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Platelet-Rich Plasma Injections Are Inferior to Corticosteroid Injections for Short-Term Pain Relief
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Synopsis:
Fifty-two patients with symptomatic KL II–III knee osteoarthritis (OA) were randomized to receive platelet-rich plasma (PRP) (n=26) or corticosteroid (CS) (n=26).The primary outcome was change in VAS pain.Secondary outcomes were NPRS pain, KOOS JR, and WOMAC.Outcomes were assessed at baseline, 6 weeks, and 3 months.Overall, the results of the study revealed that CS produced significantly larger pain reductions than PRP at 6 weeks and met MCIDs for both VAS and NPRS, whereas groups were similar by 3 months and showed comparable functional gains at both time points. These findings suggest...
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Level 1 RCT
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Synopsis:
Seventy-two patients with unilateral plantar fasciitis were randomized to receive extracorporeal shock‐wave therapy (ESWT)(n=36) or Low-Dye taping (LDT) with sham ESWT (n=36).The primary outcome of interest was pain (VAS).Secondary outcomes included FAOS subscales (Symptoms, Pain, Activities of Daily Living, Sport & Recreation, and Quality of Life).Outcomes were assessed at baseline, immediately post-treatment, and at six-week follow-up.Overall, the results of the study revealed significant within-group improvements in both arms for VAS and all FAOS subscales, with no between-group differences at any time point. The study concludes...
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Level 1 RCT
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Synopsis:
Nine hundred fourty one patients with carpal tunnel syndrome (CTS) were randomized to receive initial surgical decompression (n=470) or initial corticosteroid injection (n=471); further interventions were allowed in both arms as needed.The primary outcome was recovery at 18 months (CTS-6 <8).Secondary outcomes included time to recovery, serial CTS-6, upper-limb function (QuickDASH), palmar pain and pain-related limitation, global perception of recovery, satisfaction, additional treatments, and adverse events.Outcomes were assessed through 18 months at prespecified intervals.Overall, the results of the study revealed that 61% in the surgery group versus 45% in the injection group recovered, and median time to recovery was shorter with surgery (9.0 vs 18.0 months).Patients starting with surgery also had better 18-month QuickDASH, global recovery, and satisfaction, while palmar pain was more frequent early after surgery but comparable by later follow-up. These findings suggest...
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Level 1 RCT
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Synopsis:
Thirty two patients with full-thickness posterosuperior rotator cuff tears were randomized to immobilization with an abduction neutral-rotation brace (n=16 analyzed) or a conventional arm sling (n=16).The primary outcomes were passive shoulder ROM (forward flexion, external rotation, internal rotation) measured serially; secondary outcomes were pain (VAS) and Constant–Murley Score (CMS).Outcomes were assessed preoperatively and at 6 weeks, 3, 6, and 12 months.Overall, the results revealed better early ROM (e.g., forward flexion and external rotation at 3 months) and lower pain at 6 weeks with the brace, while 12-month ROM converged and CMS was only modestly higher in the brace group at 12 months. These findings suggest...
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Level 1 RCT
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Synopsis:
Seventy-five patients with isolated ACL rupture were randomized to bone–patellar tendon–bone (BPTB), single-bundle quadrupled hamstring tendon (HT), or over-the-top HT plus lateral extra-articular tenodesis (HT+LET) (n=25 per arm initially).At final assessment (mean 23.0±1.1 years), 61 completed PROMs, 37 underwent clinical testing, and 35 had radiographs.The primary outcomes were clinical failure/revision and long-term knee function; secondary outcomes included instrumented laxity (KT-1000; pivot-shift), and tibiofemoral/patellofemoral Osteoarthritis (OA) on standardized radiographs.Overall, the results of the study revealed no between-group differences for most PROMs; Tegner activity was slightly higher with HT+LET vs BPTB, AP laxity was lower with BPTB vs HT, and patellofemoral OA was more frequent after BPTB vs HT+LET.There were no differences in tibiofemoral OA or objective IKDC grades. In sum, all...
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Level 1 RCT
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Synopsis:
Ninety patients with knee osteoarthritis were randomized to acupuncture (n=30), sham acupuncture (n=30), or waiting list (n=30).Patients received twelve 30-minute sessions over 4 weeks.The primary outcome was response (≥2-point NRS reduction at week 4).Secondary outcomes included changes in NRS, WOMAC, STAI-S, and fMRI metrics: ALFF (resting-state spontaneous activity) and seed-based functional connectivity (FC) centered on regions identified by ALFF.Outcomes were assessed at baseline and 4 weeks.Overall, the results revealed higher response with acupuncture (85.2%) versus sham (52%) and waiting (13.6%), greater NRS improvement with acupuncture versus sham, dorsolateral prefrontal cortex (DLPFC) ALFF decreases with both acupuncture and sham, stronger DLPFC–thalamus FC increases with acupuncture, and DLPFC–cerebellum FC decreases with sham. These findings suggest...
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Level 1 RCT
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Synopsis:
Five hundred thirty-five patients undergoing elective primary Total Hip Arthroplasty (THA) were randomized to cutaneous closure with staples (n=268) or sutures (n=267).The primary outcome was SSI (<6 weeks).Secondary outcomes included prosthetic joint infection (PJI, <1 year), other wound complications (prolonged discharge, dehiscence, necrosis; <6 weeks), and length of stay.Outcomes were assessed during admission, at discharge, then at 2 weeks (removal), 6 weeks, 3 months, and 1 year.Overall, the results of the study revealed a higher—nearly significant—SSI rate with staples and a clearly higher rate of early wound complications, driven by prolonged discharge; PJI did not differ. These findings suggest...
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Level 1 RCT
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Synopsis:
Seventy-two patients with Dupuytren’s disease were randomized to Bruner (n=38) or McCash (n=34) limited fasciectomy.The primary outcome was scar/healing quality at 6 months using VAS, VSS, and POSAS (patient and observer).Secondary outcomes included wound complications (dehiscence, hematoma, infection, skin necrosis, pain) and time to healing.Outcomes were assessed through standardized clinic follow-up to 6 months.Overall, the results showed consistently worse scar scores for Bruner—VAS higher, VSS domains worse, and POSAS patient and observer domains/overall worse—and more complications (Bruner: dehiscence 5, hematoma 6, infection 1, skin necrosis 12; McCash: pain only in 6). These findings suggest...
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Level 1 RCT
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Synopsis:
Two hundred fifteen patients with inflammatory knee osteoarthritis (OA) and MRI effusion-synovitis were randomized to methotrexate up to 15 mg weekly (n=108) or identical placebo (n=107).The primary outcome of interest was change in knee VAS pain and effusion-synovitis maximal area over 52 weeks.Secondary outcomes of interest included WOMAC (pain, stiffness, function, total), MRI effusion-synovitis volume, infrapatellar fat pad signal metrics, OMERACT-OARSI response, PHQ-9, SF-12, and structural MRI scores.Outcomes were assessed repeatedly to 52 weeks, with MRI at baseline and week 52. Overall, the results...
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Level 1 RCT
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Synopsis:
One hundred and two patients with post-traumatic frozen shoulder were randomized to arthroscopic adhesiolysis (n=51) or to physical therapy plus joint manipulation (n=51).The primary outcome of interest was overall treatment efficacy at 3 months.Secondary outcomes included pain intensity (VAS, PPI, PRI), Constant-Murley subdomains (ADL, ROM, MMT), detailed shoulder ROM (flexion, abduction, external and internal rotation), adverse events, and exploratory risk factors for response using multivariable logistic regression.Outcomes were assessed at baseline and 3 months.Overall, the results of the study revealed higher total effectiveness with adhesiolysis (96.1% vs 82.4%) and greater improvements in pain, function, and ROM at 3 months. The authors conclude...
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Level 1 RCT
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