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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:
This systematic review and meta-analysis included 10 studies, comprising randomized controlled trials, single-arm studies, and a retrospective cohort, evaluating PRP in ankle disorders.The pooled outcomes of interest were the American Orthopaedic Foot and Ankle Society (AOFAS) score and Visual Analog Scale (VAS) score.The analysis found no statistically significant difference in AOFAS scores between PRP and control treatments, although PRP showed better efficacy in patients with talar cartilage injuries.PRP was effective in reducing pain, particularly for talar cartilage injuries. The results suggest...
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Level 1 Meta Analysis
7%
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
7%
①
Synopsis:
Fifty-six patients with subacromial impingement syndrome (SIS) were randomized to receive either exercise therapy (ET) alone (n=28) or exercise therapy with two doses of Platelet-Rich Plasma (PRP) injections (n=28).The primary outcome was pain reduction, assessed by the Visual Analog Scale (VAS).Secondary outcomes included functionality (Constant-Murley Score, CMS) and QoL (SF-36).Outcomes were assessed at baseline and after 6 months.Overall, the study revealed that both treatments were effective; however, the PRP group demonstrated superior improvements in resting and nighttime pain (VAS scores) and in shoulder abduction strength and range of motion. These findings suggest...
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Level 1 RCT
7%
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
5%
①
Synopsis:
Four randomized controlled trials (RCTs) including 390 patients with early-stage knee osteoarthritis (KL I-II) were included in this systematic review and meta-analysis comparing intra-articular hyaluronic acid (HA) injections with other biologically active injections such as platelet-rich plasma (PRP) and corticosteroids (CSs).Pooled outcomes of interest included the visual analogue scale (VAS), the Western Ontario McMaster Osteo-Arthritis Index (WOMAC), and its subscales (pain, stiffness, and function).At the final follow-up (mean: 7.5 months), no significant differences were found between HA and other biologically active compounds in any measured outcomes. These findings suggest...
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Level 1 Meta Analysis
3%
Comparing knee stability, subjective function, and OA development between DB & SB ACL reconstruction
②
Synopsis:
60 patients requiring anterior cruciate ligament (ACL) reconstruction were randomized to either double-bundle reconstruction or single-bundle reconstruction.Patients were assessed for instrumented anteroposterior knee laxity (KT-2000), subjective function, objective functional performance on hop tests, and osteoarthritis development over 6-year follow-up.Results demonstrated no significant differences in any outcome measure between the two groups. One case of...
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Level 2 RCT
3%
①
Synopsis:
Eight randomized controlled trials including 434 patients with isolated meniscal tears treated via arthroscopic meniscectomy were included in this systematic review and meta-analysis comparing home-based rehabilitation (HBP) versus supervised inpatient and/or outpatient physical therapy (IOP).Pooled outcomes of interest included the Lysholm score, subjective IKDC score, knee flexion and extension, thigh girth, hop test performance, and return-to-work time.Short-term results showed that IOP was associated with slightly better Lysholm scores and vertical hop performance, while HBP showed better thigh girth outcomes.However, midterm results showed no significant differences in primary or secondary outcomes between groups. These findings suggest...
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Level 1 Meta Analysis
3%
①
Synopsis:
This systematic review and meta-analysis included 24 randomized controlled trials with 1711 participants diagnosed with sciatica due to lumbar disc herniation.It compared surgical treatment, primarily discectomy, to non-surgical treatments and epidural steroid injections.The primary outcomes assessed were leg pain and disability, while secondary outcomes included adverse events, back pain, quality of life, and treatment satisfaction.The pooled results indicated that discectomy provided moderate reductions in leg pain in the short term, with diminishing benefits over time.Effects on disability were smaller, showing only minor improvements.The long-term outcomes revealed no significant differences between surgical and non-surgical treatments. These findings suggest...
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Level 1 Meta Analysis
3%
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
1%
①
Synopsis:
1054 patients being treated for bone or joint infection at 26 UK centers were randomized in this non-inferiority trial to receive 6 weeks of oral antibiotic therapy (n=527) or 6 weeks of intravenous antibiotic therapy (n=527).The primary outcome of interest was the rate of definite treatment failure.Secondary outcomes of interest included the rate of treatment discontinuation, catheter complications, diarrhea caused by C.difficile, serious adverse events, length of hospitalization, and patient-reported outcomes (Oxford Hip and Knee Scores [OHS; OKS]; EuroQual-5Dimension scores [EQ-5D]).Outcomes were assessed at 6 weeks, 4 months, and 1 year follow-up.Oral antibiotics were found to be non-inferior to intravenous antibiotics with regards to the risk of definitive treatment failure.The incidence of early discontinuation of treatment and catheter complications, and length of hospitalization were significantly higher in the intravenous group, however, no differences in the incidence of diarrhea or serious adverse events were observed between the two groups. EQ-5D scores and...
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Level 1 RCT