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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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Greater Quality of Life But Longer Operative Time With THA vs HA for Displaced Femoral Neck Fracture
①
Synopsis:
Sixteen randomized controlled studies containing a total of 3084 patients were included in this meta-analysis including patients with displaced femoral neck fractures undergoing total hip arthroplasty (THA; n=1521) or hemiarthroplasty (HA; n=1563).Pooled outcomes of interest included the following: incidence of revision, functional outcomes (evaluated using the Harris hip score), incidence of mortality, health-related quality of life (QoL; evaluated using the EuroQol-5 Dimensions [EQ-5D] Index), incidence of periprosthetic fracture, incidence of dislocation, and operative time.Subgroup analyses was conducted by level of risk of bias.Revision surgery, incidence of mortality and dislocation were all analyzed at 12-60 months follow-up, where as the rest of the outcomes were assessed at 12-36 months.Pooled results revealed that health-related quality of life, evaluated using EQ-5D Index, was statistically significantly in favour of the THA group vs.HA (p=0.001).However, pooled operative time was statistically significantly shorter in the HA group vs THA (p=0.001). All other pooled...
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Author verified Level 1 Meta Analysis
①
Synopsis:
12,211 patients from 21 trauma centers in the United States and Canada were included in this non-inferiority randomized trial comparing aspirin (n=6,101) and low molecular-weight heparin (n=6110).The primary outcome of interest was death by any cause at 90 days.Secondary outcomes of interest included the risk of thromboembolic events (pulmonary embolism; deep-vein thrombosis), cause-specific death, bleeding & wound complications, and the rate of infection.Aspirin was found to be non-inferior to low molecular-weight heparin with respect to the primary outcome of death by any cause. No differences in...
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Level 1 RCT
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
②
Synopsis:
63 patients, over the age of 50, suffering from both rotator cuff injuries and type II SLAP lesions were randomized to undergo repair of both injuries or only the rotator cuff repair. Results, following a minimum follow-up of 2.9 years, indicated that patients who underwent repair of only the rotator cuff had significantly better UCLA scores and ROM.
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Author verified Level 2 RCT
Synopsis:
This systematic review identified 5 studies (four RCTs and one cohort study: total of 365 patients for all studies) that assessed which treatment modality - surgical or conservative - was the optimal treatment for acute, displaced midshaft clavicle fractures.Results indicated that the surgical treatment led to a better functional outcome (measured with the Constant score) and lower mal- and non-union rates compared to conservative treatment. However, clinical relevance...
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Author verified Meta Analysis
②
Synopsis:
30 patients with carpal tunnel syndrome were randomized to undergo single- or two-incision carpal tunnel release to compare clinical and functional outcomes between surgical techniques.Upon analysis, results revealed no significant difference between groups with respect to the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, Brigham and Womens Carpal Tunnel Questionnaire (BWCTQ) for symptom severity and functional status, grip strength, pinch strength, scar tenderness, or radial and ulnar pillar pain. The single-incision group...
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Author verified Level 2 RCT
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Synopsis:
79 women aged 40 years and older diagnosed with severe stage IV osteoarthritis (OA) were randomly assigned to undergo ligament reconstruction and tendon interposition (LRTI) of the basal thumb joint using either the Burton-Pellegrini (BP) or the Weilby technique.The BP technique uses a bone tunnel at the base of the thumb, while the Weilby technique does not.The purpose of this study was to compare the short- and long-term pain and physical function outcomes of both techniques.Findings suggested the BP technique prompted faster recovery than the Weilby technique, with better clinical outcome at 3 months. Outcome at 12...
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Author verified Level 2 RCT
②
Synopsis:
40 postmenopausal females patients with proximal humerus fractures were randomized to receive either daily 20ug injections of parathyroid hormone (PTH 1-34) for 4 weeks or a control treatment with no injections.The primary purpose of this study was to determine whether the use of teriparatide (Forteo) was able to accelerate fracture healing.Function and pain outcomes, as well as the use of opioid analgesics, were also compared. The findings of...
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Author verified Level 2 RCT
Synopsis:
40 patients scheduled for total shoulder arthroplasty were randomized to either a stemless implant or a standard stemmed implant.Clinical and radiographic outcomes were assessed over 5-year follow-up.After 5 years, Constant scores did not significantly differ between groups. No cases of...
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RCT
②
Synopsis:
76 patients with Dupuytren's contracture and a palpable nodule were randomized to one of four groups; 0.25mg collagenase clostridium histolyticum (CCH) injection, 0.40mg CCH injection, 0.60mg CCH injection, or placebo injection.Patients were assessed over 8-week follow-up nodule size and hardness, pain, patient satisfaction, and investigator-rated improvement.After 8 weeks, reduction in nodule size was significantly greater in the 0.40mg and 0.60mg CCH groups compared to placebo, and reduction in nodule hardness was significantly greater in the 0.25mg, 0.40mg, and 0.60mg CCH groups compared to placebo. Composite responder rate...
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Level 2 RCT