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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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①
Synopsis:
This systematic review and meta-analysis included 10 randomized controlled trials involving patients diagnosed with knee osteoarthritis.The study compared arthroscopic surgery to various conservative treatments such as physical therapy, pharmacologic interventions, and placebo.Pooled outcomes of interest included pain relief, functional recovery (WOMAC and SF-36), and patient satisfaction.Results showed no significant differences in pain relief, functional recovery, or patient satisfaction between arthroscopy and conservative treatments. The findings suggest...
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Level 1 Meta Analysis
4%
①
Synopsis:
One hundred nine patients with severe hip osteoarthritis were randomized to receive either total hip replacement (n=53) or supervised resistance training (n=56).The primary outcome of interest was the change in the Oxford Hip Score from baseline to six months, which evaluates pain and function.Secondary outcomes included various dimensions of quality of life, physical activity levels, and functional performance tests.Outcomes were assessed at baseline and six months.Overall, total hip replacement demonstrated significantly greater improvements in hip pain and function compared to resistance training. The findings suggest...
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Level 1 RCT
4%
①
Synopsis:
Eight studies, including 615 patients who underwent total hip arthroplasty (THA), were analyzed in this systematic review and meta-analysis comparing the Direct Anterior Approach (DAA; n=303) to the Postero-Lateral Approach (PLA; n=312).Pooled outcomes of interest included surgical site infection rate, duration of the operation, length of incision, and pain scores using the visual analog scale (VAS) after surgery.The meta-analysis revealed no statistically significant difference in wound infections between DAA and PLA.However, DAA was associated with a shorter incision length, longer operative times, and lower postoperative pain VAS scores within 6 weeks. Additional research is...
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Level 1 Meta Analysis
3%
①
Synopsis:
This systematic review and meta-analysis included 16 randomized controlled trials (RCTs) with a total of 1,993 patients with knee osteoarthritis.The study compared the effects of platelet-rich plasma (PRP) injections versus various nonoperative treatments, including hyaluronic acid (HA), corticosteroids, and saline.Pooled outcomes of interest were patient-reported symptom relief, pain improvement, reintervention rates, and cartilage status assessed by MRI.The findings showed PRP had significantly better outcomes in symptom relief, reduced reintervention rates, and pain improvement compared to controls, but no significant benefit for cartilage regeneration. These findings suggest...
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Level 1 Meta Analysis
3%
①
Synopsis:
Eight randomized controlled trials including a total of 454 patients undergoing total knee arthroplasty were included in this systematic review and meta-analysis comparing local infiltration anaesthesia (LIA) versus femoral nerve block (FNB).Pooled outcomes of interest included pain scores at rest and during movement, opioid consumption, and patient satisfaction.The results indicated no significant difference in resting and movement-related pain scores between LIA and FNB groups.However, LIA was associated with significantly lower opioid consumption. The main findings...
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Level 1 Meta Analysis
3%
①
Synopsis:
One hundred eighty-three patients with indications for primary uncemented total hip arthroplasty were randomized to receive Trident hemispheric components (n=91) or Trilogy components (n=92).The primary outcome was the prevalence of postoperative noises, with secondary outcomes including quality of life (EQ-5D-3L), pain (EQ-VAS), and activity levels (UCLA scale).Outcomes were assessed at 3 and 12 months postoperatively.Overall, the study found no significant differences in the prevalence of noises between the two groups.Both groups showed comparable improvements in quality of life and functional status. These findings suggest...
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Level 1 RCT
3%
①
Synopsis:
Three hundred and eleven patients with degenerative knee osteoarthritis or rheumatoid arthritis scheduled for primary total knee arthroplasty were randomized to receive either the limb occlusion pressure (LOP) method (n=154) or the systolic blood pressure (SBP) method (n=157) for determining tourniquet pressure.The primary outcome of interest was post-operative thigh pain.Secondary outcomes included knee range of motion (ROM), blood loss, wound complications, and the quality of the bloodless surgical field.Outcomes were assessed from postoperative days 1 to 3 and at six weeks.Overall, the study revealed that the LOP method required lower tourniquet pressures and resulted in significantly less post-operative thigh pain with better early postoperative knee ROM. The findings suggest...
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Level 1 RCT
3%
①
Synopsis:
The PREPARE Trial was a cluster-randomized, crossover trial part of the PREP-IT program, which compared alcohol-based anti-septic solutions of iodine povacrylex vs.chlorhexidine gluconate in operative fracture patients.THE PREPARE Trial included a total of 8485 patients who underwent fracture fixation: 1700 patients with open limb fractures and 6785 with closed lower-limb or pelvic fractures.Randomization occurred at the hospital level.The primary outcome of interest was the incidence of surgical-site infection, which included superficial incisional infections within 30 days and deep incisional or organ-space infections within 60 days post-surgery.Secondary outcomes included unplanned fracture-related reoperations and serious adverse events.The iodone povacrylex group (77/3205; 2.4%) had a lower incidence of surgical site infections compared to chlorhexidine (108/3272; 3.3%) in closed-fracture patients [OR, 0.74; 95% CI, 0.55 to 1.00; p=0.049].The rates were similar in open-fracture patients between the iodine (54/3272; 6.5%) and chlorhexidine (60/3272; 7.3%) [OR, 0.86; 95% CI, 0.58 to 1.27; p=0.45].In the closed-fracture group, 5.5% in the iodine group and 5.9% in the chlorhexidine group underwent unplanned reoperations [OR, 0.96; 95% CI, 0.77 to 1.20].In the open-fracture group, the figures were 16.1% for iodine and 14.5% for chlorhexidine [OR, 1.16; 95% CI, 0.87 to 1.54]. The results of...
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Level 1 RCT
2%
①
Synopsis:
1629 patients with complex lower limb fractures were randomized to receive negative pressure wound therapy (NPWT, n=813) or standard wound dressings (n=816) after surgical fixation.The primary outcome was the Disability Rating Index (DRI).Secondary outcomes included health-related quality of life (EQ-5D), pain (VAS), neuropathic pain (DN4), and complications.Outcomes were assessed annually for up to five years.Overall, the study revealed no significant differences between the groups in DRI scores, quality of life, pain levels, or complications over five years.Both groups reported persistent high disability and reduced quality of life. The findings suggest...
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Level 1 RCT
2%
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