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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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100%
7%
②
Synopsis:
220 patients with isolated pertrochanteric femoral fractures were randomized to receive surgical intervention with a short or long cephalomedullary nail.Primary outcomes of interest included the Short Form 36 (SF-36) questionnaire and the Harris Hip Score.Secondary outcomes of interest included implant failure, peri-implant failure, mortality, operative time, estimated blood loss and the incidence of re-operation.Outcomes were assessed up to 12 months post-operation.Results revealed significantly favourable 3 month Harris Hip scores, lower operative time and lower estimated blood loss in the short nail group compared to the long nail group. No significant differences...
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Level 2 RCT
5%
①
Synopsis:
1319 patients with open or closed tibial shaft fractures were included in this trial to compare the effects of reamed and unreamed intramedullary nailing approaches (Study to Prospectively Evaluate Reamed Intramedullary Nails in Patients with Tibial Fractures (SPRINT)).Patients were randomized to treatment with either reamed or unreamed intramedullary nails.The results at the 12 month follow up period indicated that fewer patients with closed fractures, treated with reamed intramedullary nailing, experienced the primary composite outcome (bone grafting, implant exchange or dynamization in patients with a fracture gap greater <1cm).However, this significant result was due to differences in autodynamization. In patients with...
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Author verified Level 1 RCT
3%
①
Synopsis:
2551 patients with an open fracture of the extremity were included in this randomized, 2 by 3 factorial design trial to investigate the effects of irrigation pressure and solution on reoperation rates.The patients were randomized to receive irrigation with either soap or saline at high, low, or very low pressure.After a 12 month follow-up period, the results indicated that the use of saline was superior to the use of soap for the irrigation of open fractures.Additionally, there were no differences between the different pressures, establishing very low pressure as a low-cost alternative in the irrigation of open fractures.The analysis indicated that there was no interaction between irrigation solution and pressure.
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Author verified Level 1 RCT
2%
Synopsis:
Six ACE Reports (5 randomized controlled trials and 1 systematic review/meta-analysis) were identified from the OrthoEvidence database which evaluated the efficacy of platelet-rich plasma in the treatment of knee osteoarthritis.All included studies were randomized controlled trials, and reported clinical and functional assessment at various time points between 1 and 6 months following treatment.Pooled analysis of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Total scores suggested a possible beneficial effect with PRP injection in comparison to saline and a lower effect versus hyaluronic acid.Beneficial effects were also noted for individual subscales of the WOMAC assessment (pain, stiffness, and physical function).However, pooling of OMERACT-OARSI responders and a review of the literature indicated that there was no significant difference between PRP and comparison groups in other functional outcome measures, such as the International Knee Documentation Committee (IKDC) assessment and Knee Injury and Osteoarthritis Outcome Score (KOOS).Furthermore, contrasting results were obtained between two studies reporting function on the Lequesne Index. The discrepancy in...
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ACE Review
2%
Synopsis:
Hip fractures are an exceedingly common injury.Much new evidence has been established through international randomized controlled trials which has helped to inform their management.The management of Garden I and II (non-displaced or minimally displaced) fractures remains unclear in the elderly.The authors performed a secondary analysis of data from the FAITH trial to assess risk factors for subsequent arthroplasty after fixation of Garden I and II fractures in the elderly.555 patients were included in the sample. The authors found...
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Conference Report
2%
Immediate MRI referral vs. usual care in general practice in patients with traumatic knee complaints
②
Synopsis:
A non-inferiority trial including 356 patients presenting to a general practitioner with traumatic knee complaints were randomized to receive immediate referral for magnetic resonance imaging (MRI) or usual protocol directed by the guidelines provided by the Dutch college of general practitioners.The primary outcome of interest was the Lysholm knee score.Secondary outcomes of interest included the EQ-5D quality of life questionnaire, the Knee Injury and Osteoarthritis Outcome Scale (KOOS), pain on a numeric rating scale (NRS), as well as patient perceived recovery and satisfaction.Follow up was performed at 6 weeks, 3, 6, 9 and 12 months. Results found no...
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Level 2 RCT
2%
Synopsis:
Forty-nine thousand, five hundred and ninety-seven patients aged 60 years or older from Ontario who underwent either total hip arthroplasty or hemi-arthroplasty for the treatment of displaced femoral neck fractures were included in this retrospective study examining clinical outcomes and associated factors with each procedure.A matched cohort of 9,238 patients was used to compare clinical outcomes.Outcomes of interest included the risk of hip dislocation, revision surgery, and death.Results of the study found a higher risk of 1-year revision surgery and dislocation in the total hip arthroplasty group compared to the hemi-arthroplasty group. The risk of...
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Conference Report
1%
①
Synopsis:
4 studies were included in this meta-analysis which investigated the efficacy of various non-operative immobilization techniques in the treatment of acute scaphoid fractures.The studies involved a total of 523 patients, and compared below- and above-elbow casting, immobilization with or without inclusion of the thumb, and casting with the wrist in either flexion or extension. The results produced...
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Level 1 Meta Analysis
1%
Synopsis:
13 ACE reports (4 reviews/ meta-analyses, 9 RCTs) were included from the OrthoEvidence database that compared operative versus nonoperative or operative versus operative treatments for displaced midshaft clavicle fractures.The findings of this review demonstrated that surgical procedures led to a lower rate of nonunion and malunion with better functional outcome when compared to nonoperative treatment. Comparisons of operative treatments indicated that an optimal surgical procedure - between plate fixation, nailing, and pin fixation - could not be determined based on union rates or functional outcome. The results of...
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ACE Review
1%
②
Synopsis:
340 primary total knee arthroplasties were performed with cementless fixation of the femoral component and cement fixation of the patellar and tibial components.The knees were randomized to receive cefuroxime-impregnated cement or cement without cefuroxime.Patients were followed-up for an average of 49 months. The rate of...
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Level 2 RCT