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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:
One-hundred-fourteen patients with isolated ACL rupture were randomized to receive a bone–patellar tendon–bone (BPTB) graft (n = 58) or a hamstring graft (n = 56).The primary outcome was side-to-side anterior laxity measured with the KT-1000 arthrometer.Secondary outcomes included isokinetic knee-extension/flexion strength, Lachman and pivot-shift tests, KOOS, Tegner and Lysholm scores, and Kellgren–Lawrence (KL) osteoarthritis grade.Outcomes were assessed up to a mean of 19 years (range 18–20).Overall, the study revealed no significant between-group difference in KT-1000 laxity.However, hamstring-graft knees showed a 10.7 % lower peak flexion torque and 17.2 % lower total flexion work at 60 deg/s.Patient-reported scores, clinical laxity tests, and KL OA grades were similar. These findings suggest...
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Level 1 RCT
②
Synopsis:
101 patients with an acute Achilles tendon rupture were randomized to one of two groups: a surgical group, wherein surgical repair was performed and early weight-bearing was encouraged, or a non-surgical group, wherein patients were treated conservatively and early weight-bearing was also encouraged.The purpose of this study was to evaluate these two treatment methods with respect to functional outcomes. Results indicated that...
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Level 2 RCT
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Synopsis:
186 patients with a severe lateral ankle sprain (type III) were randomized to treatment to 3 weeks of rigid immobilization with a walking boot followed by 3 weeks of immobilization with a functional brace, or to a functional brace for 6 weeks.The purpose was to compare these two conservative treatment methods for outcomes in pain, function, and ankle stability up to 12 weeks after the injury.AOFAS scores were better for the first 6 weeks in patients receiving the functional brace, and pain and comfort outcomes also benefited within the first few weeks from using a functional brace. By 12 weeks,...
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Author verified Level 2 RCT
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Synopsis:
13 studies with a total of 3647 men were included in this meta-analysis to analyze the effect of eight drugs (alfacalcidol, alendronate, ibandronate, risedronate, zoledronate, strontium ranelate, teriparatide, and parathyroid hormone) on bone mass density (BMD) in the lumbar spine (LS) and fracture incidence in males with osteoporosis. Network meta-analysis based on direct and indirect comparisons demonstrated that zoledronate had the greatest efficacy in increasing BMD in LS when compared to placebo, and teriparatide had the greatest efficacy in reducing fracture rate when compared to placebo.
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Level 1 Meta Analysis
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Synopsis:
76 patients with Dupuytren's contracture and a palpable nodule were randomized to one of four groups; 0.25mg collagenase clostridium histolyticum (CCH) injection, 0.40mg CCH injection, 0.60mg CCH injection, or placebo injection.Patients were assessed over 8-week follow-up nodule size and hardness, pain, patient satisfaction, and investigator-rated improvement.After 8 weeks, reduction in nodule size was significantly greater in the 0.40mg and 0.60mg CCH groups compared to placebo, and reduction in nodule hardness was significantly greater in the 0.25mg, 0.40mg, and 0.60mg CCH groups compared to placebo. Composite responder rate...
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Level 2 RCT
Synopsis:
30 blinded randomized controlled trials evaluating the use of hyaluronic acid injections in comparison to a placebo injection in patients with knee osteoarthritis were included in this systematic review and meta-analysis.The objective of this systematic review and meta-analysis was to compare the efficacy and safety of hyaluronic acid injections across different dosing regimens.At 3 months, data were available for 2-4 injection and 5+ injection groups.The 2-4 injection groups demonstrated significantly lower pain scores compared placebo (SMD -0.76 p<0.00001), while the 5+ injection groups did not demonstrate significantly lower pain compared to placebo (SMD -0.20; p=0.09).At 6 months, both the 2-4 injection group (SMD -0.36; p=0.008) and 5+ injection group demonstrated significantly lower pain compared to placebo (SMD -0.18; p=0.04).The single injection groups did not significantly reduce pain compared to placebo at 6 months (SMD -0.04; p=0.67).When looking at the incidence of adverse events, only the 5+ injection group demonstrated a significantly greater incidence compared to placebo (RR 1.67; p=0.02).
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Meta Analysis
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Synopsis:
This systematic review and meta-analysis included 24 randomized controlled trials with 1711 participants diagnosed with sciatica due to lumbar disc herniation.It compared surgical treatment, primarily discectomy, to non-surgical treatments and epidural steroid injections.The primary outcomes assessed were leg pain and disability, while secondary outcomes included adverse events, back pain, quality of life, and treatment satisfaction.The pooled results indicated that discectomy provided moderate reductions in leg pain in the short term, with diminishing benefits over time.Effects on disability were smaller, showing only minor improvements.The long-term outcomes revealed no significant differences between surgical and non-surgical treatments. These findings suggest...
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Level 1 Meta Analysis
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Synopsis:
10 randomized controlled trials (555 patients) that compared the effect of exercise on bone mineral density (BMD) in middle-aged and older men against a control were included in this meta-analysis.Outcomes of interest included changes in lumbar spine BMD, femoral neck BMD, total hip BMD, and trochanter BMD. All outcomes favored...
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Level 1 Meta Analysis
Perioperative Blood Flow Restriction Therapy Program After Anterior Cruciate Ligament Reconstruction
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Synopsis:
Forty-six patients who sustained an anterior cruciate ligament (ACL) tear and were scheduled for reconstruction were randomized into a group receiving either a blood flow restriction (BFR) therapy program (n=22) or a control group without BFR (n=24).The primary outcome of interest was isometric quadriceps strength at 3 months postoperatively, measured as peak and mean torques during seated leg extension exercises and presented as a ratio of the healthy limb.Secondary outcomes included patient-reported outcomes such as pain, knee function, and physical function, knee range of motion, quadriceps circumference and adverse effects.Outcomes were assessed up to 6 months postoperatively. Overall, the study...
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Level 1 RCT
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Synopsis:
This systematic review and meta-analysis included 14 randomized controlled trials involving 698 patients with low back pain.The studies compared the effects of respiratory exercises to routine lower back pain treatments.Pooled outcomes of interest included pain intensity and physical disability.The results showed that respiratory exercises significantly reduced pain intensity (p < .00001) and improved physical disability (p < .00001). The main findings...
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Level 1 Meta Analysis