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24%
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7%
4%
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100%
5%
Improved function and time to union with plating versus sling for mid-shaft clavicle fractures
②
Synopsis: 69 patients with a closed, displaced clavicle fracture (Robinson type 2B) were randomized to surgery with open reduction and internal fixation with a plate, or two nonoperative treatment with an arm pouch sling.Patients were followed over 24-month follow-up for union, incidences of nonunion and malunion, complications, and function through the Constant score.Results demonstrated no significant differences in the rate of nonunion between groups, though time to union was significantly shorter in the plate group compared to sling group. Additionally, function at... Read More »
Level 2 RCT
4%
Percutaneous versus open repair of acute Achilles tendon rupture
②
Synopsis: 82 patients with a complete Achilles tendon rupture were randomized to either percutaneous repair or open repair.Follow-up was performed over 12 months after surgery for functional scores, range of motion, complications, and rerupture rate.Results demonstrated no significant differences between groups for any of the assessed outcome measures. No patient in... Read More »
Author verified Level 2 RCT
4%
NSAIDs associated with reduction in heterotopic ossification development versus placebo in THA
①
Synopsis: 29 randomized controlled trials were selected for inclusion in this meta-analysis which compared the rates of heterotopic ossification after total hip arthroplasty between groups of patients treated with selective non-steroidal anti-inflammatory drugs (NSAIDs), groups treated with non-selective NSAIDS, and groups treated with placebo.Compared to placebo, both selective and non-selective NSAID groups demonstrated significantly lower rates of heterotopic ossification development. No significant difference... Read More »
Level 1 Meta Analysis
3%
1-3 week immobilization period following distal radius fracture improves early function vs 6 weeks
②
Synopsis: 133 patients with a distal radius fracture scheduled for open reduction and internal fixation with a volar plate were randomized to a postoperative immobilization period or either 1 week, 3 weeks, or 6 weeks.Primary outcomes included wrist function, pain, and range of motion in wrist extension and forearm supination.Follow-up was performed at 6 weeks, 12 weeks, and 26 weeks postoperatively.Results demonstrated significantly better results related to the Patient-Rated Wrist Evaluation, visual analog scales for pain, and active range of wrist extension at 6 weeks for patients allocated to immobilization for only 1 or 3 weeks as compared to patients allocated to immobilization for 6 weeks.Differences between the three groups for results at 12 and 26 weeks were not statistically significant. Loss of fracture... Read More »
Level 2 RCT
2%
Functional brace versus cast immobilization of stable type B ankle fractures
②
Synopsis: 44 patients with a stable type B malleolar fracture were randomized to postoperative immobilization using either a removable functional brace or a below-the-knee cast.Patients were assessed for function, pain, comfort, and range of motion over a 52 week follow-up.Results demonstrated no significant differences between groups at any time point on the Olerud-Molander score, VAS pain, or AAOS foot and ankle score. VAS comfort scores... Read More »
Author verified Level 2 RCT
2%
Bone mineral density loss following total joint arthroplasty mitigated by bisphosphonate therapy
①
Synopsis: 25 randomized controlled trials were included in this meta-analysis which compared bisphosphonate therapy to control intervention for effect on postoperative bone mineral density following total hip and total knee arthroplasty.Overall, in THA and TKA cohorts, bisphosphonate therapy was associated with significantly greater total periprosthetic bone mineral density compared to control intervention up to 5-10 year follow-up. Among THA cohorts,... Read More »
Level 1 Meta Analysis
2%
No difference in 4-yr clinical outcome or stability between cemented & cementless hip arthroplasty
②
Synopsis: 141 elderly patients scheduled for hip arthroplasty after having suffered a displaced femoral neck fracture were randomized to either cement or cementless fixation of the femoral stem in either hemiarthroplasty or total hip arthroplasty.Patients were followed up for clinical scores, radiographic assessment of stem subsidence, acetabular erosion, radiolucency, component loosening, and reoperation rate 4 years after surgery.The cemented group was significantly favoured with respect to results on total Harris Hip Score at 4 months, Short Musculoskeletal Function Assessment dysfunction score from 4 months to 1 year, and SMFA bother score from 1 year to 2 years. However, by 4... Read More »
Level 2 RCT
1%
Routine robotic-assistance for UKA does not significantly affect clinical outcomes in first 2 years
②
Synopsis: 139 patients scheduled for unicompartmental knee arthroplasty were randomized to either robotic-assisted or conventional surgery.Patients were assessed for patient-reported outcome measures and the incidence of revision over the first 2 years after surgery.Overall PROMs, with the exception of stiffness on a visual analog scale, did not significantly differ between the two groups at 2 years. In a subgroup... Read More »
Level 2 RCT
1%
IORA prophylaxis achieves greater vancomycin tissue concentration vs IV administration in TKA
②
Synopsis: 22 patients with a BMI over 35 and scheduled for total knee arthroplasty were randomized to either intraosseous regional administration (IORA) vancomycin 500mg or intravenous vancomycin 15mg/kg.Intraoperative samples of subcutaneous fat and femoral bone were obtained and tested for concentrations of vancomycin. Results demonstrated significantly... Read More »
Level 2 RCT
1%
Comparing femoral component rotation and intercompartmental force differences between GB and MR TKA
②
Synopsis: 91 patients scheduled for total knee arthroplasty were randomized to surgery completed using either the gap balancing technique or the measured resection technique.Outcomes of interest included final femoral component rotational alignment, and the difference between the medial and lateral compartment forces (Intercompartmental Force Difference) at full extension, 45 degrees flexion, 90 degrees flexion, and full flexion while trialing components.Mean femoral component external rotation alignment was significantly lower in the GB group compared to the MR group, though a greater degree of variation in final external rotation of the component was observed in the GB group. The intercompartmental force... Read More »
Level 2 RCT