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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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Functional brace improves early function and is more cost-effective than casting in Achilles rupture
①
Synopsis:
High quality evidence has revealed that non-operative management of acute Achilles tendon rupture achieves optimal outcomes in most patients.Among non-operative treatment options, the most commonly used are functional bracing (walking boot with heel wedges) and casting in equinus position.There has been a recent move towards early mobilization and more use of functional bracing over casts in a number of different areas, and it is unclear if there is a benefit in favour of either strategy in the context of Achilles tendon ruptures.In this study, the authors randomized patients to plaster cast versus functional bracing, and performed an accompanying economic evaluation.They found that patients treated with functional brace had significantly better functional scores at eight weeks, and that bracing was dominant from a cost-effectiveness perspective, with modest savings and slightly better utility. There was no...
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Level 1 RCT
8%
①
Synopsis:
Five hundred three patients with unilateral primary frozen shoulder were randomized to receive manipulation under anaesthesia with steroid injection (n=201), arthroscopic capsular release with or without steroid injection (n=203), or early structured physiotherapy with steroid injection (n=99).The primary outcome was the Oxford Shoulder Score (OSS) at 12 months.Secondary outcomes included the QuickDASH, pain intensity (Numeric Rating Scale), perceived extent of recovery, and quality of life (EQ-5D-5L).Outcomes were assessed at baseline, 3, 6, and 12 months.Overall, the results revealed that all three treatments resulted in substantial improvements in OSS, but none were clinically superior.Arthroscopic capsular release had slightly higher OSS at 12 months but also more adverse events and higher costs.Manipulation under anaesthesia was the most cost-effective. These findings suggest...
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Level 1 RCT
5%
①
Synopsis:
One hundred thirty-five patients with ankle osteoarthritis were randomized to receive either a single corticosteroid injection (n = 61) or a dual injection protocol of corticosteroid plus hyaluronic acid (n = 74).The corticosteroid-only group received one intra-articular injection consisting of corticosteroid, bupivacaine, and saline.The dual group received an initial injection of corticosteroid, hyaluronic acid, bupivacaine, and saline, followed by two additional weekly injections of hyaluronic acid alone.The primary outcome was change in the Ankle Osteoarthritis Scale (AOS).Secondary outcomes included Visual Analogue Scale (VAS), SF-36 scores, and complication rates.Assessments were conducted at baseline, 6 weeks, and 12 weeks.Overall, the results revealed significantly greater improvement in AOS scores in the dual injection group at both 6 and 12 weeks, while VAS scores showed a greater early reduction in the corticosteroid-only group at 6 weeks, with no difference at 12 weeks.No significant group differences were found for SF-36. The study concludes...
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Level 1 RCT
4%
①
Synopsis:
Forty-six patients with early to mid-stage knee osteoarthritis were randomized to receive either intra-articular Cell-Free Fat Extract (CEFFE) (n=26) or hyaluronic acid (HA) (n=26).Each group received five weekly injections of 2 ml.The primary outcome was clinical efficacy measured at 6 months, including VAS, WOMAC, and Lysholm scores.Secondary outcomes included MRI-based bone marrow edema grading at 6 months.Overall, the results revealed that both treatments significantly improved clinical symptoms and reduced bone marrow edema, but CEFFE demonstrated superior improvement in all measures at 6 months (P<0.05). These findings suggest...
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Level 1 RCT
4%
Synopsis:
One hundred twenty-seven patients undergoing outpatient total hip arthroplasty with the direct anterior (DA) approach were prospectively randomized and compared to fifty-one patients undergoing outpatient total hip arthroplasty with the direct lateral (DL) approach.The primary outcome of interest was the overall cost from a Canadian healthcare payer perspective.Secondary outcomes included costs from a societal perspective, encompassing patient-incurred costs, productivity losses, and informal care.Cost data were collected during hospitalization and via patient-reported diaries after discharge.Overall, the results of the study revealed no significant differences in healthcare payer costs (DA: $7910.19 vs DL: $7847.17, p=0.80) or societal costs (DA: $14657.21 vs DL: $14581.21, p=0.96). These findings suggest...
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Conference Report
4%
COA 2025: Greater Kinematic Alignment Following Unicompartmental Compared to Total Knee Arthroplasty
Synopsis:
Thirty patients with knee osteoarthritis were randomized to receive either unicompartmental knee arthroplasty (UKA; n=12) or total knee arthroplasty (TKA; n=18).The primary outcome of interest was gait biomechanics, including sagittal and coronal knee angle metrics during walking.Secondary outcomes of interest included the Oxford Knee Score (OKS) and the WOMAC sub-scores for pain, stiffness, and physical function.Outcomes were assessed pre-operatively and at one year post-operatively.Overall, the results of the study revealed that UKA was associated with gait patterns more closely resembling native knee biomechanics, including greater sagittal knee angle correlation and lower coronal knee angle RMSE (F4,25, P=0.010), while PROMs improved similarly in both groups (p<0.001). These findings suggest...
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Conference Report
2%
①
Synopsis:
One hundred twenty-eight patients with sciatica lasting 4 to 12 months due to lumbar disc herniation were randomized to receive either microdiscectomy (n=64) or 6 months of standardized nonoperative care (n=64).The primary outcome was leg pain intensity at 6 months.Secondary outcomes included back pain, Oswestry Disability Index (ODI), SF-36 quality-of-life scores, employment status, and treatment satisfaction, assessed at multiple time points up to 12 months.Overall, the results of the study revealed that microdiscectomy led to a significantly greater reduction in leg pain at 6 months and consistent improvements in secondary outcomes. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
182/230 patients from the PATH-2 trial responded to this 2-year follow-up study of the PATH-2 trial comparing platelet-rich plasma (PRP; n=88/114) and placebo (92/116).The outcomes of interest included the Achilles Tendon Rupture Score (ATRS), the Patient-Specific Functional Scale (PSFS), and the Short-Form 12 (SF-12) mental and physical component quality of life scores. The results of...
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Level 1 RCT
2%
①
Synopsis:
Three hundred twenty-one patients with degenerative meniscal tears were randomized to receive arthroscopic partial meniscectomy (n=159) or exercise-based physical therapy (n=162).The primary outcome of interest was patient-reported knee function assessed by the International Knee Documentation Committee (IKDC) questionnaire.Secondary outcomes included radiographic progression of knee osteoarthritis, symptomatic OA, pain during activities, physical functioning (KOOS-PS), and quality of life.Outcomes were assessed at multiple time points up to 5 years.Overall, the results of the study revealed that physical therapy was noninferior to surgery for knee function, with no clinically meaningful differences in OA progression or other secondary outcomes. These findings suggest...
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Level 1 RCT
2%
①
Synopsis:
Thirty-three randomized controlled trials including 1154 patients with chronic ankle instability were included in this systematic review and meta-analysis comparing strength training, balance training, and a combination of both.Pooled outcomes of interest included self-reported function scores and dynamic balance measures.The combination of strength and balance training showed greater improvements in patient-reported outcomes compared to either intervention alone, with significant improvements in dynamic balance observed only in the balance training group. The findings suggest...
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Level 1 Meta Analysis