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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:
Twenty-nine elderly patients (≥80 years) with displaced 3- or 4-part proximal humerus fractures were randomized to receive reverse shoulder arthroplasty (RSA) (n=17) or nonoperative treatment (n=12).The primary outcome was the Constant score.Secondary outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) score, range of motion (ROM), pain (VAS), SF-12, EQ-5D, and radiographic findings.Outcomes were assessed at a mean follow-up of approximately 7.5 years.Overall, the results revealed that RSA achieved significantly higher Constant scores and better ROM, with no significant differences in quality-of-life measures or pain.Radiographically, all nonoperative cases healed in malposition without revision, whereas one RSA patient required revision for dislocation. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
One hundred seventy-two patients undergoing total knee arthroplasty for osteoarthritis were randomized to receive either 5 mg melatonin (n=86) or 125 mg vitamin C placebo (n=86).The primary outcome was the Pittsburgh Sleep Quality Index (PSQI).Secondary outcomes included patient-reported measures of pain and physical function, opioid prescriptions, medication compliance, and adverse events.Outcomes were assessed at both 6 weeks and 90 days.Overall, the results showed no significant differences in PSQI or secondary outcomes between the melatonin and placebo groups at either time point. The findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Ninety-three patients with severe knee or hip osteoarthritis were randomized to receive either high-intensity interval training (HIIT; n=30), passive heat therapy (Heat; n=30), or home-based exercise (Home; n=33) as prehabilitation before total hip or knee arthroplasty.The primary outcome of interest was peak oxygen consumption (peak 𝑉𝑂2).Secondary outcomes included the anaerobic threshold, physical function measures, and subjective health assessments.Outcomes were assessed over a 12-week period.Overall, the results revealed that HIIT significantly improved peak 𝑉𝑂2V and the anaerobic threshold compared to the other groups.Heat therapy also increased the anaerobic threshold but not peak 𝑉𝑂2. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Sixty patients with rotator cuff tears undergoing open repair were randomized to receive either gabapentin 600 mg daily in two divided doses starting 3 days before surgery and continuing for 1 week postoperatively (n = 30) or placebo (n = 30).The primary outcome was postoperative pain intensity (NRS) over the first postoperative week.Secondary outcomes included opioid (morphine, oxycodone) consumption, sleep quality and duration, side effects, and patient satisfaction.Outcomes were assessed repeatedly during hospitalization and daily until postoperative day 7.Overall, the gabapentin group had significantly lower pain scores from the first 24 hours to day 4, reduced morphine use in the first 6 hours and oxycodone use over 1 week, longer and better-quality sleep until day 5, and higher satisfaction, without increased adverse effects. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Eighty patients undergoing primary unilateral total hip arthroplasty for osteoarthritis, osteonecrosis of the femoral head, or developmental dysplasia of the hip were randomized to receive anterior iliopsoas muscle space block (AIMSB) combined with local infiltration analgesia (LIA) (n=40) or sham AIMSB with LIA (n=40).The primary outcome was cumulative morphine consumption within 24 hours after surgery.Secondary outcomes included pain scores at rest and during motion, time to first rescue analgesia, total morphine and intraoperative opioid use, postoperative recovery milestones, quality of recovery, quadriceps strength, and adverse effects.Outcomes were assessed up to two postoperative days.Overall, the AIMSB group had significantly lower opioid requirements, lower pain scores within the first 24 hours, faster recovery (earlier ambulation and discharge), and improved quality-of-recovery scores without motor weakness or increased complications. The findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Five studies including 390 children with upper limb fractures were included in this systematic review and meta-analysis comparing waterproof casts vs.standard non-waterproof casts.Pooled outcomes of interest included comfort, itchiness, child and parent satisfaction, functional performance (ASK-P), return to activities, and complication rates.Waterproof casts significantly improved comfort, itchiness, and satisfaction, and yielded higher functional scores on the ASK-P.There were no significant differences in pain, skin complications, or loss of fracture reduction. These findings suggest...
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Level 1 Meta Analysis
3%
①
Synopsis:
Sixty male patients with unilateral ACL rupture undergoing autologous hamstring tendon reconstruction were randomized to receive either Nordic hamstring exercises with standard rehabilitation (n=30) or conventional rehabilitation alone (n=30).The primary outcome was muscle strength recovery measured by peak torque, total work, and average peak torque at 60°/s and 120°/s.Secondary outcomes included thigh circumference, Lysholm Knee Score, and knee stability tests (Lachman, anterior drawer, KT-1000).Outcomes were assessed preoperatively, and at 12 and 24 weeks postoperatively.Overall, the study showed that the Nordic hamstring group had significantly greater improvements in thigh circumference (p<0.001), hamstring strength (p<0.05 across multiple measures), and Lysholm Knee Score (97.4±3.0 vs 88.9±7.9, p=0.041). The findings suggest...
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Level 1 RCT
2%
①
Synopsis:
One hundred four patients with end-stage hip joint diseases undergoing primary total hip arthroplasty were randomized to receive intraoperative bone wax (n=52) or no bone wax (n=52).The primary outcome was total blood loss.Secondary outcomes included serum hemoglobin level, change in hemoglobin, thigh swelling (lower limb diameters), range of motion at discharge, length of postoperative hospital stay, and adverse events.Outcomes were assessed on postoperative days (POD) 1 and 3, and during follow-up at 3 weeks and 6 months.Overall, the results of the study revealed significantly lower total blood loss, smaller hemoglobin drop, and shorter hospital stays in the bone wax group. The study concludes...
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Level 1 RCT
2%
①
Synopsis:
Ninety patients with painful trapeziometacarpal osteoarthritis were randomized to receive a single intra-articular injection of platelet-rich plasma (n=45) or saline placebo (n=45).The primary outcome was change in pain on load (NRS 0–100) from baseline to 6 months.Secondary outcomes included change in pain on load at 3 months, pain at rest, Patient-Rated Wrist and Hand Evaluation (PRWHE) score, Disability of the Arm, Shoulder, and Hand (DASH) score, thumb range of motion, and pinch strength at 3 and 6 months.Overall, the results showed no significant difference in pain on load at 6 months between PRP and placebo, and no clinically relevant differences in secondary outcomes. The study concludes...
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Level 1 RCT
2%
Perioperative Blood Flow Restriction Therapy Program After Anterior Cruciate Ligament Reconstruction
①
Synopsis:
Forty-six patients who sustained an anterior cruciate ligament (ACL) tear and were scheduled for reconstruction were randomized into a group receiving either a blood flow restriction (BFR) therapy program (n=22) or a control group without BFR (n=24).The primary outcome of interest was isometric quadriceps strength at 3 months postoperatively, measured as peak and mean torques during seated leg extension exercises and presented as a ratio of the healthy limb.Secondary outcomes included patient-reported outcomes such as pain, knee function, and physical function, knee range of motion, quadriceps circumference and adverse effects.Outcomes were assessed up to 6 months postoperatively. Overall, the study...
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Level 1 RCT