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16%
Synopsis: Fifty-two patients with symptomatic KL II–III knee osteoarthritis (OA) were randomized to receive platelet-rich plasma (PRP) (n=26) or corticosteroid (CS) (n=26).The primary outcome was change in VAS pain.Secondary outcomes were NPRS pain, KOOS JR, and WOMAC.Outcomes were assessed at baseline, 6 weeks, and 3 months.Overall, the results of the study revealed that CS produced significantly larger pain reductions than PRP at 6 weeks and met MCIDs for both VAS and NPRS, whereas groups were similar by 3 months and showed comparable functional gains at both time points. These findings suggest... Read More »
Level 1 RCT
9%
Synopsis: Nine hundred fourty one patients with carpal tunnel syndrome (CTS) were randomized to receive initial surgical decompression (n=470) or initial corticosteroid injection (n=471); further interventions were allowed in both arms as needed.The primary outcome was recovery at 18 months (CTS-6 <8).Secondary outcomes included time to recovery, serial CTS-6, upper-limb function (QuickDASH), palmar pain and pain-related limitation, global perception of recovery, satisfaction, additional treatments, and adverse events.Outcomes were assessed through 18 months at prespecified intervals.Overall, the results of the study revealed that 61% in the surgery group versus 45% in the injection group recovered, and median time to recovery was shorter with surgery (9.0 vs 18.0 months).Patients starting with surgery also had better 18-month QuickDASH, global recovery, and satisfaction, while palmar pain was more frequent early after surgery but comparable by later follow-up. These findings suggest... Read More »
Level 1 RCT
7%
Synopsis: Seventy-two patients with unilateral plantar fasciitis were randomized to receive extracorporeal shock‐wave therapy (ESWT)(n=36) or Low-Dye taping (LDT) with sham ESWT (n=36).The primary outcome of interest was pain (VAS).Secondary outcomes included FAOS subscales (Symptoms, Pain, Activities of Daily Living, Sport & Recreation, and Quality of Life).Outcomes were assessed at baseline, immediately post-treatment, and at six-week follow-up.Overall, the results of the study revealed significant within-group improvements in both arms for VAS and all FAOS subscales, with no between-group differences at any time point. The study concludes... Read More »
Level 1 RCT
5%
Synopsis: Forty-two sport-active patients with chronic insertional Achilles tendinopathy were randomized to low tendon compression rehabilitation (LTCR; n=20) or high tendon compression rehabilitation (HTCR; n=22).The primary outcome was VISA-A at 12 and 24 weeks.Secondary outcomes included patient satisfaction, return-to-sport, pain on hopping (VAS-HOP) and during ADLs (VAS-ADL), single-leg heel-raise repetitions, and ultrasound tendon thickness; outcomes were assessed at baseline, 12, and 24 weeks.Overall, the results of the study revealed larger VISA-A gains with LTCR at both 12 weeks and 24 weeks, alongside higher satisfaction and better pain metrics. In short, limiting... Read More »
Level 1 RCT
3%
Synopsis: Thirty two patients with full-thickness posterosuperior rotator cuff tears were randomized to immobilization with an abduction neutral-rotation brace (n=16 analyzed) or a conventional arm sling (n=16).The primary outcomes were passive shoulder ROM (forward flexion, external rotation, internal rotation) measured serially; secondary outcomes were pain (VAS) and Constant–Murley Score (CMS).Outcomes were assessed preoperatively and at 6 weeks, 3, 6, and 12 months.Overall, the results revealed better early ROM (e.g., forward flexion and external rotation at 3 months) and lower pain at 6 weeks with the brace, while 12-month ROM converged and CMS was only modestly higher in the brace group at 12 months. These findings suggest... Read More »
Level 1 RCT
3%
Synopsis: Ninety patients with knee osteoarthritis were randomized to acupuncture (n=30), sham acupuncture (n=30), or waiting list (n=30).Patients received twelve 30-minute sessions over 4 weeks.The primary outcome was response (≥2-point NRS reduction at week 4).Secondary outcomes included changes in NRS, WOMAC, STAI-S, and fMRI metrics: ALFF (resting-state spontaneous activity) and seed-based functional connectivity (FC) centered on regions identified by ALFF.Outcomes were assessed at baseline and 4 weeks.Overall, the results revealed higher response with acupuncture (85.2%) versus sham (52%) and waiting (13.6%), greater NRS improvement with acupuncture versus sham, dorsolateral prefrontal cortex (DLPFC) ALFF decreases with both acupuncture and sham, stronger DLPFC–thalamus FC increases with acupuncture, and DLPFC–cerebellum FC decreases with sham. These findings suggest... Read More »
Level 1 RCT
3%
Synopsis: Five hundred thirty-five patients undergoing elective primary Total Hip Arthroplasty (THA) were randomized to cutaneous closure with staples (n=268) or sutures (n=267).The primary outcome was SSI (<6 weeks).Secondary outcomes included prosthetic joint infection (PJI, <1 year), other wound complications (prolonged discharge, dehiscence, necrosis; <6 weeks), and length of stay.Outcomes were assessed during admission, at discharge, then at 2 weeks (removal), 6 weeks, 3 months, and 1 year.Overall, the results of the study revealed a higher—nearly significant—SSI rate with staples and a clearly higher rate of early wound complications, driven by prolonged discharge; PJI did not differ. These findings suggest... Read More »
Level 1 RCT
1%
Synopsis: Fifty-six patients with lateral malleolar (rotational ankle) fractures were randomized to receive 2-octyl cyanoacrylate (n=27) or n-butyl (90% n-butyl/10% 2-octyl) cyanoacrylate (n=28) for skin closure after standardized plate fixation; fifty-five completed follow-up.The primary outcome was cosmetic appearance by HWES at three and six months.Secondary outcomes included patient satisfaction with cosmesis by VAS (0–100) and 5-point Likert scales at three and six months, and ankle function by OMAS at six months.Overall, the results of the study revealed no statistically significant differences between groups for HWES, VAS, Likert satisfaction, or OMAS at six months. In short, 2-octyl... Read More »
Level 1 RCT
1%
Synopsis: Ninety patients with intra-articular hip disorders, mainly osteoarthritis, were randomized to receive fluoroscopy-guided intra-articular steroid injection via the anterior approach (n=30), the anterolateral approach (n=30), or the proximal anterolateral approach (n=30).The primary outcome was successful injection in a single attempt.Secondary outcomes included pain during injection (VAS), radiation exposure, complications, and short-term functional improvement measured by the modified Harris hip score (mHHS).Outcomes were assessed at baseline and 2 weeks post-injection.Overall, the results revealed no significant differences between approaches in single-attempt success, VAS pain, radiation exposure, or mHHS improvement. The study concludes... Read More »
Level 1 RCT
1%
Synopsis: One hundred twenty-eight patients with knee osteoarthritis were randomized to receive prolotherapy with 5% dextrose (n=30), 10% dextrose (n=30), 20% dextrose (n=30), or exercise plus hotpack only (n=30).All prolotherapy groups received three injection sessions at weeks 0, 3, and 6, combined with a home exercise program and hotpack therapy.The primary outcome was pain assessed by VAS.Secondary outcomes included WOMAC scores, knee range of motion, timed up and go (TUG) test, and SF-36 quality of life scores.Outcomes were measured at baseline, 6 weeks, and 12 weeks.Overall, results showed that 10% and 20% dextrose groups had significantly greater pain reduction and functional improvements compared with exercise alone, while 20% dextrose also improved knee flexion. The findings suggest... Read More »
Level 1 RCT