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3%
1-3 week immobilization period following distal radius fracture improves early function vs 6 weeks
②
Synopsis: 133 patients with a distal radius fracture scheduled for open reduction and internal fixation with a volar plate were randomized to a postoperative immobilization period or either 1 week, 3 weeks, or 6 weeks.Primary outcomes included wrist function, pain, and range of motion in wrist extension and forearm supination.Follow-up was performed at 6 weeks, 12 weeks, and 26 weeks postoperatively.Results demonstrated significantly better results related to the Patient-Rated Wrist Evaluation, visual analog scales for pain, and active range of wrist extension at 6 weeks for patients allocated to immobilization for only 1 or 3 weeks as compared to patients allocated to immobilization for 6 weeks.Differences between the three groups for results at 12 and 26 weeks were not statistically significant. Loss of fracture... Read More »
Level 2 RCT
3%
Larger drop in Hb noted with closed suction drainage versus no drainage in total knee arthroplasty
②
Synopsis: 36 patients scheduled for total knee arthroplasty were randomized to either postoperative closed suction drainage or nondrainage.Patients were assessed during hospital stay for hemoglobin (Hb) levels, pain, knee range of motion, and knee circumference, as well as at follow-up of 6 weeks, 3 months, 6 months, and 12 months related to knee range of motion, the Knee Injury and Osteoarthritis Outcome Score, and the Oxford Knee Score.Hb drop postoperatively was significantly greater in the CSD group compared to the nondrainage group.No significant differences were observed in knee range of motion between groups.Numeric rating scale pain scores during hospital stay to 10 days were significantly lower in the CSD group compared to the nondrainage group, and significance continued on the KOOS Pain score at 6 weeks and 3 months. From 6 to... Read More »
Level 2 RCT
2%
Suprapatellar IM nailing advantageous over infrapatellar IM nailing for tibial shaft fractures
①
Synopsis: Four randomized controlled trials were included in this meta-analysis which compared outcomes between suprapatellar intramedullary nailing and infrapatellar intramedullary nailing.Pooled analysis demonstrated a significant difference between approaches in favour of suprapatellar intramedullary nailing for pain scores, Lysholm scores, and fluoroscopy time. No significant differences... Read More »
Level 1 Meta Analysis
2%
Testing of noninferiority of PT vs partial meniscectomy on knee fuction in meniscal tear treatment
②
Synopsis: 321 patients with a nonobstructive mensical tear were randomized to either an 8-week physical therapy program or to arthroscopic partial meniscectomy.The primary purpose of this study was to determine if the PT group was noninferior to the APM for outcome on the International Knee Documentation Committee (IKDC) subjective score at a noninferiority margin of 8pts. When analyzed in... Read More »
Author verified Level 2 RCT
1%
No difference in 10-yr clinical outcome and survivorship between mobile- and fixed-bearing TKA
②
Synopsis: 240 patients scheduled for total knee arthroplasty were randomized to either a mobile-bearing tibial component, a modular-metal-backed fixed-bearing tibial component, or an all-polyethylene fixed-bearing tibial component.The purpose of the current study was to report 10-year survivorship, clinical scores, and range of motion between the three groups. Results at 10... Read More »
Level 2 RCT
1%
Dislocation and suture failure rates lower with tendon-to-bone vs. tendon-to-tendon repair in THA
②
Synopsis: 168 patients scheduled for total hip arthroplasty through a posterolateral approach were randomized to posterior soft tissue repair through either a tendon-to-bone or tendon-to-tendon method.Patients were assessed over the first 1 year postoperatively for incidents of hip dislocation and suture failure.Cases of suture failure were assessed using No.26 metal wire placed at an interval of 1.2cm apart during surgery, and then monitored for cases of increase in width between markers of 2.5cm or more during subsequent follow-up. Both dislocation rates... Read More »
Level 2 RCT
1%
Sliding hip screw versus cancellous screws for fixation of hip fractures
①
Synopsis: 1108 patients with a hip fracture were randomized to fixation through either a sliding hip screw or cancellous screws.The outcomes of interest included reoperation rate and patient-reported outcome measures (PROMs) over a 24-month follow-up.The overall rate of reoperation for any reason did not significantly differ between groups, 20% in the sliding hip screw group and 22% for patients in the cancellous screws group. Rates of implant... Read More »
Level 1 RCT
1%
Improved function and time to union with plating versus sling for mid-shaft clavicle fractures
②
Synopsis: 69 patients with a closed, displaced clavicle fracture (Robinson type 2B) were randomized to surgery with open reduction and internal fixation with a plate, or two nonoperative treatment with an arm pouch sling.Patients were followed over 24-month follow-up for union, incidences of nonunion and malunion, complications, and function through the Constant score.Results demonstrated no significant differences in the rate of nonunion between groups, though time to union was significantly shorter in the plate group compared to sling group. Additionally, function at... Read More »
Level 2 RCT
1%
TightRope fixation versus clavicular hook plate for acromioclavicular joint dislocation
②
Synopsis: 76 patients with a Rockwood type III acromioclavicular joint dislocation were randomized to either TightRope fixation or clavicular hook plate fixation.Patients were assessed over 1 year postoperatively.Constant-Murley score and coracoclavicular distance did not significantly differ between groups over the first year of follow-up.Pain scores were significantly lower in the TightRope group. However, three patients... Read More »
Level 2 RCT
1%
Decompression of no statistical benefit over sham, and no clinical benefit over exercise for SIS
②
Synopsis: 210 patients with shoulder impingement syndrome were randomized to one of three treatment groups: arthroscopic subacromial decompression, diagnostic arthroscopy (sham surgery), or an exercise therapy program.Primary outcomes were pain at rest and pain during activity, and follow-up was performed over 24 months.Analyses demonstrated no statistically significant differences in pain scores between the arthroscopic subacromial decompression group and the diagnostic arthroscopy group. Additionally, while statistically... Read More »
Level 2 RCT