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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 randomized controlled trials involving patients diagnosed with knee osteoarthritis.The study compared arthroscopic surgery to various conservative treatments such as physical therapy, pharmacologic interventions, and placebo.Pooled outcomes of interest included pain relief, functional recovery (WOMAC and SF-36), and patient satisfaction.Results showed no significant differences in pain relief, functional recovery, or patient satisfaction between arthroscopy and conservative treatments. The findings suggest...
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Level 1 Meta Analysis
8%
①
Synopsis:
This systematic review and meta-analysis included 16 randomized controlled trials (RCTs) with a total of 1,993 patients with knee osteoarthritis.The study compared the effects of platelet-rich plasma (PRP) injections versus various nonoperative treatments, including hyaluronic acid (HA), corticosteroids, and saline.Pooled outcomes of interest were patient-reported symptom relief, pain improvement, reintervention rates, and cartilage status assessed by MRI.The findings showed PRP had significantly better outcomes in symptom relief, reduced reintervention rates, and pain improvement compared to controls, but no significant benefit for cartilage regeneration. These findings suggest...
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Level 1 Meta Analysis
8%
①
Synopsis:
Seventy-six patients with chronic mid-portion Achilles tendinopathy were randomized to receive either 24 weeks of daily GTN ointment (n=37) or placebo ointment (n=39), both combined with a 12-week eccentric exercise program.The primary outcome was improvement in the Victorian Institute of Sports Assessment–Achilles (VISA-A) scores at 24 weeks.Secondary outcomes included pain severity, physical function, calf muscle function, pressure pain thresholds, and tendon thickness changes assessed at 6, 12, and 24 weeks.Overall, both groups showed significant improvements in VISA-A scores and other outcomes, but there were no statistically significant differences between the groups. The findings suggest...
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Level 1 RCT
8%
①
Synopsis:
Six studies involving 422 patients with chronic midportion Achilles tendinopathy were included in this systematic review and meta-analysis comparing PRP injections with nonoperative treatments.Pooled outcomes included VISA-A scores and maximal Achilles tendon (AT) thickness across three time points (3, 6, and 12 months).No significant differences were observed in functional outcomes (VISA-A score) or tendon thickness between PRP and control groups at any time point (e.g., short-term VISA-A, p = 0.29; intermediate-term AT thickness, p = 0.20). This review suggests...
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Level 1 Meta Analysis
8%
①
Synopsis:
One hundred and six patients undergoing bilateral total knee arthroplasty (TKA) were randomized to receive either 20 mg of duloxetine (n=53) or a placebo (n=53) from preoperative day 2 to postoperative day 28.The primary outcome of interest was pain control, measured using the visual analogue scale (VAS) at rest (rVAS) and during mobilization (mVAS).Secondary outcomes included additional non-steroidal anti-inflammatory drug (NSAID) consumption, patient satisfaction, and safety profile assessment.Outcomes were assessed at 48 hours, 1 week, 2 weeks, 4 weeks, and 3 months postoperatively.Overall, the study revealed that duloxetine significantly reduced pain scores (rVAS and mVAS) and NSAID consumption during the first two postoperative weeks, with differences leveling off by the 4-week follow-up.Patient satisfaction was also higher in the duloxetine group, with a comparable safety profile. These findings suggest...
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Level 1 RCT
4%
①
Synopsis:
Forty-eight patients with surgically repaired Achilles tendon ruptures were randomized to receive either standard loading (n=24) or delayed loading (n=24).The primary outcome of interest was the heel-rise height difference between the injured and uninjured sides at one year.Secondary outcomes included tendon length measured with MRI, muscle fascicle length and pennation angle of the gastrocnemius medialis, Doppler activity, Achilles tendon Total Rupture Score (ATRS), and isometric muscle strength.Outcomes were assessed for up to one year.Overall, the results of the study revealed no significant difference in heel-rise height deficit between the two groups.However, the delayed group had less Doppler activity at 12 weeks and a better ATRS at 52 weeks. These findings suggest...
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Level 1 RCT
4%
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:
One hundred forty-one cognitively intact patients undergoing hip fracture surgery were randomized to receive either a simplified pain management protocol (modTP) including fentanyl TTS 12.5 mcg/hour (n=68) or a standard treatment protocol (stdTP) with multiple analgesics and rescue opioids (n=73).The primary outcome was patient-reported well-being assessed on the day following PACU discharge.Secondary outcomes included opioid consumption, pain intensity scores, postoperative complications, and delirium rates.Outcomes were assessed over a 24-hour postoperative PACU stay.Overall, the study revealed no significant differences in well-being, opioid consumption, or complications between the two groups. The findings suggest...
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Level 1 Meta Analysis
4%
①
Synopsis:
One hundred nine patients with severe hip osteoarthritis were randomized to receive either total hip replacement (n=53) or supervised resistance training (n=56).The primary outcome of interest was the change in the Oxford Hip Score from baseline to six months, which evaluates pain and function.Secondary outcomes included various dimensions of quality of life, physical activity levels, and functional performance tests.Outcomes were assessed at baseline and six months.Overall, total hip replacement demonstrated significantly greater improvements in hip pain and function compared to resistance training. The findings suggest...
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Level 1 RCT
4%
①
Synopsis:
Seventy-two patients with shoulder tendinopathies were randomized to receive therapeutic exercise (n=36) or myofascial trigger point therapy (n=36).The primary outcome was pain intensity assessed by the Numerical Rating Scale.Secondary outcomes included pressure pain threshold and range of motion in multiple directions.Outcomes were measured at baseline and after 10 treatment sessions over five weeks.Overall, both interventions significantly improved pain intensity and range of motion.However, therapeutic exercise demonstrated a greater reduction in pressure-induced pain compared to myofascial trigger point therapy. These findings suggest...
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Level 1 RCT