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6%
Synopsis: 60 patients with primary arthritis of the knee were enrolled in this study to examine the effectiveness of a computer assisted total knee arthroplasty as compared to a conventional surgical method, in regards to component alignment and the precision of implantation.The results at 6 months indicated that computer-assisted implantation during total knee replacement improved the frontal and sagittal alignment of the femoral component. These improvements, however,... Read More »
Level 2 RCT
6%
Synopsis: Two hundred and seven studies with 32959 participants were analyzed in this network meta-analysis.The aim of this study was to compare outpatient treatments for managing acute pain from non-low back musculoskeletal injuries.Results revealed that the treatment with the greatest benefit was using topical nonsteroidal anti-inflammatory agents (NSAIDs).Afterwards, oral NSAIDs were beneficial which was followed by acetiminophen with or without diclofenac.The benefits included relieving pain 1-7 days, as well physical functioning , and symptom relief. Moreover, topical NSAIDs demonstrated increase in treatment satisfaction. Fentanyl and acetaminophen... Read More »
Meta Analysis
3%
Synopsis: 220 patients with isolated pertrochanteric femoral fractures were randomized to receive surgical intervention with a short or long cephalomedullary nail.Primary outcomes of interest included the Short Form 36 (SF-36) questionnaire and the Harris Hip Score.Secondary outcomes of interest included implant failure, peri-implant failure, mortality, operative time, estimated blood loss and the incidence of re-operation.Outcomes were assessed up to 12 months post-operation.Results revealed significantly favourable 3 month Harris Hip scores, lower operative time and lower estimated blood loss in the short nail group compared to the long nail group. No significant differences... Read More »
Level 2 RCT
3%
Synopsis: Seventy-nine patients with unilateral hip osteoarthritis scheduled to undergo a primary total hip arthroplasty (THA) via a direct anterior approach (DAA) or direct lateral approach (DLA) were randomized to receive a collard (n=36) or collarless femoral stem (n=33).Specifically, patients undergoing DAA (n=49) were divided into receiving a collard (n=23) and collarless femoral stem (n=26) implants.Similarily, patients undergoing a DLA were divided into receiving collard (n=13) and collarless femoral stem (n=17) implants.Outcomes of interest included implant migration via supine radiostereometric analysis imaging, as well as patient reported outcomes (PROMS).All outcomes were measured up to 1 year post-THA.Results revealed no significant difference for PROMS between the DLA and DAA groups (p>0.05).Implant subsidence at 2 weeks post-THA compared to day of surgery was significantly higher in the DAA group compared to the DLA group in both collared stems (p=0.02) and collarless stems (p=0.001);yet, this difference was not observed after 2 weeks post-operation (p>0.05). Patients in the... Read More »
Conference Report
2%
Synopsis: 119 patients, aged 70 years or greater, were randomized to undergo total knee arthroplasty (TKA) using either a mobile-bearing (MB) or a fixed bearing (FB) prosthesis.The results at 2 years from this double blind study indicate that there were no functional or clinical differences between the two types of prostheses. The MB group... Read More »
Level 1 RCT
2%
Synopsis: 55 patients, scheduled to undergo total knee replacement, were randomized to receive either fixed or mobile-bearings.The results from a 5 year follow-up indicated that elderly patients (>70 years of age) with fixed bearings had better improvements in gait parameters in comparison to those with mobile bearings. These results was... Read More »
Author verified Level 1 RCT
2%
Synopsis: Thirty-four studies involving 39,446 patients were included in this systematic review and meta-analysis comparing anticoagulated patients and non-anticoagulated patients.Outcomes of interest included the time to surgery, odds of having surgery beyond the recommended 48 hours from admission, and the odds of 30-day all cause mortality.Pooled comparisons between direct oral anticoagulants and Vitamin K antagonists were also performed.Resulted revealed that anticoagulated patients were delayed 13.7 hours to surgery compared to non-anticoagulated patients.Moreover, the odds of a >48 hour delay in operation and the odds of 30 day all cause mortality were significantly higher in the anticoagulated patient group compared to the non-anticoagulated group. No significant differences... Read More »
Conference Report
1%
Synopsis: 28 patients with 29 shoulders undergoing arthroscopic repair for a type-II superior labrum anterior-posterior (SLAP) lesion were randomized to undergo a new fixation technique using double anchors or a conventional technique.The results after a one year follow-up suggest that the new fixation technique adequately restores the anatomical position of the SLAP lesion and provides improved short-term clinical and structural outcomes; including VAS pain and constant scores. Read More »
Author verified Level 2 RCT
1%
Synopsis: Six ACE Reports (5 randomized controlled trials and 1 systematic review/meta-analysis) were identified from the OrthoEvidence database which evaluated the efficacy of platelet-rich plasma in the treatment of knee osteoarthritis.All included studies were randomized controlled trials, and reported clinical and functional assessment at various time points between 1 and 6 months following treatment.Pooled analysis of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Total scores suggested a possible beneficial effect with PRP injection in comparison to saline and a lower effect versus hyaluronic acid.Beneficial effects were also noted for individual subscales of the WOMAC assessment (pain, stiffness, and physical function).However, pooling of OMERACT-OARSI responders and a review of the literature indicated that there was no significant difference between PRP and comparison groups in other functional outcome measures, such as the International Knee Documentation Committee (IKDC) assessment and Knee Injury and Osteoarthritis Outcome Score (KOOS).Furthermore, contrasting results were obtained between two studies reporting function on the Lequesne Index. The discrepancy in... Read More »
ACE Review
1%
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