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You are viewing the most viewed ACE Reports by Primary Care Physicians over the last 30 days in all specialties.
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Synopsis:
Ninety-eight patients with for anterior cruciate ligament (ACL) rupture were randomized to receive a quadrupled semitendinosus (ST-only) graft (n=49) or a doubled semitendinosus–gracilis (ST/G) graft (n=49); one ST-only patient was converted intra-op and excluded.The primary outcome was IKDC-Subjective score.Secondary outcomes included KOOS subscales, Tegner Activity Score (TAS), KT-1000 side-to-side laxity, Lachman and pivot-shift grades, sports/activity participation, and need for secondary surgery (including revision).Outcomes were assessed pre-op, 2 years, and again at a median of 8 years (range 5–10).Overall, the results of the study revealed no between-group differences at long-term follow-up for IKDC (ST 81.7 vs ST/G 82.1; p=0.93), instrumented or clinical stability, KOOS subscales, or revision rates; however, cyclops removal was more frequent with ST/G (p=0.014).Both groups showed large, durable improvements from baseline. These findings suggest...
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Level 1 RCT
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Synopsis:
Two hundred thirty-one patients with chronic lateral epicondylosis were randomized to physiotherapy (n=58), extracorporeal shockwave therapy (ESWT) (n=62), prolotherapy (n=56), or platelet-rich plasma (PRP)(n=55).The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH); the secondary outcome was a 6-point Subjective Satisfaction Score (SSS).Outcomes were assessed at baseline, 3, 6, 18, and 24 months, with 24 months pre-specified as primary.Overall, the results of the study revealed that PRP achieved the largest DASH improvement at 24 months (−31.18) and the highest SSS (4.60±0.90), with prolotherapy also outperforming physiotherapy and ESWT on both outcomes; all groups exceeded the DASH MCID. These findings suggest...
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Level 1 RCT
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Synopsis:
One hundred twenty patients with symptomatic tibiofemoral knee osteoarthritis (Kellgren–Lawrence grade 2–3) were randomised to receive a single intra-articular injection of autologous micro-fragmented adipose tissue (n=60) or placebo isotonic saline (n=60) following abdominal liposuction.The primary outcome of interest was KOOS4 at 6 months.Secondary outcomes included KOOS subscales (Pain, Symptoms, ADL, Sports/Recreation, QoL), Tegner activity score, proportion achieving the KOOS4 MCID, treatment failure, return to work and sport, adverse events, and treatment-related discomfort, assessed at 3, 6, 12, and 24 months.Overall, the results of the study revealed no statistically significant or clinically important between-group differences in KOOS4 at any time point (6-month between-group difference in change 1.7, 95% CI −3.6 to 7.1; p=0.52), nor in Tegner scores or other secondary outcomes, although both groups showed substantial and sustained improvements from baseline over 2 years. These findings suggest...
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Level 1 RCT
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Synopsis:
Eight randomized controlled trials, including 689 patients with chronic neck pain, were included in this systematic review and meta-analysis comparing telerehabilitation versus control interventions.Pooled outcomes of interest included pain intensity, disability, fear-avoidance beliefs, and quality of life.The meta-analysis showed a significant reduction in pain and a significant reduction in disability in the telerehabilitation group compared to the control. The findings suggest...
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Level 1 Meta Analysis
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Synopsis:
Two hundred fifty-four patients with deep surgical incisions requiring orthopedic surgery were randomized to receive either Stratafix barbed sutures (n=127) or conventional interrupted knotted sutures (n=127).The primary outcome of interest was the deep fascia suture time per unit length.Secondary outcomes included relative cost, the number of suture materials used, and wound-related complications.Outcomes were assessed over a 3-month follow-up period.Overall, the study revealed that the Stratafix technique reduced the suture time per unit length for wounds ≥5 cm, used fewer suture materials, and resulted in fewer wound-related complications compared to the conventional technique. These findings suggest...
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Level 1 RCT
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Synopsis:
Seventy-six patients with traumatic anterior shoulder dislocation were randomized to receive Tang’s method (n=40) or the Hippocrates method (n=36).The primary outcome of interest was reduction success rate.Secondary outcomes included reduction time, pain (VAS) before/during/after reduction, and ASES scores at one, three, and six months.Outcomes were assessed up to six months.Overall, the results of the study revealed that Tang’s method achieved a 100% success rate vs 80.6% with Hippocrates and markedly shorter reduction time (≈71 s vs ≈412 s).Moreover, pain during and after reduction was lower and functional recovery (ASES) was superior at all follow-ups with Tang’s method. These findings suggest...
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Level 1 RCT
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Synopsis:
One hundred eight patients with tricompartmental knee osteoarthritis (OA) were randomized to gel cold pack (n=36), cryo-cuff (n=36), or mobile cold compression device (MCCD) (n=36) applied immediately post-TKA and refreshed every 6 hours until discharge.The primary outcome was pain intensity at prespecified intervals through 72 hours and again at 2 weeks.Secondary outcomes included morphine consumption (24/48/72 h), knee ROM (flexion, extension lag), knee swelling (girth change), length of stay, and patient satisfaction (SAPS-based).Outcomes were assessed up to 72 hours and at 2 weeks.Overall, the results showed lower pain at 8 hours with MCCD versus gel cold pack and versus cryo-cuff, while cryo-cuff produced less swelling at 72 hours than gel cold pack and MCCD. In conclusion, MCCD...
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Level 1 RCT
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Synopsis:
One hundred and twenty-four adults with hip and/or knee osteoarthritis (OA) were randomized to receive either a 4-week interactive eLearning program (n=62) or an electronic OA information pamphlet (n=62).The primary outcomes were changes in OA knowledge (OAKS) and pain self-efficacy (ASES pain) over 5 weeks.Secondary outcomes included exercise self-efficacy, fear of movement, OA illness perceptions, physical activity levels, and use of various self-management behaviors.Outcomes were assessed at 5 and 13 weeks.Overall, the results of the study revealed that eLearning produced significantly greater improvements in OA knowledge at both 5 and 13 weeks but had no effect on pain self-efficacy.Small benefits in exercise self-efficacy, illness perceptions, fear of movement, and weight-loss behaviors also favored eLearning. These findings suggest...
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Level 1 RCT
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Synopsis:
One hundred fifty six adults with chronic plantar fasciitis were randomized to receive ultrasound-guided corticosteroid injection (n=76) or radial extracorporeal shock wave therapy (rESWT; n=80).The corticosteroid group received 2 mL methylprednisolone acetate (40 mg/mL) + 2 mL 2% lidocaine delivered under ultrasound guidance, while the rESWT group received 2000 impulses at 2.5 bars and 15 Hz weekly for three consecutive weeks.The primary outcome of interest was pain, assessed using the Visual Analogue Scale (VAS) at the first step in the morning, at rest, and during ADLs.Secondary outcomes included the FAAM-ADL and FAAM-Sports subscales and ultrasound-measured plantar fascia thickness.Outcomes were measured at baseline, 4 weeks, and 8 weeks.Overall, the results revealed that corticosteroid injection produced greater reductions in pain, better functional improvement, and greater reduction in plantar fascia thickness at both 4 and 8 weeks compared with rESWT. In conclusion, early...
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Level 1 RCT
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