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28%
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100%
3%
Synopsis: 88 patients scheduled for total knee arthroplasty were randomized to surgery with or without the application of a tourniquet.The purpose of this study was to compare functional recovery between groups, primarily though range of motion in flexion, with secondary functional outcomes of range of motion in extension, the straight leg raise test, and the timed up-and-go (TUG) test.In addition, pain at rest on a visual analog scale was assessed.Patients were followed at 1 and 3 days postoperatively, and at 3 months postoperatively.No significant differences between groups were observed in range of motion or straight leg raise test outcomes. TUG test time... Read More »
Level 1 RCT
3%
Synopsis: 112 patients with trigger finger were randomized to percutaneous release of the A1 pulley with or without the addition of a steroid injection.Patients were assessed after 3 weeks and 3 months for outcome on a patient global impression of improvement scale, modified Quinnell grade, and pain on a visual analog scale. Results demonstrated significantly... Read More »
Level 2 RCT
1%
Synopsis: 70 patients undergoing primary total knee arthroplasty were randomized into one of the following groups: wound closure with skin staples on the upper half and nylon sutures on the lower half of the wound, or wound closure with nylon sutures on the upper half and skin staples on the lower half of the wound.The purpose of this study was to compare the two wound closure techniques with regards to wound closure time, pain score at stitch removal, wound complication rate, patient satisfaction score, and the Hollander wound evaluation score.Findings indicated a quicker wound closure time using skin staples, but greater pain experience during removal compared to sutures. Wound complications, the... Read More »
Author verified Level 2 RCT
1%
Synopsis: 240 patients scheduled for short intramedullary nail fixation for an intertorchanteric fracture were randomized to one of three distal locking configurations: static locked, dynamic locked, or unlocked.Patients were assessed for intraoperative variables - including operative and fluoroscopy times, blood loss, and transfusion rate - and postoperative outcomes related to fracture healing, function, pain, and complications.Results demonstrated significant differences only in operative variables, with operative time, fluoroscopy time, and blood loss favoured in the unlocked group compared to the two distal locking groups. Postoperative outcomes did... Read More »
Author verified Level 2 RCT
1%
Synopsis: 42 patients with complete anterior cruciate ligament (ACL) tears were randomized to receive an ACL reconstruction with either a quadrupled hamstring tendon (QHT) graft (semitendinosus and gracilis tendon) or a bone-patellar tendon-bone (BPTB) graft.Outcomes of interest included functional outcomes measures (Lysholm, Cincinnati scores), anterior knee pain, and instability assessments (Lachman, anterior drawer and pivot shift tests).Follow up was performed at 2 weeks, 6 weeks, 3 months, 6 months and 1 year.No significant differences were observed in both Lysholm and Cincinnati scores at 2 weeks, 6 weeks, 3 months, 6 months and 1 year post-operation.However, significant differences in several Cincinnati sub-scores (pain, overall activity level, running activity) were observed between the two groups.The proportion of patients who reported anterior knee pain was similar between the two groups.Similarly, the proportion of patient who reported altered sensation over the anterolateral aspect of the proximal leg was not significantly different between groups. Lachman test, anterior... Read More »
Level 2 RCT
1%
Synopsis: 160 patients scheduled for a total joint arthroplasty (hip/knee) were randomized to receive either a closed incision negative pressure wound therapy (ciNPWT; PREVENA) device or a standard-of-care silver-impregnated occlusive wound dressing.The primary outcome of interest was the incidence of wound complications.Secondary outcomes included the rates or re-admission and re-operation.Follow up was performed at 2 weeks, 4 weeks, and 12 weeks post-surgery.Results revealed a significantly favourable rate of wound complications in the ciNPWT group compared to the control group at 2 weeks and overall.The rate of re-operation was significantly in favour of the ciNPWT group at 12 weeks and overall compared to the control group.Two cases of infection were reported in the ciNPWT group, whilst 8 cases were reported in the control group. No differences were... Read More »
Level 2 RCT
1%
Synopsis: 161 patients with a sub-capital femoral fracture and undergoing arthroplasty were randomized to one of three groups: topical fibrin sealant application, topical tranexamic acid applications, or standard haemostasis through electrocoagulation alone.The primary outcome of this study was volume of blood loss to postoperative drainage. Results demonstrated no... Read More »
Level 2 RCT
1%
Synopsis: 144 patients with primary complete Achilles tendon rupture were randomized to be treated with either a surgical repair and accelerated functional rehabilitation or with only the accelerated functional rehabilitation. Over the course of a two year follow up, it was observed that Achilles tendon rupture led to clinically similar results between the two treatment groups. Read More »
Level 2 RCT
1%
Synopsis: 80 patients with acute ruptures of the tendo Achillis were randomized to receive operative treatment using an open technique or non-operative treatment using a cast. The results of the 1-year study indicated that there were no significant differences in terms of re-rupture rate, flexion, and function between the two groups at the end of the study. Read More »
Author verified Level 2 RCT
1%
Synopsis: 13 ACE reports (4 reviews/ meta-analyses, 9 RCTs) were included from the OrthoEvidence database that compared operative versus nonoperative or operative versus operative treatments for displaced midshaft clavicle fractures.The findings of this review demonstrated that surgical procedures led to a lower rate of nonunion and malunion with better functional outcome when compared to nonoperative treatment. Comparisons of operative treatments indicated that an optimal surgical procedure - between plate fixation, nailing, and pin fixation - could not be determined based on union rates or functional outcome. The results of... Read More »
ACE Review