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You are viewing the most viewed ACE Reports by Orthopaedic Surgeons over the last 30 days in all specialties.
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Platelet-Rich Plasma Injections Are Inferior to Corticosteroid Injections for Short-Term Pain Relief
①
Synopsis:
Fifty-two patients with symptomatic KL II–III knee osteoarthritis (OA) were randomized to receive platelet-rich plasma (PRP) (n=26) or corticosteroid (CS) (n=26).The primary outcome was change in VAS pain.Secondary outcomes were NPRS pain, KOOS JR, and WOMAC.Outcomes were assessed at baseline, 6 weeks, and 3 months.Overall, the results of the study revealed that CS produced significantly larger pain reductions than PRP at 6 weeks and met MCIDs for both VAS and NPRS, whereas groups were similar by 3 months and showed comparable functional gains at both time points. These findings suggest...
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Level 1 RCT
7%
①
Synopsis:
Nine hundred fourty one patients with carpal tunnel syndrome (CTS) were randomized to receive initial surgical decompression (n=470) or initial corticosteroid injection (n=471); further interventions were allowed in both arms as needed.The primary outcome was recovery at 18 months (CTS-6 <8).Secondary outcomes included time to recovery, serial CTS-6, upper-limb function (QuickDASH), palmar pain and pain-related limitation, global perception of recovery, satisfaction, additional treatments, and adverse events.Outcomes were assessed through 18 months at prespecified intervals.Overall, the results of the study revealed that 61% in the surgery group versus 45% in the injection group recovered, and median time to recovery was shorter with surgery (9.0 vs 18.0 months).Patients starting with surgery also had better 18-month QuickDASH, global recovery, and satisfaction, while palmar pain was more frequent early after surgery but comparable by later follow-up. These findings suggest...
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Level 1 RCT
6%
①
Synopsis:
Five hundred thirty-five patients undergoing elective primary Total Hip Arthroplasty (THA) were randomized to cutaneous closure with staples (n=268) or sutures (n=267).The primary outcome was SSI (<6 weeks).Secondary outcomes included prosthetic joint infection (PJI, <1 year), other wound complications (prolonged discharge, dehiscence, necrosis; <6 weeks), and length of stay.Outcomes were assessed during admission, at discharge, then at 2 weeks (removal), 6 weeks, 3 months, and 1 year.Overall, the results of the study revealed a higher—nearly significant—SSI rate with staples and a clearly higher rate of early wound complications, driven by prolonged discharge; PJI did not differ. These findings suggest...
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Level 1 RCT
6%
①
Synopsis:
Seventy patients with isolated, closed humeral shaft fractures (HSF) were randomized to operative fixation (n=36) or functional bracing (n=34).The primary outcome was the DASH score at 3 months.Secondary outcomes included EQ-5D/EQ-VAS, SF-12 PCS/MCS, pain, shoulder/elbow ROM, complications, radiographic alignment, and return to work/sport.Outcomes were assessed at 2 and 6 weeks and at 3, 6, and 12 months.Overall, the results revealed better DASH scores with surgery at 6 weeks and 3 months (p=.01 for both), but no differences at 6 or 12 months; surgery also improved early HRQoL and SF-12 MCS to 6 months, with higher return-to-sport rates.Brace-related dermatitis was more common with nonoperative care, and nonunion was numerically higher with bracing. These findings suggest...
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Level 1 RCT
5%
①
Synopsis:
One hundred fifty-eight patients with displaced fifth metacarpal neck fractures were treated with either K-wire pinning (KP; n=60), intramedullary pinning (IP; n=50), or combined intramedullary pinning with K-wire pinning (IPKP; n=48).The primary outcome was radiological correction (angulation and shortening).Secondary outcomes included range of motion (TAM), Quick-DASH scores, cosmetic scores, and complication rates.Outcomes were assessed preoperatively, postoperatively, and at 1-year follow-up.Overall, the study found that IPKP achieved significantly better angulation, less shortening, and higher cosmetic scores.Functional outcomes were similar, though stiffness occurred only in the KP and IP groups. These findings suggest...
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Level 1 RCT
4%
①
Synopsis:
Seventy-five patients with isolated ACL rupture were randomized to bone–patellar tendon–bone (BPTB), single-bundle quadrupled hamstring tendon (HT), or over-the-top HT plus lateral extra-articular tenodesis (HT+LET) (n=25 per arm initially).At final assessment (mean 23.0±1.1 years), 61 completed PROMs, 37 underwent clinical testing, and 35 had radiographs.The primary outcomes were clinical failure/revision and long-term knee function; secondary outcomes included instrumented laxity (KT-1000; pivot-shift), and tibiofemoral/patellofemoral Osteoarthritis (OA) on standardized radiographs.Overall, the results of the study revealed no between-group differences for most PROMs; Tegner activity was slightly higher with HT+LET vs BPTB, AP laxity was lower with BPTB vs HT, and patellofemoral OA was more frequent after BPTB vs HT+LET.There were no differences in tibiofemoral OA or objective IKDC grades. In sum, all...
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Level 1 RCT
4%
①
Synopsis:
Fifty-six patients with lateral malleolar (rotational ankle) fractures were randomized to receive 2-octyl cyanoacrylate (n=27) or n-butyl (90% n-butyl/10% 2-octyl) cyanoacrylate (n=28) for skin closure after standardized plate fixation; fifty-five completed follow-up.The primary outcome was cosmetic appearance by HWES at three and six months.Secondary outcomes included patient satisfaction with cosmesis by VAS (0–100) and 5-point Likert scales at three and six months, and ankle function by OMAS at six months.Overall, the results of the study revealed no statistically significant differences between groups for HWES, VAS, Likert satisfaction, or OMAS at six months. In short, 2-octyl...
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Level 1 RCT
3%
①
Synopsis:
Two hundred fifteen patients with inflammatory knee osteoarthritis (OA) and MRI effusion-synovitis were randomized to methotrexate up to 15 mg weekly (n=108) or identical placebo (n=107).The primary outcome of interest was change in knee VAS pain and effusion-synovitis maximal area over 52 weeks.Secondary outcomes of interest included WOMAC (pain, stiffness, function, total), MRI effusion-synovitis volume, infrapatellar fat pad signal metrics, OMERACT-OARSI response, PHQ-9, SF-12, and structural MRI scores.Outcomes were assessed repeatedly to 52 weeks, with MRI at baseline and week 52. Overall, the results...
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Level 1 RCT
3%
①
Synopsis:
Thirty two patients with full-thickness posterosuperior rotator cuff tears were randomized to immobilization with an abduction neutral-rotation brace (n=16 analyzed) or a conventional arm sling (n=16).The primary outcomes were passive shoulder ROM (forward flexion, external rotation, internal rotation) measured serially; secondary outcomes were pain (VAS) and Constant–Murley Score (CMS).Outcomes were assessed preoperatively and at 6 weeks, 3, 6, and 12 months.Overall, the results revealed better early ROM (e.g., forward flexion and external rotation at 3 months) and lower pain at 6 weeks with the brace, while 12-month ROM converged and CMS was only modestly higher in the brace group at 12 months. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
One hundred and five patients with medial compartment knee osteoarthritis (OA) and 6–12° varus were randomized to receive combined wedge osteotomy (CW) High tibial osteotomy (HTO) (n=51) or lateral closing wedge (LCW) HTO (n=52); 1-year primary outcome data were available for 50 and 51 patients, respectively.The primary outcome was accuracy of correction to 4° valgus (success: 2–6°).Secondary outcomes included changes in tibial slope (Moore-Harvey), patellar height (Insall-Salvati, Caton), leg length, and PROMS (VAS pain at rest/loading; KOOS domains).Outcomes were assessed at 1 year.Overall, the results showed similar correction accuracy and no between-group differences in radiological parameters except a small leg-length shift favoring CW, while all PROMS improved substantially over time without group differences. These findings suggest...
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Level 1 RCT