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You are viewing the most viewed ACE Reports by Orthopaedic Resident/Interns over the last 30 days in all specialties.
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①
Synopsis:
This systematic review and meta-analysis included 20 randomized controlled trials (RCTs) with a total of 1,528 patients with extra-articular distal tibia fractures.The study compared intramedullary nail (IMN) fixation versus plate fixation.Pooled outcomes of interest included surgery time, union time, weight-bearing time, wound infection rates, malunion rates, anterior knee pain, secondary procedures, and functional assessment scores.IMN was associated with shorter surgery time, faster union, and earlier full weight-bearing compared to plate fixation.Additionally, IMN significantly reduced the risk of wound infection and secondary procedures.However, IMN had a higher risk of malunion and anterior knee pain.Functional assessment scores and rates of nonunion and delayed union were comparable between both groups. These findings suggest...
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Level 1 Meta Analysis
6%
Synopsis:
Three hundred ninety-four patients with orthopedic trauma were randomized to receive either CEAA supplementation (n=XX) or a standard diet (n=XX).The primary outcome of interest was changes in fat-free mass (FFM).Secondary outcomes included complication rates, surgical site infections, unplanned reoperations, and mortality.Outcomes were assessed at baseline, 2, 6, and 12 weeks postoperatively, with complications monitored up to one year.Overall, the results revealed that patients with open fractures/polytrauma (OF/PT) experienced significant muscle loss at six weeks, while fragility fracture (FFx) patients lost muscle mass at 12 weeks.Patients with isolated fractures (IFx) gained muscle mass at 12 weeks.CEAA supplementation appeared to mitigate muscle loss in the OF/PT and FFx groups and was associated with a reduced risk of non-union, mortality, and total complications. These findings suggest...
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Conference Report
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
4%
②
Synopsis:
This study was based on previous work completed by the same authors in 2004 which looked at the outcomes of autologous chondrocyte implantation and microfracture surgery at 2-year follow-up.This current study looks at outcomes at 5-year follow-up.80 patients with a single chronic symptomatic cartilage defect on the femoral condyle were randomized to undergo one of two treatments.One group underwent an autologous chondrocyte implantation procedure while the other group underwent microfracture surgery.Results showed that clinical outcomes were comparable between the two groups. One-third of the...
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Level 2 RCT
4%
Synopsis:
Seventy patients with isolated, closed humeral shaft fractures were randomized to receive either open reduction and plate fixation (n=36) or functional bracing (n=34).The primary outcome of interest was the DASH score at three months.Secondary outcomes included health-related quality of life (HRQoL), pain scores, shoulder/elbow range of motion, complications, and return to activity over one year.Overall, the results revealed that surgery led to superior functional outcomes at three months (mean DASH 24.5 vs.39.4; MD 15.0, p=0.006) and improved HRQoL and pain scores over the first six months.Surgery also resulted in better shoulder and elbow mobility and a higher rate of return to sport.However, by one year, there were no significant differences between groups. These findings suggest...
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Conference Report
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:
Four randomized controlled trials (RCTs) including 423 elderly patients (aged ≥ 60 years) with displaced distal radius fractures (DRFs) were included in this systematic review and meta-analysis comparing volar locked plate (VLP) fixation versus closed reduction and casting (CRC).Pooled outcomes of interest included the Patient-Rated Wrist Evaluation (PRWE), Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, EuroQol 5 Dimension 5-level score (EQ-5D-5L), grip strength, and incidence of reoperation.VLP fixation was associated with statistically significant improvements in PRWE score, DASH score, and grip strength, but no significant differences in EQ-5D-5L scores or reoperation rates. Despite some functional...
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Level 1 Meta Analysis
3%
①
Synopsis:
One hundred thirty patients undergoing primary total knee arthroplasty (TKA) for knee osteoarthritis were randomized to receive surgery with a tourniquet (n=65) or without a tourniquet (n=65).The primary outcome was quadriceps thickness.Secondary outcomes included quadriceps stiffness, operation time, intraoperative blood loss, postoperative blood loss, total blood loss, transfusion rate, thigh circumference, pain scores (VAS), D-Dimer and CRP levels, knee function scores, patient satisfaction, and complications.Outcomes were assessed up to two years postoperatively.Overall, the results revealed that the tourniquet group had significantly less total blood loss and intraoperative blood loss but greater postoperative blood loss and a higher D-Dimer level on postoperative day 3.Other clinical parameters, including quadriceps thickness, stiffness, pain scores, function scores, and complications, showed no significant differences between groups. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Four randomized controlled trials (RCTs) comprising 244 patients with Rockwood type III acromioclavicular (AC) joint dislocation were included in this systematic review and meta-analysis comparing operative versus conservative treatment.The pooled outcomes of interest included Constant score (CS), coracoclavicular distance (CCD), pain levels, and complication rates.Results indicated no significant difference in long-term functional outcomes between the two treatment approaches.Operative treatment provided superior early pain relief at all follow-up points; however, it did not translate into better long-term functional outcomes and was associated with a higher incidence of posttraumatic osteoarthritis and hardware-related complications.Conservative treatment resulted in fewer complications and similar long-term results. These findings suggest...
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Level 1 Meta Analysis
3%
①
Synopsis:
Twenty-eight randomized controlled trials including 2,296 patients with osteoarthritis undergoing total knee or hip arthroplasty were included in this systematic review and meta-analysis comparing prehabilitation vs.usual care.Pooled outcomes of interest included self-reported function, pain, health-related quality of life (HRQoL), and performance-based measures of strength, range of motion (ROM), balance, and functional mobility.Prehabilitation demonstrated significant improvements in function, pain, HRQoL, strength, ROM, and functional mobility postoperatively.However, no significant effect was observed for balance. High risk of...
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Level 1 Meta Analysis