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33%
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7%
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1%
Synopsis: 43 patients (62 proximal interphalangeal joints) with proximal interphalangeal joint osteoarthritis were included in a study to examine the effectiveness of three types of arthroplasty implants.Patients were randomized to receive surface replacement arthroplasty with a titanium-polyethylene (TI) implant, a pyrocarbon (PY) implant, or arthroplasty with a silicone (SI) spacer.Over a mean follow up period of 35 months, the PY and TI groups tended to have higher maximum range of motion scores than the SI group, but the difference was not significant.The PY and TI groups also had a higher complication rate than the SI group. There were no... Read More »
Level 2 RCT
1%
Synopsis: 53 patients scheduled for simultaneous bilateral total knee arthroplasty were randomized to have one knee operated on with circumpatellar electroautery with concurrent patellar resurfacing intraoperatively, and the other knee without patellar resurfacing.Patients were assessed for the incidence of anterior knee pain, clinical scores, and radiographic measures over 2-year follow-up, as well as intraoperative data, including operative time and blood loss.Results demonstrated no significant differences between groups in the incidence of anterior knee pain or clinical scores. The patellar resurfacing... Read More »
Level 2 RCT
1%
Synopsis: 664 patients scheduled for total knee arthroplasty were randomized to either topical tranexamic acid or intravenous tranexamic acid.Patients were assessed for total blood loss, postoperative blood loss, and the incidence of transfusion. Results demonstrated that... Read More »
Level 2 RCT
1%
Synopsis: 150 patients scheduled for total hip arthroplasty and administered an intravenous dose of tranexamic acid prior to incision were randomized to either an additional 2, 3, or 4 IV TXA doses after 3 hour intervals thereafter.Patients were assessed for hidden blood loss, total blood loss, intraoperative blood loss, hemoglobin drop, transfusion rate, length of hospital stay, and incidence of thromboembolic complications.Results demonstrated significantly lower hidden blood loss, lower total blood loss, and smaller Hb drop in the 4 dose group compared with either the 3 or 2 dose group, though no transfusion was required in any group. No cases symptomatic... Read More »
Level 1 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: 398 patients scheduled for primary or revision total hip or knee arthroplasty were randomized to post-surgical management with either incisional negative pressure wound therapy. Results demonstrated no overall differences in wound appearance score, infection rate, rates of patients with mild or moderate/severe drainage, rates of dressing-related complications, or rates of reoperation due to wound complications. Read More »
Level 2 RCT
1%
Synopsis: Traditionally, patients undergoing total hip arthroplasty (THA) have been advised to avoid certain movements that would put them at risk for dislocation.This has been of particular concern with the posterolateral, which has historically been associated with the highest dislocation rates.In recent years, however, improvements in surgical technique and implants (e.g.larger heads) have dramatically reduced dislocation rates.Thus, it is unclear if hip precautions are still necessary.The authors randomized 408 patients to standard care and patients who still had hip precautions while awake, but had no restrictions on sleeping position.Primary outcome was dislocation at 8 weeks, secondary outcomes were deep infection, pulmonary embolism, deep vein thrombosis, pain, function, and health-related quality of life.There were no significant differences on any outcomes between the two groups. The trial was... Read More »
Level 1 RCT
1%
Synopsis: Forty-nine thousand, five hundred and ninety-seven patients aged 60 years or older from Ontario who underwent either total hip arthroplasty or hemi-arthroplasty for the treatment of displaced femoral neck fractures were included in this retrospective study examining clinical outcomes and associated factors with each procedure.A matched cohort of 9,238 patients was used to compare clinical outcomes.Outcomes of interest included the risk of hip dislocation, revision surgery, and death.Results of the study found a higher risk of 1-year revision surgery and dislocation in the total hip arthroplasty group compared to the hemi-arthroplasty group. The risk of... Read More »
Conference Report
<1%
Synopsis: 40 patients with unstable wrist fracture to be treated with external fixators were randomized for the use of titanium pins (TI) or Hydroxyapatite-coated titanium pins (HA).Clinical evaluation of pin site with regard to erythema, drainage, pain value and radiological assessment for loosening at T1 (mean, 9 days), T2 (mean, 43 days), and T3 (mean, 56 days) was conducted.In the case of infection, a detailed follow up with the specifics of antibiotic and any surgical procedure was recorded.The results from this study indicated that there were no significant differences in terms of these outcomes. However, there was... Read More »
Author verified Level 2 RCT
<1%
Synopsis: 42 patients with radigographically verified degenerative osteoarthritis (OA) of the knee were randomized to receive either hyaluronan or triamcinolone injection treatment.This study assessed the efficacy of hyaluronan and triamcinolone injections for the treatment of OA, while also comparing outcome measures of these two treatments.The results from this study indicated that both injections provide a number of improvements from baseline measures, including VAS pain scores, Knee Society Scores and in a number of others. There were no... Read More »
Level 1 RCT