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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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4.5 yr functional outcomes with early weight-bearing in non-operative treatment of Achilles ruptures
②
Synopsis:
Previous studies have established the success of non-operative treatment following Achilles tendon rupture.37/60 patients were analyzed in this follow-up study comparing an early weight-bearing protocol to standard weight-bearing protocol during dynamic rehabilitative treatment of acute Achilles tendon ruptures.The primary outcome of interest was the Achilles Tendon Rupture Score (ATRS).Secondary outcomes of interest included heel raise height and work, as well as the return to level (heavy, light but active, sedentary) of work and sporting, and the incidence of re-rupture.Follow up was performed at 4.5 years post-operation.At 4.5 years, there were no significant differences between the early weight-bearing and usual care groups in ATRS score, heel raise height or heel raise work.All 37 patients had return to some level of work by the 4.5 year follow up, and 33/37 patients had returned to some level of sporting activity. Three cases of...
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Level 2 RCT
5%
Immediate MRI referral vs. usual care in general practice in patients with traumatic knee complaints
②
Synopsis:
A non-inferiority trial including 356 patients presenting to a general practitioner with traumatic knee complaints were randomized to receive immediate referral for magnetic resonance imaging (MRI) or usual protocol directed by the guidelines provided by the Dutch college of general practitioners.The primary outcome of interest was the Lysholm knee score.Secondary outcomes of interest included the EQ-5D quality of life questionnaire, the Knee Injury and Osteoarthritis Outcome Scale (KOOS), pain on a numeric rating scale (NRS), as well as patient perceived recovery and satisfaction.Follow up was performed at 6 weeks, 3, 6, 9 and 12 months. Results found no...
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Level 2 RCT
3%
②
Synopsis:
116 patients with a chronic anterior cruciate ligament (ACL) rupture and scheduled for an arthroscopic ACL reconstruction were randomized to receive preparation of the femoral tunnel via an anteromedial technique or a transtibial technique.Outcomes of interest included anatomical outcomes, bio-mechanical outcomes, the International Knee Documentation Committee (IKDC) subjective score, the Lysholm score, and incidence of graft failure.Follow up was performed up to 2 years post-operation.Results from this study found no significant differences between the anteromedial and transtibial groups in the IKDC subjective score and Lysholm score.Femoral tunnel length and graft angulation in the sagittal and coronal planes were significantly smaller in the anteromedial group compared to the transtibial groups.Absolute improvement in internal rotation was significantly greater in the anteromedial group compared to the transtibial group. The incidence of...
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Level 2 RCT
3%
①
Synopsis:
Paediatric flexible flatfoot is a very common condition which tends to improve over time in many children.During the period of its persistence, however, it can be quite painful and debilitating.The authors randomized patients to receive a customized arch support for 12 weeks or control (no insoles).Outcomes included radiographic outcomes, pain, function, stair ascent time, and overall mobility. Patients with customized...
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Level 1 RCT
3%
①
Synopsis:
The use of anticoagulants for lower limb outpatient procedures such as knee arthroscopy is varied, and questions remain.The authors performed a meta-analysis of nine randomized controlled trials. The interventions included low molecular weight heparin (LMWH), Rivaroxaban, and acetylsalicylic acid (ASA), and comparators included no treatment, placebo, and compression stockings.A total of 4290 patients were included.Overall, they found no significant difference between pharmacologic interventions and controls in terms of symptomatic venous thromboembolism (excluding distal deep vein thrombosis (DVT)).There were significantly fewer symptomatic distal DVTs in the treatment group. Overall, the authors...
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Level 1 Meta Analysis
2%
②
Synopsis:
48 single or double blinded, prospective, randomized control trails that used human subjects and compared the therapeutic effects of intra-articular hyaluronic acid with intra-articular injection of a placebo to treat osteoarthritis of the knee were analyzed to determine if the qualitative conclusions by authors about the therapeutic effects of hyaluronic acid was affected by industry sponsorship or financial conflicts of interest. Results of the systematic review indicated that industry funding may have an effect on the conclusions provided within the study and that clinicians should be aware of potential financial conflicts of interest in authors reporting on the topic of intra-articular injection of hyaluronic acid for treatment of knee OA.
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Level 2 Meta Analysis
2%
Synopsis:
Acute syndesmotic injures are commonly associated with ankle fractures, and can have long-term implications on patient function and stability.Suture buttons and syndesmotic screws are the two most commonly used techniques to treat these injuries.The authors randomized 97 patients to suture button versus syndesmotic screw fixation.Outcomes included the American Orthoapedic Foot & Ankle Society Ankle-Hindfoot Scale (AOFAS), Olerud-Molander Ankle score (OMA), pain on walking on a visual analogue scale (VAS), and the EuroQol-5-D (EQ-5D).Follow-up time was five years post-operatively.The suture button had significantly higher AOFAS and OMA scores, significantly less frequent ankle osteoarthritis and better maintenance of reduction.There was no difference in terms of VAS or EQ-5D. Overall, suture button...
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Conference Report
1%
②
Synopsis:
34 patients with lateral epicondylitis were randomized to receive either saline and lidocaine, corticosteroid and lidocaine, or autologous blood and lidocaine injections. The results of the study indicated that there were no significant differences in regards to the Disabilities of the Arm, Shoulder, and Hand (DASH), pain and function scores among the three groups.
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Author verified Level 2 RCT
1%
①
Synopsis:
23 patients diagnosed with patellar tendinopathy were randomized to treatment with eccentric exercise and either ultrasound-guided leukocyte-rich platelet-rich plasma (PRP) injection with dry needling (DN) or dry needling without PRP injection.The purpose of this trial was to compare patient-reported outcomes between to the interventions.Results at 12 weeks revealed statistically and clinically significant improvements in Victorian Institute of Sports Assessment (VISA), Lysholm, and VAS scores versus baseline with PRP whereas only Lysholm scores improved with DN.At 26 weeks, VISA, Tegner, Lysholm and VAS scores improved significantly versus baseline with DN whereas this occurred with only VISA and VAS scores in PRP patients. Nevertheless, overall outcome...
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Author verified Level 1 RCT
1%
Synopsis:
99 patients with a partial-thickness rotator cuff tear or rotator cuff tendinopathy were randomized to injection therapy with either a platelet rich plasma injection or corticosteroid injection.Patients were assessed for outcome on a visual analog scale for pain, the Western Ontario Rotator Cuff Index, the American Shoulder and Elbow Surgeons (ASES) score, and incidence of patients who progressed to operative treatment. Results demonstrated significantly...
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Conference Report