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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:
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
23%
Platelet-Rich Plasma Injections Are Inferior to Corticosteroid Injections for Short-Term Pain Relief
①
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
11%
①
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
5%
①
Synopsis:
Six randomized controlled trials including 348 patients with painful knee osteoarthritis were included in this systematic review and meta-analysis comparing intraarticular botulinum toxin type A (BTA) vs.corticosteroid vs.hyaluronic acid (HA).Pooled outcomes of interest included pain measured by visual analog scale (VAS), total and individual components of the Western Ontario McMaster Universities Arthritis Index (WOMAC) scores.The pooled results suggested that intraarticular BTA is as effective as corticosteroids in improving pain and function but is more effective than HA in reducing knee pain. These findings suggest...
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Level 1 Meta Analysis
5%
①
Synopsis:
Six studies involving 517 patients with neck pain were included in this systematic review and meta-analysis, comparing cervical manipulations to thoracic or cervicothoracic manipulations.Pooled outcomes of interest included pain intensity, neck disability, and cervical range of motion.The analysis revealed no significant differences in pain reduction, disability improvement, or cervical range of motion between the intervention groups. Moderate to very...
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Level 1 Meta Analysis
5%
①
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
5%
①
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
5%
①
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
5%
①
Synopsis:
Seventy patients with isolated, closed humeral shaft fractures (HSF) were randomized to operative fixation (n=36) or functional bracing (n=34).The primary outcome was the DASH score at 3 months.Secondary outcomes included EQ-5D/EQ-VAS, SF-12 PCS/MCS, pain, shoulder/elbow ROM, complications, radiographic alignment, and return to work/sport.Outcomes were assessed at 2 and 6 weeks and at 3, 6, and 12 months.Overall, the results revealed better DASH scores with surgery at 6 weeks and 3 months (p=.01 for both), but no differences at 6 or 12 months; surgery also improved early HRQoL and SF-12 MCS to 6 months, with higher return-to-sport rates.Brace-related dermatitis was more common with nonoperative care, and nonunion was numerically higher with bracing. These findings suggest...
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Level 1 RCT
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