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You are viewing the most viewed ACE Reports by Orthopaedic Resident/Interns over the last 30 days in all specialties.
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13%
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
10%
Synopsis:
Ninety-eight patients undergoing unilateral knee arthroplasty were randomized to receive either standard care (n=47) or a multicomponent intervention for opioid-free pain control (OFPC) (n=51).The primary outcome of interest was the rate of OFPC at eight weeks.Secondary outcomes included pain levels, patient satisfaction, recruitment and adherence rates, and feasibility metrics such as follow-up and retention.Outcomes were assessed at 3, 6, 9, and 12 months.Overall, the results of the study revealed that 67% of patients in the intervention group achieved OFPC at eight weeks, with high adherence to most components of the intervention and follow-up exceeding 90% at 12 months. These findings suggest...
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Conference Report
6%
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
3%
②
Synopsis:
59 patients (>18 years of age) who were diagnosed with mallet finger (with or without fracture) and who had undergone continuous splint/cast immobilization and hyper-extension intervention (6-8 weeks), were randomly assigned into 1 of 2 treatment groups to determine the effect of an additional one month of night splinting on extensor lag.Participants either received an additional one month intervention with a night splint following their continuous splinting period or received no additional intervention (control). Results from the...
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Author verified Level 2 RCT
3%
Synopsis:
80 patients scheduled for primary total hip arthroplasty were randomized to surgery completed through either a lateral approach or a posterior approach.Primary outcomes were cup inclination and anteversion, as well as the number of cups placed outside of Lewinnek "target zone" (40+/-10deg inclination; 15+/-10deg anteversion). While results for...
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RCT
3%
①
Synopsis:
1054 patients being treated for bone or joint infection at 26 UK centers were randomized in this non-inferiority trial to receive 6 weeks of oral antibiotic therapy (n=527) or 6 weeks of intravenous antibiotic therapy (n=527).The primary outcome of interest was the rate of definite treatment failure.Secondary outcomes of interest included the rate of treatment discontinuation, catheter complications, diarrhea caused by C.difficile, serious adverse events, length of hospitalization, and patient-reported outcomes (Oxford Hip and Knee Scores [OHS; OKS]; EuroQual-5Dimension scores [EQ-5D]).Outcomes were assessed at 6 weeks, 4 months, and 1 year follow-up.Oral antibiotics were found to be non-inferior to intravenous antibiotics with regards to the risk of definitive treatment failure.The incidence of early discontinuation of treatment and catheter complications, and length of hospitalization were significantly higher in the intravenous group, however, no differences in the incidence of diarrhea or serious adverse events were observed between the two groups. EQ-5D scores and...
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Level 1 RCT
3%
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
3%
①
Synopsis:
One hundred and sixty-two patients undergoing a total joint arthroplasty (TJA; total hip or knee arthroplasty) were randomized to receive one of 3 new wound closure techniques: surgical zipper (n=54), monofilament suture plus adhesive (n=55), or monofilament suture plus polyester mesh with adhesive (n=53).The primary outcome of interest was closure time.Secondary outcomes of interest included peri-operative complication rates, 90-day readmission, and emergency room visit rates.Results revealed no significant differences in closure time between the 3 techniques; however, when analyzing total hip arthroplasty patients, only the closure time was significantly faster in the suture plus adhesive group (p=0.032). No significant differences...
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Level 1 RCT
3%
①
Synopsis:
One hundred four patients with end-stage hip joint diseases undergoing primary total hip arthroplasty were randomized to receive intraoperative bone wax (n=52) or no bone wax (n=52).The primary outcome was total blood loss.Secondary outcomes included serum hemoglobin level, change in hemoglobin, thigh swelling (lower limb diameters), range of motion at discharge, length of postoperative hospital stay, and adverse events.Outcomes were assessed on postoperative days (POD) 1 and 3, and during follow-up at 3 weeks and 6 months.Overall, the results of the study revealed significantly lower total blood loss, smaller hemoglobin drop, and shorter hospital stays in the bone wax group. The study concludes...
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Level 1 RCT
3%
①
Synopsis:
One hundred thirty-nine patients with trapeziometacarpal osteoarthritis were randomized to receive either tendon interposition arthroplasty (n=75 hands) or total joint replacement with a dual mobility prosthesis (n=75 hands).The primary outcome of interest was hand strength.Secondary outcomes included pain (VAS), function (DASH), range of motion (Kapandji and radial abduction), and patient satisfaction.Outcomes were assessed preoperatively and at 1, 3, 6, 12, and 24 months postoperatively.Overall, the results revealed that patients receiving the prosthesis experienced faster and greater improvements in strength, range of motion, and pain relief, with sustained superiority in strength outcomes at 24 months. These findings suggest...
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Level 1 RCT