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Synopsis: This meta-analysis included 6 randomized trials comparing the outcomes of cemented all-polyethylene acetabular components to other acetabular designs in terms of durability, function and adverse events after total hip arthroplasty (THA).907 patients in total were identified from the 6 studies.Over various time periods (from less than 3 years to more than 10 years), there were no significant differences in outcomes between the two components. There was, however,... Read More »
Level 1 Meta Analysis
2%
Synopsis: Six ACE Reports were identified from the OrthoEvidence database which compared intra-articular injection(s) of hyaluronic acid to corticosteroid in the treatment of osteoarthritis of the knee.All of the included studies were randomized controlled trials which reported pain and/or functional outcomes within 6 months of intervention.Pooled analysis of pain on a visual analog scale indicated that pain relief was significantly better with hyaluronic acid injections at both 3 and 6 months follow-up; however, this finding was strongly influenced by two studies of lower methodological quality. No significant differences between hyaluronic acid and corticosteroid injections were observed in any functional outcome measurement.Due to incomplete or lack of reporting adverse events, an assessment of safety could not be performed along with this review. Furthermore, these findings... Read More »
ACE Review
2%
Synopsis: 269 patients, aged 18 and older, scheduled to undergo total knee arthroplasty for primary knee osteoarthritis were randomly assigned into one of two groups to investigate the effect of dexamethasone and ramosetron on postoperative outcomes.Patients intravenously received either both drugs or ramosetron alone. Results demonstrated that... Read More »
Author verified Level 1 RCT
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Synopsis: 275 patients undergoing unilateral total knee arthroplasty were randomized to receive spinal epidural anaesthesia, VenaFlow compression device, and enoxaparin or spinal epidural anaesthesia, VenaFlow compression device, and aspirin to prevent deep vein thrombosis.Enoxaparin and aspirin were taken for 4 weeks after surgery.Deep vein thrombosis was diagnosed through ultrasonography completed 3 to 5 days and 4 to 6 weeks after surgery. At the end... Read More »
Level 2 RCT
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Synopsis: 103 patients undergoing primary total knee arthroplasty (TKA) were randomized to evaluate the efficacy of the gap balancing approach (GB) against the measured resection technique (MR) for TKA.Patients were monitored for 24 months, and were primarily evaluated on femoral component rotation (Hollywood Perth-Protocol CT-scan) and joint-line (defined as the difference between resected bone and prosthesis thickness from femoral and tibial sides).The evidence presented in this trial indicated significantly raised joint-line associated with gap balancing when compared to the measured resection technique (MR) - and ultimately better gap symmetry. Functional outcomes, along... Read More »
Author verified Level 2 RCT
1%
Synopsis: 80 patients, age 34- 82, with primary osteoarthritis or avascular necrosis of the femoral head, were placed into one of two THA treatment groups to test the effectiveness of different bearing types: The first group, metal-on-metal, was given a metal-on-metal bearing following surgery, while the second group was given a ceramic-on-ceramic bearing. Results showed that radiologically and clinically there was no difference between the groups, but the metal-on-metal group had significantly higher medium cobalt serum levels 2 years after treatment. Read More »
Level 2 RCT
1%
Synopsis: 8 ACE Reports (all randomized controlled trials) from the OrthoEvidence database were included in this review/meta-analysis examining the effect of arthroscopic surgery and physical therapy in the treatment of degenerative tears of the meniscus and knee osteoarthritis.The purpose of this review was to determine if any differences in outcome were demonstrated between arthroscopy followed by physical therapy versus physical therapy alone, regarding pain, function, satisfaction, adverse events, or osteoarthritis progression.Pain results were pooled at 3 different time point: 2-3 months, 6 months, and 12-24 months postintervention.At short-term (2-3 months) and long-term (12-24 months) follow-up, pain was similar between groups, with no significant difference observed.There tended to be less pain experienced at 6 months following arthroscopy, however this only reached significance in the KOOS pain outcome and the clinical importance of this observation is unknown.Assessments of functional outcome, either pooled or qualitative, suggested no significant difference between groups as well. The rate of... Read More »
ACE Review
1%
Synopsis: 100 patients with osteoarthritis of the hip were randomized to cemented total hip arthroplasty (THA) with either an oxidized zirconium or a stainless steel femoral head, and either highly-crosslinked polyethylene (HXLPE) or ultra-high-molecular-weight polyethylene (UHMWPE).The purpose of the study was to determine whether there were differences in radiographic steady-state femoral head penetration rate between femoral head materials, as well as between different types of polyethylene.Follow-up was performed for a minimum of 4 years postoperatively.When paired with either HXLPE or UHMWPE, groups that received an oxidized zirconium femoral head demonstrated a significantly lower steady-state wear rate compared to stainless steel.In comparing wear rates between HXLPE and UHMWPE, a significantly lower steady-state wear rate was observed with HXLPE when paired with a stainless steel femoral head, though no significant difference between HXLPE and UHMWPE when paired with an oxidized zirconium head. Functional outcome through... Read More »
Level 2 RCT
1%
Synopsis: 78 RCTs (4814 patients) were included in this meta-analysis which examined the efficacy of platelet rich plasma (PRP) injections for the relief of pain from musculoskeletal injuries.MEDLINE, EMBASE, CINAHL, SPORTDiscus and Web of Science were searched for relevant articles, as well as reviews, trial registries and conference material.Results revealed clinically significant pain improvement after 1 year, but not 3 months, with PRP injections for musculoskeletal injuries.Moreover, lateral epicondylitis and knee osteoarthritis patients displayed significant improvements in pain after 1 year of PRP treatment. No significant effect... Read More »
Conference Report
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Synopsis: Of a total of 1441 participants with low-energy displaced femoral neck fractures in the HEALTH trial, 117 patients who required revision surgery within 24 months of sustaining a fracture were included in this secondary analysis.This analysis investigated surgical and patient predictive factors for the need of revision.Factors of interest included age, body mass index (BMI), major comorbidities, independent ambulation, type of surgical approach, length of operation, use of femoral cement, femoral head size, and degree of femoral stem offset. The analysis demonstrated... Read More »
RCT