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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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①
Synopsis:
Twenty-seven randomized controlled trials that compared the safety and efficacy of platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and hyaluronic acid (HA) were included in this meta-analysis.Outcomes of interest included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain on a Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lequesne Index Score (LEQ).WOMAC, IKDC, and VAS scores favored PRP against HA.Similarly, in the network meta-analyses comparing BMAC and HA, WOMAC, IKDC, and VAS scores favored BMAC. No differences were...
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Author verified Level 1 Meta Analysis
4%
①
Synopsis:
Four hundred and thirty-nine patients with bicortical scaphoid waist fracture were randomized to receive an open or percutaneous surgical fixation, or cast immobilization for 6-10 weeks.The primary outcome of interest was the Patient Rated Wrist Evaluation (PRWE) total score at 52 weeks post-treatment.Secondary outcomes of interest included PRWE pain and function sub-scale scores, Short Form 12 (SF-12) mental and physical component scores, degree of bone union, range of motion, grip strength, and the incidence of adverse events.Whilst significantly favourable PRWE total scores at 12 weeks, PRWE function scores at 6 and 12 weeks, and grip strength at 6 weeks were significantly in favour of the surgery group (during the period when the cast was still being worn), no significant differences were observed between the groups in all outcomes at 52 weeks. The exception included...
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Level 1 RCT
4%
①
Synopsis:
12,211 patients from 21 trauma centers in the United States and Canada were included in this non-inferiority randomized trial comparing aspirin (n=6,101) and low molecular-weight heparin (n=6110).The primary outcome of interest was death by any cause at 90 days.Secondary outcomes of interest included the risk of thromboembolic events (pulmonary embolism; deep-vein thrombosis), cause-specific death, bleeding & wound complications, and the rate of infection.Aspirin was found to be non-inferior to low molecular-weight heparin with respect to the primary outcome of death by any cause. No differences in...
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Level 1 RCT
4%
①
Synopsis:
80 patients with distal radius fractures were randomized to receive either a 4-week (n=40) or a 6-week immobilization program.The primary outcome of interest was Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores at one year.Secondary outcomes of interest included QuickDASH scores at 3 and 6 months, incidence of adverse events, and range of motion in radial and ulnar deviation, dorsiflexion, and palmar flexion.All outcomes were comparable between the two groups at all time points. Therefore, a shorter...
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Level 1 RCT
4%
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
4%
①
Synopsis:
482 patients with a first-time traumatic anterior shoulder dislocation were randomized to receive either one session of advice + supporting materials + the option to self-refer to physiotherapy (n=240) or the same advice + supporting materials plus an additional program of physiotherapy (n=242).The primary outcome of interest was the Oxford shoulder instability score (OSIS) at 6 months.Secondary outcomes of interest included the Disablities of the Arm, Shoulder, and Hand (QuickDASH) score, EuroQol-5 Dimensions (EQ-5D-5L) score, and the incidence of complications.Outcomes were assessed at 6 weeks, 3, 6, and 12 months.Overall, the results of the study revealed no significant differences in OSIS scores between the two groups at six months.All secondary outcomes were similar between the two groups at all time points. The additional program...
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Author verified Level 1 RCT
4%
①
Synopsis:
Fifty patients undergoing unilateral elective hip arthroscopy were randomized to receive either intravenous dexamethasone (n=27) or a placebo (n=23).The primary outcome of interest was postoperative pain.Secondary outcomes included opioid consumption, nausea scores, vomiting events, and adverse events up to 12 weeks postoperatively.Outcomes were assessed at 6 hours postoperatively and on postoperative days 1 and 2.Overall, the results revealed that dexamethasone significantly reduced postoperative opioid consumption by 40% and vomiting events, without significant differences in postoperative pain levels. The study concludes...
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Level 1 RCT
4%
①
Synopsis:
Eighty patients undergoing total knee arthroplasty were randomized to receive either liposomal bupivacaine (n=40) or conventional bupivacaine (n=40) in adductor canal blocks.The primary outcome of interest was pain scores within 72 hours postoperatively.Secondary outcomes included opioid consumption and length of hospital stay.Outcomes were assessed over a period of 72 hours post-surgery.Overall, the results of the study revealed that patients in the liposomal bupivacaine group had significantly lower opioid consumption during the 72-hour period, but there were no significant differences in pain scores or hospital stay between the groups. The findings suggest...
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Level 1 RCT
2%
①
Synopsis:
One hundred and forty-three patients with nonoperative proximal humerus fractures were randomized to receive 1-week immobilization (n=67) or 3-week immobilization (n=76).Outcomes of interest included the visual analogue pain scale (VAS), functional outcomes measured with the Constant score and Simple Shoulder Test (SST) and complications.No significant differences were found in pain or functional scores at any time point up to 2 years follow-up. Similarly, no differences...
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Author verified Level 1 RCT
2%
①
Synopsis:
117 patients with irreparable rotator cuff tears were randomized to receive debridment plus the insertion of a subacromial balloon spacer (n=56) or debridement only (n=61).The primary outcome of interest was the Oxford Shoulder Score (OSS) at 12 months.Secondary outcomes of interest included the Constant Shoulder Score, range of motion in flexion and abduction, the Western Ontario Rotator Cuff (WORC) index, the EuroQol EQ-5D-5L, change in symptoms, Participant Global Impression of Change (PGIC), resource use, and adverse events.Results revealed significantly better OSS scores in the debridement only group at 3, 6 and 12 months.Objective outcome measures were limited by missing data due to COVID-19 restrictions.Constant scores were also in favour of the debridement only group at 12 months.There were no differences in safety events between the two groups. The study was...
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Author verified Level 1 RCT