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You are viewing the most viewed ACE Reports by Sports Medicine Specialists over the last 30 days in all specialties.
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①
Synopsis:
One hundred sixty-four patients with moderate to severe symptomatic medial knee osteoarthritis were randomized to receive flat flexible shoes (n=82) or stable supportive shoes (n=82) for at least six hours daily over six months.The primary outcomes were changes in walking pain (measured on an 11-point numerical rating scale) and physical function (assessed by the Western Ontario and McMaster Universities Osteoarthritis Index).Secondary outcomes included additional pain measures, physical activity, and quality of life.At six months, 161 participants (98%) completed primary outcome assessments.The results showed that stable supportive shoes led to significantly greater reductions in walking pain than flat flexible shoes (mean difference, 1.1 units; 95% CI, 0.5 to 1.8; P=0.001), but there was no significant difference in function improvement between groups (mean difference, 2.3 units; 95% CI, −0.9 to 5.5; P=0.167).Quality of life and ipsilateral hip pain also favored stable supportive shoes.More adverse events were reported with flat flexible shoes. These findings suggest...
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Level 1 RCT
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Synopsis:
This systematic review and meta-analysis included 10 studies, comprising randomized controlled trials, single-arm studies, and a retrospective cohort, evaluating PRP in ankle disorders.The pooled outcomes of interest were the American Orthopaedic Foot and Ankle Society (AOFAS) score and Visual Analog Scale (VAS) score.The analysis found no statistically significant difference in AOFAS scores between PRP and control treatments, although PRP showed better efficacy in patients with talar cartilage injuries.PRP was effective in reducing pain, particularly for talar cartilage injuries. The results suggest...
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Level 1 Meta Analysis
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Synopsis:
Two hundred twenty patients with calcific tendinopathy of the shoulder persisting for at least three months were randomized to receive ultrasound-guided deposit lavage with corticosteroid injection (n=73), sham lavage with corticosteroid injection (n=74), or sham lavage with lidocaine only (n=73).The primary outcome of interest was the Oxford Shoulder Score (OSS) at four months.Secondary outcomes included QuickDASH scores, pain intensity, and radiographic changes in deposit appearance, assessed up to 24 months.Overall, the study found no significant difference in OSS improvement at four months between the treatment groups: lavage + steroid vs.sham, sham lavage + steroid vs.sham, and lavage + steroid vs.sham lavage + steroid.At 24 months, none of the study procedures were superior to sham. The findings suggest...
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Level 1 RCT
Synopsis:
Fifty-seven patients with displaced type II distal clavicle fractures were randomized to receive either operative treatment (n=27) or non-operative treatment (n=30).The primary outcome of interest was the Disabilities of the Arm, Shoulder, and Hand (DASH) score at two years.Secondary outcomes included union rates, re-operation rates, satisfaction with shoulder appearance, and return to activities.Outcomes were assessed at one and two years.Overall, the results revealed no significant difference in DASH scores between the two groups at two years, indicating excellent function in both groups.However, 48% of the operative group required hardware removal, while 20% of the non-operative group required surgical intervention due to non-union.Union rates were comparable at two years. These findings suggest...
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Conference Report
Synopsis:
Seventy patients with isolated, closed humeral shaft fractures were randomized to receive either open reduction and plate fixation (n=36) or functional bracing (n=34).The primary outcome of interest was the DASH score at three months.Secondary outcomes included health-related quality of life (HRQoL), pain scores, shoulder/elbow range of motion, complications, and return to activity over one year.Overall, the results revealed that surgery led to superior functional outcomes at three months (mean DASH 24.5 vs.39.4; MD 15.0, p=0.006) and improved HRQoL and pain scores over the first six months.Surgery also resulted in better shoulder and elbow mobility and a higher rate of return to sport.However, by one year, there were no significant differences between groups. These findings suggest...
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Conference Report
①
Synopsis:
Four randomized controlled trials (RCTs) including 390 patients with early-stage knee osteoarthritis (KL I-II) were included in this systematic review and meta-analysis comparing intra-articular hyaluronic acid (HA) injections with other biologically active injections such as platelet-rich plasma (PRP) and corticosteroids (CSs).Pooled outcomes of interest included the visual analogue scale (VAS), the Western Ontario McMaster Osteo-Arthritis Index (WOMAC), and its subscales (pain, stiffness, and function).At the final follow-up (mean: 7.5 months), no significant differences were found between HA and other biologically active compounds in any measured outcomes. These findings suggest...
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Level 1 Meta Analysis
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Synopsis:
Two hundred forty patients with chronic midportion Achilles tendinopathy were randomized to receive either a single platelet-rich plasma (PRP) injection (n=121) or a sham subcutaneous dry needle injection (n=119).The primary outcome was the VISA-A score at 6 months, which assesses pain, function, and activity limitations related to Achilles tendinopathy.Secondary outcomes included the VISA-A score at 3 months, pain via visual analog scale (VAS), and health-related quality of life using EQ-5D-5L at multiple follow-up points (2 weeks, 3 months, and 6 months).Overall, the results of the study revealed no significant difference between the PRP and sham groups in any of the measured outcomes, including the primary VISA-A score at 6 months. These findings suggest...
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Level 1 RCT
①
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
①
Synopsis:
One hundred patients with isolated traumatic meniscal tears were randomized to receive either arthroscopic partial meniscectomy (n=49) or standardized physical therapy with an option for delayed surgery (n=51).The primary outcome was the IKDC score at 24 months.Secondary outcomes included the Knee Injury and Osteoarthritis Outcome Score (KOOS), pain levels (NRS), Lysholm score, Western Ontario Meniscal Evaluation Tool (WOMET), Tegner activity level, and patient satisfaction with knee function.Follow-ups occurred at baseline, 3, 6, 9, 12, and 24 months.Overall, the study found no significant difference in IKDC scores between the two groups at 24 months.Additionally, 59% of patients in the physical therapy group did not undergo delayed surgery. These findings suggest...
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Level 1 RCT
①
Synopsis:
Ninety-seven patients with symptomatic acetabular labral tears and limited osteoarthritis (Tönnis grades 0-2) were randomized to receive either hip arthroscopy with postoperative physical therapy (SPT) (n=52) or physical therapy alone (PTA) (n=45).Patients in the PTA group who experienced unsatisfactory improvement were allowed to cross over to surgery after completing at least 14 weeks of PT (CO group, n=32).The primary outcomes were the International Hip Outcome Tool-33 (iHOT-33) and the modified Harris Hip Score (mHHS) at 24 months.Secondary outcomes included additional patient-reported outcome measures (PROMs) and pain scores.Overall, the results demonstrated that SPT led to superior improvements in functional outcomes and pain reduction compared to PTA in both the intention-to-treat and modified as-treated analyses.Additionally, patients who crossed over to surgery experienced similar postoperative outcomes to those who underwent initial surgery. These findings suggest...
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Level 1 RCT