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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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Platelet-Rich Plasma Injections Are Inferior to Corticosteroid Injections for Short-Term Pain Relief
①
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...
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Level 1 RCT
12%
①
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...
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Level 1 RCT
12%
①
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...
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Level 1 RCT
8%
①
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...
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Level 1 RCT
4%
②
Synopsis:
118 patients with displaced distal radius fractures were randomised to undergo either a long-arm sugar tong splinting intervention or a short-arm radial gutter splinting intervention.Radiographic outcomes and disability were observed.Results indicated that comparable outcomes were seen between the long- and short-arm groups. The author's recommend...
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Level 2 RCT
4%
Synopsis:
2945 women presenting to orthopaedic injury clinics were included in this multinational survey study to investigate the prevalence of intimate partner violence (IPV).Female patients who met eligibility criteria at one of the 12 orthopaedic fracture clinics in Canada, USA, Denmark, the Netherlands, or India anonymously answered direct questions about physical, emotional and sexual IPV.Additionally, these patients completed the Women Abuse Screening Tool (WAST) and the Partner Violence Screen (PVS) questionnaires to determine the prevalence of women suffering from IPV within the past year and over their lifetime.Results indicated that approximately 1 in 6 women presenting to an orthopaedic injury clinics have experienced IPV in the past year, and 1 in 3 women experience IPV in their life time.In addition, 1 in 50 women were presenting to the clinic as a direct result of IPV.Few of the women had ever been asked about IPV by any physician. Most patients thought...
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Author verified RCT
4%
①
Synopsis:
60 patients with distal interphalangeal joint (DIPj) active extensor lag were randomized to determine the efficacy between cast immobilization treatment using either a Quickcast orthosis to be worn 24 hours a day or a removable, low temperature thermoplastic, lever-type orthosis.After 24-28 weeks, there were no significant differences between the two groups in regard to success rate, orthosis discomfort, satisfaction with orthotic design, DIPj flexion stiffness, incidence of complications, and grip and tip-to-tip pinch strengths. However, the Quickcast...
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Author verified Level 1 RCT
4%
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...
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Level 1 RCT
4%
①
Synopsis:
One hundred fifty-eight patients with displaced fifth metacarpal neck fractures were treated with either K-wire pinning (KP; n=60), intramedullary pinning (IP; n=50), or combined intramedullary pinning with K-wire pinning (IPKP; n=48).The primary outcome was radiological correction (angulation and shortening).Secondary outcomes included range of motion (TAM), Quick-DASH scores, cosmetic scores, and complication rates.Outcomes were assessed preoperatively, postoperatively, and at 1-year follow-up.Overall, the study found that IPKP achieved significantly better angulation, less shortening, and higher cosmetic scores.Functional outcomes were similar, though stiffness occurred only in the KP and IP groups. These findings suggest...
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Level 1 RCT
4%
①
Synopsis:
Ninety-three patients undergoing total knee arthroplasty were randomized to receive either preoperative video-based opioid counseling (n=50) or no such intervention (n=43).The primary outcome of interest was postoperative opioid consumption in morphine milligram equivalents (MMEs).Secondary outcomes included pain levels, opioid-related side effects, and patient satisfaction with pain control.Outcomes were assessed at postoperative days (POD) 3, 7, and 14.Overall, the study revealed that patients in the video group consumed significantly fewer opioids in the first week postoperatively. The findings suggest...
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Level 1 RCT