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Synopsis: 29 studies were included in this meta-analysis comparing operative and non-operative treatment for acute Achilles tendon ruptures.The primary outcome of interest was the rate of re-rupture.Secondary outcomes included the rate of complications, functional outcomes, time to return to sports and time to return to work.The results revealed a significantly lower rate of re-rupture, but a higher rate of complications, in the operative group compared to the non-operative group.Similar findings to the primary analyses were observed in the sensitivity analyses based on early and late weight bearing status, high quality studies and studies conducted after the year 2000.There were no significant differences in re-rupture rate in studies utilizing accelerated functional rehabilitation. There was no... Read More »
Level 1 Meta Analysis
9%
Synopsis: 220 patients with isolated pertrochanteric femoral fractures were randomized to receive surgical intervention with a short or long cephalomedullary nail.Primary outcomes of interest included the Short Form 36 (SF-36) questionnaire and the Harris Hip Score.Secondary outcomes of interest included implant failure, peri-implant failure, mortality, operative time, estimated blood loss and the incidence of re-operation.Outcomes were assessed up to 12 months post-operation.Results revealed significantly favourable 3 month Harris Hip scores, lower operative time and lower estimated blood loss in the short nail group compared to the long nail group. No significant differences... Read More »
Level 2 RCT
6%
Synopsis: 7 studies were included in this meta-analysis comparing carpal tunnel release (CTR) with vs, without a flexor retinaculum release (FRR) for the treatment of carpal tunnel syndrome (CTS).Outcomes analyzed included grip strength, symptom severity score (SSS), functional status score (FSS), and complications. The results from... Read More »
Level 2 Meta Analysis
6%
Synopsis: Five randomized controlled trials were included in this meta-analysis which sought to investigate the efficacy of mesenchymal stem cell injections in patients with knee osteoarthritis.Included studies featured various control groups, including placebo injection, hyaluronic acid injection, and no injection, as well as various concomitant treatments, including high tibial osteotomy, microfracture, platelet rich plasma injection and hyaluronic acid injection.Accordingly, clinical heterogeneity was assumed.Data was pooled from 12-24 month time points. Analyses on visual... Read More »
Level 2 Meta Analysis
3%
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
3%
Synopsis: 82 patients with intra-articular calcaneal fractures of > 2mm displacement (verified by computed tomography scans) were randomly assigned into operative or non-operative groups, to compare the effectiveness of each treatment.The results demonstrated that there were no significant differences between the two groups at the one year follow up in terms of pain (VAS), or physical/mental functioning (SF-36).There was however, a trend observed at the eight-twelve year follow-up in VAS pain and function scores, and physical SF-36 scores, in favour of the operative group. The study also... Read More »
Author verified Level 2 RCT
3%
Synopsis: 131 patients with distal radius fractures participated in this study to determine the effects of immediate mobilization postoperatively.Patients began mobilization on postoperative day 1 or 2 weeks following the surgery .The results imply improved range of motion and grip strength in the immediate mobilization group at 2 weeks, as well as improved Mayo Wrist Scores at 1 year. Other functional assessments,... Read More »
Conference Report
3%
Synopsis: This meta analysis/systematic review identified 9 randomized controlled trials (760 patients) that compared local infiltration analgesia (LIA) to placebo/no infiltration during hip arthroplasty (HA).The aim of this study was to determine the efficacy and safety of LIA. Results revealed LIA... Read More »
Author verified Level 1 Meta Analysis
3%
Synopsis: 40 pediatric patients with a boxer's fracture were randomized to receive either an ulnar gutter plaster splint or a thermoplastic hand-based splint for the treatment of a boxer's fracture.The purpose of the study was to compare the two treatments based on pain, a PODCI questionnaire, ROM, and grip strength. Based on the... Read More »
Conference Report
3%
Synopsis: 19 lower-demand elderly patients (>=75) with isolated displaced olecranon fractures were randomized to either operative (tension-band wiring or plate fixation) or nonoperative (immobilization) management.The objective of this trial was to compare functional and patient-reported outcomes between open reduction and internal fixation (ORIF) and nonoperative management over a 1 year period.The results of this trial indicated that both management techniques resulted in significant within-group improvement in function at 1-year; however, there were no significant differences in functional or patient-reported outcomes between groups at any time point. Operative management was... Read More »
Conference Report