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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:
Eighty patients undergoing total knee arthroplasty were randomized to receive either liposomal bupivacaine (n=40) or conventional bupivacaine (n=40) in adductor canal blocks.The primary outcome of interest was pain scores within 72 hours postoperatively.Secondary outcomes included opioid consumption and length of hospital stay.Outcomes were assessed over a period of 72 hours post-surgery.Overall, the results of the study revealed that patients in the liposomal bupivacaine group had significantly lower opioid consumption during the 72-hour period, but there were no significant differences in pain scores or hospital stay between the groups. The findings suggest...
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Level 1 RCT
8%
①
Synopsis:
Four hundred and thirty-nine patients with bicortical scaphoid waist fracture were randomized to receive an open or percutaneous surgical fixation, or cast immobilization for 6-10 weeks.The primary outcome of interest was the Patient Rated Wrist Evaluation (PRWE) total score at 52 weeks post-treatment.Secondary outcomes of interest included PRWE pain and function sub-scale scores, Short Form 12 (SF-12) mental and physical component scores, degree of bone union, range of motion, grip strength, and the incidence of adverse events.Whilst significantly favourable PRWE total scores at 12 weeks, PRWE function scores at 6 and 12 weeks, and grip strength at 6 weeks were significantly in favour of the surgery group (during the period when the cast was still being worn), no significant differences were observed between the groups in all outcomes at 52 weeks. The exception included...
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Level 1 RCT
8%
①
Synopsis:
One hundred twenty-eight patients with lumbar spinal stenosis were randomized to receive spinal manipulation, electrical dry needling, and conventional physical therapy (MEDNCPT group, n=65) or conventional physical therapy alone (CPT group, n=63).The primary outcome of interest was pain reduction measured by the Numeric Pain Rating Scale (NPRS).Secondary outcomes included disability (Oswestry Disability Index, Roland Morris Disability Index), global rating of change (GROC), and medication intake.Outcomes were assessed at 2 weeks, 6 weeks, and 3 months.Overall, the results of the study revealed that patients in the MEDNCPT group experienced significantly greater reductions in pain and disability at the 3-month follow-up compared to the CPT group. The findings suggest...
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Level 1 RCT
7%
①
Synopsis:
Seventy-two patients with nonsurgically treated, displaced, 2-part proximal humerus fractures were randomized to receive either physiotherapist-supervised exercises once a week for 10 weeks (n=37) or unsupervised home-based exercises (n=35).The primary outcome of interest was the Disability of the Arm, Shoulder, and Hand (DASH) score at 3 months.Secondary outcomes included the DASH score at 12 months, Constant-Murley Score, 15D health-related quality of life instrument, Visual Analog Scale (VAS), General Self-Efficacy Scale (GSE), and the Pain Catastrophizing Scale (PCS), with assessments at 3 and 12 months.Overall, the study found no clinically significant differences between the supervised and unsupervised groups in primary or secondary outcomes. These findings suggest...
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Level 1 RCT
7%
①
Synopsis:
Forty patients undergoing total knee arthroplasty were randomized to receive either intensive elastic resistance training (n=20) or a conventional physiotherapy protocol (n=20).The primary outcome of interest was self-administered physical function, assessed through the WOMAC questionnaire.Secondary outcome measures included pain intensity, kinesiophobia, catastrophizing, self-efficacy, range of motion, inflammatory markers (procalcitonin and C-reactive protein), and timed up-and-go (TUG) test.Outcomes were assessed at 24, 48, and 72 hours after surgery.Overall, the results of the study revealed that the intervention group showed significant improvements in physical function, pain intensity, and psychosocial variables compared to the control group. These findings suggest...
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Level 1 RCT
5%
①
Synopsis:
80 patients with distal radius fractures were randomized to receive either a 4-week (n=40) or a 6-week immobilization program.The primary outcome of interest was Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores at one year.Secondary outcomes of interest included QuickDASH scores at 3 and 6 months, incidence of adverse events, and range of motion in radial and ulnar deviation, dorsiflexion, and palmar flexion.All outcomes were comparable between the two groups at all time points. Therefore, a shorter...
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Level 1 RCT
5%
①
Synopsis:
A total of 306 patients undergoing total hip replacement for primary osteoarthritis were randomized to receive either an elastic compression dressing (n=153) or no compression dressing (n=153).The primary outcome was postoperative leg swelling, measured using a 3D infrared scanner.Secondary outcomes included estimated blood loss on postoperative days 1, 3, and 5, C-reactive protein levels, and transfusion rates.Outcomes were assessed on days 1, 3, and 5 postoperatively.Overall, the study revealed that leg swelling was significantly reduced in the compression dressing group compared to the control group.However, no significant effect on blood loss or transfusion rates was observed. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
10 randomized controlled trials (512 patients) comparing intramedullary nailing (IMN) against open reduction-internal fixation (ORIF) for humeral shaft fractures were included in this systematic review and meta-analysis.The primary outcome of interest was the incidence of nonunion.Secondary outcomes of interest included the incidence of reoperation, radial nerve palsy, and infection, time to radiographic union, and operative time. The results of...
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Author verified Level 1 Meta Analysis
3%
①
Synopsis:
The PREPARE Trial was a cluster-randomized, crossover trial part of the PREP-IT program, which compared alcohol-based anti-septic solutions of iodine povacrylex vs.chlorhexidine gluconate in operative fracture patients.THE PREPARE Trial included a total of 8485 patients who underwent fracture fixation: 1700 patients with open limb fractures and 6785 with closed lower-limb or pelvic fractures.Randomization occurred at the hospital level.The primary outcome of interest was the incidence of surgical-site infection, which included superficial incisional infections within 30 days and deep incisional or organ-space infections within 60 days post-surgery.Secondary outcomes included unplanned fracture-related reoperations and serious adverse events.The iodone povacrylex group (77/3205; 2.4%) had a lower incidence of surgical site infections compared to chlorhexidine (108/3272; 3.3%) in closed-fracture patients [OR, 0.74; 95% CI, 0.55 to 1.00; p=0.049].The rates were similar in open-fracture patients between the iodine (54/3272; 6.5%) and chlorhexidine (60/3272; 7.3%) [OR, 0.86; 95% CI, 0.58 to 1.27; p=0.45].In the closed-fracture group, 5.5% in the iodine group and 5.9% in the chlorhexidine group underwent unplanned reoperations [OR, 0.96; 95% CI, 0.77 to 1.20].In the open-fracture group, the figures were 16.1% for iodine and 14.5% for chlorhexidine [OR, 1.16; 95% CI, 0.87 to 1.54]. The results of...
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Level 1 RCT
1%
②
Synopsis:
299 healthy older patients with displaced intracapsular fractures were randomised to undergo one of three surgical procedures.The three methods of treatment were reduction and fixation, bipolar hemiarthroplasty with cement, and total hip replacement with cement.The primary outcomes were hip function, clinical results, and healthcare costs. The results of...
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Level 2 RCT