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You are viewing the most viewed ACE Reports by Primary Care Physicians over the last 30 days in all specialties.
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①
Synopsis:
Two hundred twenty patients with calcific tendinopathy of the shoulder persisting for at least three months were randomized to receive ultrasound-guided deposit lavage with corticosteroid injection (n=73), sham lavage with corticosteroid injection (n=74), or sham lavage with lidocaine only (n=73).The primary outcome of interest was the Oxford Shoulder Score (OSS) at four months.Secondary outcomes included QuickDASH scores, pain intensity, and radiographic changes in deposit appearance, assessed up to 24 months.Overall, the study found no significant difference in OSS improvement at four months between the treatment groups: lavage + steroid vs.sham, sham lavage + steroid vs.sham, and lavage + steroid vs.sham lavage + steroid.At 24 months, none of the study procedures were superior to sham. The findings suggest...
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Level 1 RCT
6%
Progressive Stepped Exercise Program in Patients With Knee Osteoarthritis for Pain and Functionality
①
Synopsis:
Three hundred forty-five patients with symptomatic knee osteoarthritis were randomized to receive either a stepped exercise program (STEP-KOA) (n=230) or an arthritis education (AE) control intervention (n=115).The STEP-KOA intervention involved a progressive three-step approach: an internet-based exercise program (step 1), followed by biweekly physical activity coaching (step 2) for non-responders, and in-person physical therapy (step 3) for those still not meeting response criteria.The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, with secondary outcomes including objective physical function tests and self-reported physical activity.Outcomes were assessed at 3, 6, and 9 months.Overall, the study found that at 9 months, the STEP-KOA group demonstrated a greater improvement in WOMAC scores compared to the AE group, but there were no significant differences in objective physical function tests or self-reported physical activity. The findings suggest...
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Level 1 RCT
6%
①
Synopsis:
One hundred twenty-six patients with knee osteoarthritis were randomized into three groups: acupressure (n=42), sham (n=42), and control (n=42).The acupressure and sham groups applied pressure to specific acupoints daily for one month, while the control group received routine care.The primary outcome was pain severity measured using the Visual Analogue Scale (VAS), and the secondary outcome was sleep quality assessed via the Pittsburgh Sleep Quality Index (PSQI).Follow-up assessments were conducted one month after the intervention ended.Overall, the study found that self-administered acupressure significantly improved sleep quality over time compared to the control group, but no significant group differences were observed in pain reduction. These findings suggest...
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Level 1 RCT
6%
①
Synopsis:
Ninety-seven patients with symptomatic acetabular labral tears and limited osteoarthritis (Tönnis grades 0-2) were randomized to receive either hip arthroscopy with postoperative physical therapy (SPT) (n=52) or physical therapy alone (PTA) (n=45).Patients in the PTA group who experienced unsatisfactory improvement were allowed to cross over to surgery after completing at least 14 weeks of PT (CO group, n=32).The primary outcomes were the International Hip Outcome Tool-33 (iHOT-33) and the modified Harris Hip Score (mHHS) at 24 months.Secondary outcomes included additional patient-reported outcome measures (PROMs) and pain scores.Overall, the results demonstrated that SPT led to superior improvements in functional outcomes and pain reduction compared to PTA in both the intention-to-treat and modified as-treated analyses.Additionally, patients who crossed over to surgery experienced similar postoperative outcomes to those who underwent initial surgery. These findings suggest...
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Level 1 RCT
6%
Synopsis:
Nine RCTs with 1,104 patients undergoing fracture fixation were included in this systematic review and meta-analysis comparing NSAID use versus a control.Pooled outcomes of interest included radiographic non-union rates.Patients treated with NSAIDs had a significantly higher risk of non-union (8.9% vs.3.9%, RR = 2.20, 95% CI 1.21 - 3.63, p = 0.008).Subgroup analysis indicated that even short-term NSAID use (<2 weeks) was associated with increased non-union risk (RR = 1.97, 95% CI 1.10 - 3.53, p = 0.02).Pediatric patients did not exhibit differences in non-union rates (p > 0.99). These findings suggest...
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Conference Report
6%
Synopsis:
Fifty-seven patients with displaced type II distal clavicle fractures were randomized to receive either operative treatment (n=27) or non-operative treatment (n=30).The primary outcome of interest was the Disabilities of the Arm, Shoulder, and Hand (DASH) score at two years.Secondary outcomes included union rates, re-operation rates, satisfaction with shoulder appearance, and return to activities.Outcomes were assessed at one and two years.Overall, the results revealed no significant difference in DASH scores between the two groups at two years, indicating excellent function in both groups.However, 48% of the operative group required hardware removal, while 20% of the non-operative group required surgical intervention due to non-union.Union rates were comparable at two years. These findings suggest...
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Conference Report
3%
②
Synopsis:
106 patients with adhesive capsulitis were randomized to one of three groups to determine which mode of conservative therapy - corticosteroid injections with distension, corticosteroid injections only, or treatment-as-usual (verbal education, use of other conservative therapy) - was associated with the greatest improvement in shoulder pain, function, and range of motion on the short-term (4 and 8 weeks) and long-term (12 months).Results demonstrated that patients in both corticosteroid injection intervention groups had significant improvements in pain, function, abduction, internal rotation, and external rotation when compared to the usual treatment group when assessed at 4 and 8 weeks. Long-term improvements in...
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Level 2 RCT
3%
①
Synopsis:
One hundred sixty-four patients with moderate to severe symptomatic medial knee osteoarthritis were randomized to receive flat flexible shoes (n=82) or stable supportive shoes (n=82) for at least six hours daily over six months.The primary outcomes were changes in walking pain (measured on an 11-point numerical rating scale) and physical function (assessed by the Western Ontario and McMaster Universities Osteoarthritis Index).Secondary outcomes included additional pain measures, physical activity, and quality of life.At six months, 161 participants (98%) completed primary outcome assessments.The results showed that stable supportive shoes led to significantly greater reductions in walking pain than flat flexible shoes (mean difference, 1.1 units; 95% CI, 0.5 to 1.8; P=0.001), but there was no significant difference in function improvement between groups (mean difference, 2.3 units; 95% CI, −0.9 to 5.5; P=0.167).Quality of life and ipsilateral hip pain also favored stable supportive shoes.More adverse events were reported with flat flexible shoes. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
One hundred patients with isolated traumatic meniscal tears were randomized to receive either arthroscopic partial meniscectomy (n=49) or standardized physical therapy with an option for delayed surgery (n=51).The primary outcome was the IKDC score at 24 months.Secondary outcomes included the Knee Injury and Osteoarthritis Outcome Score (KOOS), pain levels (NRS), Lysholm score, Western Ontario Meniscal Evaluation Tool (WOMET), Tegner activity level, and patient satisfaction with knee function.Follow-ups occurred at baseline, 3, 6, 9, 12, and 24 months.Overall, the study found no significant difference in IKDC scores between the two groups at 24 months.Additionally, 59% of patients in the physical therapy group did not undergo delayed surgery. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Six hundred sixty-nine patients with acute ankle fractures were randomized to receive either a plaster cast (n=334) or a fixed-angle removable brace (n=335) following operative or nonoperative initial management.The primary outcome of interest was ankle function, measured using the Olerud-Molander Ankle Score (OMAS).Secondary outcomes included quality of life (EuroQol five-dimension five-level questionnaire), disability (Disability Rating Index), and complications.Outcomes were assessed at 16 weeks, 24 weeks, and two years.Overall, the study found no significant differences in ankle function between the two groups at two years.Quality of life and disability outcomes were also similar. These findings suggest...
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Level 1 RCT