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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:
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
4%
①
Synopsis:
12 randomized controlled trials (788 patients) comparing the use of a minimally invasive medial midvastus approach (MMV-TKA) versus the standard medial parapatellar total knee arthroplasty (MP-TKA) were included in this systematic review and meta-analysis.Outcomes of interest included the Knee Society Score (KSS), knee pain on a Visual Analog Scale (VAS), knee function on a Normalized Function Scale, knee range of motion (ROM), time to straight leg activity, incidence of loose outboard support belt use, operative time, length of stay, blood loss, and incidence of postoperative complications.KSS scores, VAS pain scores, and knee joint flexural activity at 3 months, and days of straight leg raises were significantly better in the MMV-TKA group.Operative time was significantly shorter in the MP-TKA group. All other outcomes...
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Level 1 Meta Analysis
4%
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:
Eleven studies, encompassing 749 patients with midshaft clavicle fractures, were included in this systematic review and meta-analysis, which compared the outcomes of intramedullary fixation versus plate fixation in midshaft clavicle fractures.The outcomes of interest included the incidence of postoperative wound infection, surgical incision length, operative time, blood loss, and hospital stay.The analysis revealed that intramedullary fixation demonstrated a lower risk of postoperative wound infection (OR, 5.92; 95% CI, 2.46, 14.27 p < 0.0001), smaller surgical incisions (MD, 6.57; 95% CI, 4.90, 8.25 p < 0.0001), shorter operative time (MD, 17.09; 95% CI 10.42, 23.77 p < 0.0001), less blood loss (MD, 63.62; 95% CI, 55.84, 71.39 p < 0.0001), and a shorter hospital stay (MD, 1.05; 95% CI, 0.84, 1.25 p < 0.0001). However, no statistical...
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Level 1 Meta Analysis
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①
Synopsis:
Ten randomized clinical trials, including 497 patients with rotator cuff disorders, were included in this systematic review and meta-analysis, which compared telemedicine-based rehabilitation with conventional rehabilitation.Outcomes of interest included the Constant-Murley Score (CMS), Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH) score, range of motion (ROM), and pain levels assessed by the visual analog scale (VAS).The pooled results demonstrated that telemedicine significantly improved shoulder function and pain relief compared to traditional rehabilitation. This suggests that...
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Level 1 Meta Analysis
3%
①
Synopsis:
482 patients with a first-time traumatic anterior shoulder dislocation were randomized to receive either one session of advice + supporting materials + the option to self-refer to physiotherapy (n=240) or the same advice + supporting materials plus an additional program of physiotherapy (n=242).The primary outcome of interest was the Oxford shoulder instability score (OSIS) at 6 months.Secondary outcomes of interest included the Disablities of the Arm, Shoulder, and Hand (QuickDASH) score, EuroQol-5 Dimensions (EQ-5D-5L) score, and the incidence of complications.Outcomes were assessed at 6 weeks, 3, 6, and 12 months.Overall, the results of the study revealed no significant differences in OSIS scores between the two groups at six months.All secondary outcomes were similar between the two groups at all time points. The additional program...
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Author verified Level 1 RCT
3%
①
Synopsis:
Eight studies, including 615 patients who underwent total hip arthroplasty (THA), were analyzed in this systematic review and meta-analysis comparing the Direct Anterior Approach (DAA; n=303) to the Postero-Lateral Approach (PLA; n=312).Pooled outcomes of interest included surgical site infection rate, duration of the operation, length of incision, and pain scores using the visual analog scale (VAS) after surgery.The meta-analysis revealed no statistically significant difference in wound infections between DAA and PLA.However, DAA was associated with a shorter incision length, longer operative times, and lower postoperative pain VAS scores within 6 weeks. Additional research is...
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Level 1 Meta Analysis
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①
Synopsis:
One hundred twenty-six patients aged over sixty were randomized to receive preoperative oral rehydration solution (ORS; n=63) or to undergo conventional overnight fasting (n=63).The primary outcome of interest was the occurrence of transient myocardial electrocardiographic ischemic changes within 30 minutes post-spinal anesthesia induction.Secondary outcomes included hemodynamic parameters and intraoperative complications such as hypotension and tachycardia, assessed up to 30 minutes post-induction.Overall, the results of the study revealed that the ORS group had significantly fewer ischemic changes and better hemodynamic stability compared to the fasting group. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
Seventy-four patients undergoing lower limb orthopedic surgeries under spinal anesthesia were randomized to receive either intranasal tapentadol (44.5 mg, n=37) or intravenous paracetamol (1 g, n=37) every 6 hours for 72 hours, starting 3 hours after surgery.The primary outcome was pain intensity measured by the Visual Analog Scale (VAS).Secondary outcomes included systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), and the need for rescue analgesia.Outcomes were assessed at multiple time points up to 72 hours post-intervention.Overall, the study revealed that intranasal tapentadol resulted in significantly lower pain scores compared to intravenous paracetamol. Additionally, patients in...
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Level 1 RCT
2%
①
Synopsis:
One hundred and one patients undergoing primary total hip arthroplasty were randomized to receive either the direct anterior approach (DAA, n=52) or the mini-posterior approach (MPA, n=49).The primary outcome assessed was the Harris Hip Score (HHS).Secondary outcomes included the 12-Item Short Form Health Survey (SF-12) physical and mental scores, Hip Disability and Osteoarthritis Outcome Score (HOOS) subscores, complication rates, reoperations, and revisions.Outcomes were evaluated over a mean follow-up period of 7.5 years.Overall, results demonstrated no clinically meaningful differences in primary or secondary outcomes, including complication rates and revisions, between the two approaches.
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Level 1 RCT