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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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5%
①
Synopsis:
One-hundred-fourteen patients with isolated ACL rupture were randomized to receive a bone–patellar tendon–bone (BPTB) graft (n = 58) or a hamstring graft (n = 56).The primary outcome was side-to-side anterior laxity measured with the KT-1000 arthrometer.Secondary outcomes included isokinetic knee-extension/flexion strength, Lachman and pivot-shift tests, KOOS, Tegner and Lysholm scores, and Kellgren–Lawrence (KL) osteoarthritis grade.Outcomes were assessed up to a mean of 19 years (range 18–20).Overall, the study revealed no significant between-group difference in KT-1000 laxity.However, hamstring-graft knees showed a 10.7 % lower peak flexion torque and 17.2 % lower total flexion work at 60 deg/s.Patient-reported scores, clinical laxity tests, and KL OA grades were similar. These findings suggest...
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Level 1 RCT
5%
①
Synopsis:
Seven randomized controlled trials including 658 patients with intertrochanteric femur fractures were included in this systematic review and meta-analysis comparing short versus long cephalomedullary nails (CMN).Pooled outcomes of interest included Harris hip score, 1-year mortality, overall complication rates, reoperation rates, duration of surgery, intraoperative blood loss, tip-apex distance, and hospital stay length.The pooled results showed no significant differences in Harris hip score, mortality, complications, or reoperations.However, short nails were associated with shorter surgery time, lower blood loss, and reduced tip-apex distace. These findings suggest...
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Level 1 Meta Analysis
4%
①
Synopsis:
Twenty-nine elderly patients (≥80 years) with displaced 3- or 4-part proximal humerus fractures were randomized to receive reverse shoulder arthroplasty (RSA) (n=17) or nonoperative treatment (n=12).The primary outcome was the Constant score.Secondary outcomes included Disabilities of the Arm, Shoulder and Hand (DASH) score, range of motion (ROM), pain (VAS), SF-12, EQ-5D, and radiographic findings.Outcomes were assessed at a mean follow-up of approximately 7.5 years.Overall, the results revealed that RSA achieved significantly higher Constant scores and better ROM, with no significant differences in quality-of-life measures or pain.Radiographically, all nonoperative cases healed in malposition without revision, whereas one RSA patient required revision for dislocation. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Sixty patients with rotator cuff tears undergoing open repair were randomized to receive either gabapentin 600 mg daily in two divided doses starting 3 days before surgery and continuing for 1 week postoperatively (n = 30) or placebo (n = 30).The primary outcome was postoperative pain intensity (NRS) over the first postoperative week.Secondary outcomes included opioid (morphine, oxycodone) consumption, sleep quality and duration, side effects, and patient satisfaction.Outcomes were assessed repeatedly during hospitalization and daily until postoperative day 7.Overall, the gabapentin group had significantly lower pain scores from the first 24 hours to day 4, reduced morphine use in the first 6 hours and oxycodone use over 1 week, longer and better-quality sleep until day 5, and higher satisfaction, without increased adverse effects. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Five studies including 390 children with upper limb fractures were included in this systematic review and meta-analysis comparing waterproof casts vs.standard non-waterproof casts.Pooled outcomes of interest included comfort, itchiness, child and parent satisfaction, functional performance (ASK-P), return to activities, and complication rates.Waterproof casts significantly improved comfort, itchiness, and satisfaction, and yielded higher functional scores on the ASK-P.There were no significant differences in pain, skin complications, or loss of fracture reduction. These findings suggest...
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Level 1 Meta Analysis
3%
①
Synopsis:
This systematic review and meta-analysis included 24 randomized controlled trials with 1711 participants diagnosed with sciatica due to lumbar disc herniation.It compared surgical treatment, primarily discectomy, to non-surgical treatments and epidural steroid injections.The primary outcomes assessed were leg pain and disability, while secondary outcomes included adverse events, back pain, quality of life, and treatment satisfaction.The pooled results indicated that discectomy provided moderate reductions in leg pain in the short term, with diminishing benefits over time.Effects on disability were smaller, showing only minor improvements.The long-term outcomes revealed no significant differences between surgical and non-surgical treatments. These findings suggest...
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Level 1 Meta Analysis
3%
①
Synopsis:
One hundred seventy-two patients undergoing total knee arthroplasty for osteoarthritis were randomized to receive either 5 mg melatonin (n=86) or 125 mg vitamin C placebo (n=86).The primary outcome was the Pittsburgh Sleep Quality Index (PSQI).Secondary outcomes included patient-reported measures of pain and physical function, opioid prescriptions, medication compliance, and adverse events.Outcomes were assessed at both 6 weeks and 90 days.Overall, the results showed no significant differences in PSQI or secondary outcomes between the melatonin and placebo groups at either time point. The findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Thirty patients with bilateral carpal tunnel syndrome were randomized to receive a landmark-based corticosteroid injection on one hand and a TCL-penetrating injection on the other.The primary outcome was the symptom domain score of the Boston Carpal Tunnel Questionnaire (BCTQ-S) at 3 months.Secondary outcomes included pain VAS scores, function domain of BCTQ (BCTQ-F), pain during needle insertion, and degree of skin hypopigmentation measured by the modified Vancouver Scar Scale (mVSS).Outcomes were assessed at baseline, 4 weeks, 3 months, and 6 months.
Overall, the study found no significant differences in pain or functional scores between techniques, though the TCL-penetrating approach resulted in significantly less skin hypopigmentation at all time points but caused greater immediate procedural pain. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Ninety-four patients with primary knee osteoarthritis scheduled for unilateral total knee arthroplasty were randomized to receive exsanguination via Esmarch bandages (n=49) or simple leg elevation (n=45).The primary outcome of interest was surgical field visualization, assessed at four intraoperative stages.Secondary outcomes included operative time, intraoperative and total blood loss, postoperative pain, leg swelling, and complications.Outcomes were assessed intraoperatively and up to three days postoperatively, with complications monitored for one month.Overall, the results of the study revealed that the Esmarch group had superior surgical field visualization (p<0.001), but no significant differences in operative time, blood loss, or pain.However, knee swelling was greater in the Esmarch group. These findings suggest...
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Level 1 RCT
3%
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