be less pain experienced at 6 months following arthroscopy, however this only reached significance in the KOOS pain outcome and the clinical importance of this observation is unknown.Assessments of functional outcome, either pooled or qualitative, suggested no significant difference between groups as well. The rate of... Read More »
ACE Review
1%
Synopsis: 9 studies (8 RCTs, 1 controlled clinical trial) were selected for a systematic review of elderly patients with a proximal humerus fracture.The goal of this study was to determine whether surgical or nonoperative treatment is the optimal intervention in patients over the age of 60.Operative treatments identified in the included trials were the tension band technique, locking plates, pinning and hemiarthroplasty.The results of this review indicated that many studies did not find a significant difference in functional outcomes when comparing locking plates or tension bands to nonoperative treatment at 1 year.There was a significantly better health-related quality of life and Euroqol-5D in patients that received a hemiarthroplasty compared to the nonoperative group for patients with 4-part fractures.Complications were common in the operative treatment groups. This study highlights... Read More »
Level 2 Meta Analysis
<1%
Synopsis: 396 patients (501 primary knee replacements) were randomized to receive a cemented or cementless method of fixation for press-fit condylar (PFC) total knee replacement (TKR).The primary outcome was the long-term survival rate (15-year period) of the prosthesis. Results indicated good... Read More »
Level 2 RCT
<1%
Synopsis: 59 patients who underwent treatment for stage IIA/IIB, intramedullary, high-grade osteosarcoma, between 1981 and 1984, were randomized to receive either T-10B protocol adjuvant chemotherapy or no adjuvant chemotherapy following definitive surgical resection.Improvements in disease-free survival (DFS) and overall survival (OS) were monitored over 25 years, and tumor necrosis was evaluated for implications in prognosis. Results demonstrated a... Read More »
Author verified Level 2 RCT