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37%
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16%
Synopsis: In this meta-analysis, fifteen randomized controlled trials were included to compare operative (ORIF with locked plates, locked IMN, cemented, uncemented, nonmodular or modular hemiarthroplasty, and reverse shoulder arthroplasty) versus non-operative treatment for proximal humeral fractures.Outcomes of interest were normalized function, pain on the Visual Analog Scale (VAS), and the incidence of reoperation.In the pooled analysis comparing operative treatment with nonoperative treatment, no differences were found between all outcomes. When comparing ORIF... Read More »
Level 1 Meta Analysis
12%
Synopsis: Thirty patients with partial-thickness tears of the supraspinatus tendon were randomized to receive a platelet-rich plasma injection (n=15) or corticosteroid injection (n=15).The primary outcome of interest was tear size.The secondary outcome of interest was functional outcomes, measured with the American Shoulder and Elbow Surgeons (ASES) score and the Constant Murley (CM) score.Outcomes were measured at 6 months post-injection.The improvement from baseline in tear size at 6 months in the coronal and sagittal views was significantly greater in the platelet-rich plasma group. Similarly, ASES and... Read More »
Level 1 RCT
4%
Synopsis: 100 patients with anterior cruciate ligament (ACL) tears were randomized to receive an ACL reconstruction using an average-sized graft combined with a lateral extra-articular tenodesis (LET) procedure, or an ACL reconstruction with a large-size graft.Outcomes of interest included graft failure, pivot shift results, and the International Knee Documentation Committee score (IKDC).The follow-up was 2 years post-operation.Patients who received an average-sized graft with LET reported lower rates of graft failure and lower rates of rotational instability (as measured by the pivot shift) compared to ACL reconstruction with a large graft. No difference in... Read More »
Level 1 RCT
3%
Synopsis: 8 randomized controlled trials containing a total of 444 patients with chronic plantar fasciitis were included in this meta-analysis comparing dextrose prolotherapy to other interventions, such as exercise, platelet-rich plasma injection, and extracorporeal shockwave therapy.The pooled outcomes of interest included pain on a Visual Analog Scale (VAS), the Foot Function Index (FFI), the American Orthopaedic Foot and Ankle Society score (AOFAS), and plantar fascia thickness.Dextrose prolotherapy provided a significantly greater reduction in plantar fascia thickness vs.comparators, as well as a greater improvement in foot function in the first 6 months.Whilst overall pooled pain scores were not different between groups, dextrose prolotherapy demonstrated significantly better pooled pain scores vs. nonactive interventions such... Read More »
Level 1 Meta Analysis
3%
Synopsis: 200 patients scheduled for unilateral arthroscopic anterior cruciate ligament (ACL) reconstruction were randomized to receive a tourniquet (n=100) or no tourniquet (n=100) during the procedure.Primary outcomes of interest included intraoperative visualization, operative time, and sterile saline consumption.Secondary outcomes of interest included blood loss, pain, opioid consumption, limb swelling, functional scores, and graft healing.Outcomes were assessed up to 12 months post-operation.Results revealed significantly better intra-operative visualization, less intra-operative blood loss, shorter operative time, and less sterile saline consumption in the tourniquet group. No differences in... Read More »
Level 1 RCT
3%
Synopsis: 34 geriatric patients with distal femoral fractures were randomized to receive double plating fixation (n=18) or distal femoral replacement (n=16).Outcomes of interest included functional, radiological, and safety outcomes measured up to 12 months.Range of motion at 1 month was better in the replacement group.However, KSS knee scores and range of motion at 12 months were significantly better in the double-plating group compared to the replacement group. No differences in... Read More »
Level 1 RCT
2%
Synopsis: One hundred patients undergoing total hip arthroplasty were randomized to receive tranexamic acid with dexamethasone (n=50) or tranexamic acid alone (n=50).Outcomes of interest were CRP and IL-6, pain scores, POVN incidence, and use of analgesics after 24, 48, and 72 hours.Significant differences were reported in CRP and IL-6 levels at all time points with lower levels in the TXA+DEXA group. Significantly lower VAS... Read More »
Level 1 RCT
2%
Synopsis: 181 patients with end-stage knee osteoarthritis scheduled to receive a total knee arthroplasty were randomized to receive intravenous and intra-articular tranexamic acid (n=90) or epsilon-aminocaproic acid (n=91).The primary outcomes of interest were total blood loss, transfusion rate, and hemoglobin drop.Secondary outcomes of interest included postoperative length of stay and complications.The tranexamic acid group reported significantly less blood loss, a shorter length of stay, and a smaller hemoglobin drop compared to the epsilon-aminocaproic acid group. However, the rate... Read More »
Level 1 RCT
2%
Synopsis: 50 patients with chronic biceps tendinopathy undergoing a subpectoral biceps tenodesis were randomized to receive the procedure with the elbow and forearm positioned in pronation-supination (n=25) or in a neutral position (n=25).Outcomes of interest included pain on a Visual Analog Scale (VAS), the American Shoulder and Elbow Surgeons (ASES) score, Constant scores, and flexion and supination force.Outcomes were measured up to 12 months post-operation.The results of this study found that placing the forearm in pronation-supination during the procedure significantly improved pain and functional outcomes (VAS; ASES) in the first 6 months compared to a neutral position. However, a statistically... Read More »
Level 1 RCT
1%
Synopsis: Sixty-four patients with de Quervain's tenosynovitis were randomized to receive a local injection of ketorolac (n=31) or triamcinolone acetonide (n=33).Outcomes of interest included pain scores on a Visual Numeric Rating Scale (VNRS), the Disabilities of the Arm, Shoulder and Hand (DASH) score, grip strength and pinch strength, and the need for additional injection, assessed at 6 weeks follow up.The results revealed superior pain scores, DASH scores, and grip strength outcomes in the triamcinolone group vs.the ketorolac group. The need for... Read More »
Level 1 RCT