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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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Synopsis:
One hundred twenty-seven patients undergoing outpatient total hip arthroplasty with the direct anterior (DA) approach were prospectively randomized and compared to fifty-one patients undergoing outpatient total hip arthroplasty with the direct lateral (DL) approach.The primary outcome of interest was the overall cost from a Canadian healthcare payer perspective.Secondary outcomes included costs from a societal perspective, encompassing patient-incurred costs, productivity losses, and informal care.Cost data were collected during hospitalization and via patient-reported diaries after discharge.Overall, the results of the study revealed no significant differences in healthcare payer costs (DA: $7910.19 vs DL: $7847.17, p=0.80) or societal costs (DA: $14657.21 vs DL: $14581.21, p=0.96). These findings suggest...
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Conference Report
6%
①
Synopsis:
One hundred four patients with end-stage hip joint diseases undergoing primary total hip arthroplasty were randomized to receive intraoperative bone wax (n=52) or no bone wax (n=52).The primary outcome was total blood loss.Secondary outcomes included serum hemoglobin level, change in hemoglobin, thigh swelling (lower limb diameters), range of motion at discharge, length of postoperative hospital stay, and adverse events.Outcomes were assessed on postoperative days (POD) 1 and 3, and during follow-up at 3 weeks and 6 months.Overall, the results of the study revealed significantly lower total blood loss, smaller hemoglobin drop, and shorter hospital stays in the bone wax group. The study concludes...
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Level 1 RCT
6%
①
Synopsis:
One hundred eighteen patients with peri-trochanteric hip fractures were randomized to receive intramedullary nailing with either a single lag screw (n=54) or an additional anti-rotational screw (n=64).The primary outcome of interest was the incidence of postoperative complications.Secondary outcomes included radiographic parameters, operation time, radiation exposure, and clinical mobility scores.Outcomes were assessed for a minimum of three months.Overall, the results of the study revealed significantly more complications in the single-screw group (p < 0.05), particularly in unstable fractures. The addition of...
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Level 1 RCT
5%
COA 2025: Greater Kinematic Alignment Following Unicompartmental Compared to Total Knee Arthroplasty
Synopsis:
Thirty patients with knee osteoarthritis were randomized to receive either unicompartmental knee arthroplasty (UKA; n=12) or total knee arthroplasty (TKA; n=18).The primary outcome of interest was gait biomechanics, including sagittal and coronal knee angle metrics during walking.Secondary outcomes of interest included the Oxford Knee Score (OKS) and the WOMAC sub-scores for pain, stiffness, and physical function.Outcomes were assessed pre-operatively and at one year post-operatively.Overall, the results of the study revealed that UKA was associated with gait patterns more closely resembling native knee biomechanics, including greater sagittal knee angle correlation and lower coronal knee angle RMSE (F4,25, P=0.010), while PROMs improved similarly in both groups (p<0.001). These findings suggest...
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Conference Report
5%
Functional brace improves early function and is more cost-effective than casting in Achilles rupture
①
Synopsis:
High quality evidence has revealed that non-operative management of acute Achilles tendon rupture achieves optimal outcomes in most patients.Among non-operative treatment options, the most commonly used are functional bracing (walking boot with heel wedges) and casting in equinus position.There has been a recent move towards early mobilization and more use of functional bracing over casts in a number of different areas, and it is unclear if there is a benefit in favour of either strategy in the context of Achilles tendon ruptures.In this study, the authors randomized patients to plaster cast versus functional bracing, and performed an accompanying economic evaluation.They found that patients treated with functional brace had significantly better functional scores at eight weeks, and that bracing was dominant from a cost-effectiveness perspective, with modest savings and slightly better utility. There was no...
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Level 1 RCT
4%
①
Synopsis:
Seventy-two children with displaced medial humeral epicondyle fractures were randomized to receive open surgical reduction and internal fixation followed by casting (n=37) or casting alone without reduction (n=35).The primary outcome of interest was the QuickDASH score at 12 months.Secondary outcomes included elbow range of motion, grip strength, return to sports, cosmetic appearance, and rates of fracture union.Outcomes were assessed at 1, 3, 6, and 12 months.Overall, the results of the study revealed that casting was noninferior to surgery in terms of functional outcome at 12 months, despite a higher rate of radiographic nonunion.Cosmetic appearance favored casting, and all participants returned to their preinjury activities. These findings suggest...
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Level 1 RCT
3%
Synopsis:
Ninety-eight patients undergoing unilateral knee arthroplasty were randomized to receive either standard care (n=47) or a multicomponent intervention for opioid-free pain control (OFPC) (n=51).The primary outcome of interest was the rate of OFPC at eight weeks.Secondary outcomes included pain levels, patient satisfaction, recruitment and adherence rates, and feasibility metrics such as follow-up and retention.Outcomes were assessed at 3, 6, 9, and 12 months.Overall, the results of the study revealed that 67% of patients in the intervention group achieved OFPC at eight weeks, with high adherence to most components of the intervention and follow-up exceeding 90% at 12 months. These findings suggest...
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Conference Report
2%
①
Synopsis:
Eighty patients with single-level cervical spondylosis were randomized to receive uncovertebral joint fusion (UJF) (n=40) or end plate space fusion (ESF) (n=40).The primary outcome was the fusion rate at 3 months postoperatively.Secondary outcomes included complications and patient-reported outcomes (JOA, NDI, VAS-arm, and VAS-neck scores).Outcomes were assessed at 3, 6, and 12 months.Overall, the results revealed significantly higher early fusion rates in the UJF group at both 3 months (66.7% vs.13.2%, p < 0.0001) and 6 months (94.1% vs.66.7%, p = 0.006), with no significant difference at 12 months.PROMs and complication rates were comparable between groups. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
One hundred fourty patients with primary or secondary knee osteoarthritis were randomized to receive either a cruciate-retaining (CR) implant (n=72) or a posterior-stabilized (PS) implant (n=68).The primary outcome was knee function, including range of motion (ROM) and flexion.Secondary outcomes included patient-reported outcome measures (PROMs), complication and reoperation rates, and satisfaction.Outcomes were assessed at baseline, 3 months, 1 year, and 2 years postoperatively.Overall, the results of the study revealed that the PS group had better knee flexion and ROM at 1 and 2 years, but no significant differences in PROMs or satisfaction compared to the CR group. These findings suggest...
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Level 1 RCT
1%
①
Synopsis:
Ninety-six patients with rotator cuff tears smaller than 3 cm were randomized to receive either arthroscopic rotator cuff repair (ARCR) with leukocyte-poor platelet-rich plasma (LP-PRP) injection (n=48) or ARCR without PRP (n=48).The primary outcome was the retear rate, assessed via MRI at six months.Secondary outcomes included pain (VAS), functional scores (ASES, SANE), and sleep quality (PSQI), evaluated at six and twelve months postoperatively.Overall, the study found that the retear rate in the PRP group was significantly lower than in the control group (15.2% vs.34.1%, p = 0.037).However, there were no significant differences in functional outcomes between groups. The findings suggest...
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Level 1 RCT