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OTA 2013: Unstable intertrochanteric hip fractures: intra- vs extra- medullary fixation
Synopsis: 205 patients suffering from unstable (AO-A2) intertrochanteric hip fractures were randomized to compare the clinical and radiographic outcomes associated with intramedullary and extramedullary device fixation.Patients were assessed over 12 months, and were evaluated using the Lower Extremity Measure (LEM), a 2-minute walk test, the Timed Up and Go (TUG) test, the functional independent measure (FIM), and a Trendelenburg test.Radiographs were conducted for tip-to-apex distance (TAD), femoral neck shortening, and heterotopic ossification.Results from 168 patients who completed final follow-up indicate that intramedullary and extramedullary fixation present comparable clinical outcomes. Intramedullary devices are... Read More »
Conference Report
4%
AAOS2018: Comparing nonoperative, hemiarthroplasty, ORIF and rTSA for 3- and 4-part humerus fracture
Synopsis: Eight randomized controlled trials were included in this meta-analysis comparing four different treatment options for 3- and 4-part humeral fractures in elderly patients: nonoperative management, open reduction and internal fixation (ORIF), hemiarthroplasty (HA), and reverse total shoulder arthroplasty (rTSA).The body of literature allowed comparison of rTSA to only HA, while nonoperative treatment, ORIF, and HA were all compared directly to each other. Pairwise comparisons identified... Read More »
Conference Report
4%
Arthroscopic surgery vs nonoperative treatment in patients over 40yo with degenerative meniscal tear
①
Synopsis: 9 randomized controlled trials were included in this meta-analysis, comparing arthroscopic surgery to conservative management for the treatment of degenerative meniscal tears in patients over the age of 40 years.Outcomes of interest included knee pain and knee function. The results from... Read More »
Level 1 Meta Analysis
2%
Gaseous and traditional forms of cryotherapy provide similar outcomes following TKA
②
Synopsis: 66 patients, who underwent TKA, were randomized into three groups to receive different types of cryotherapy therapy, to assess differences in functional outcomes.Patients underwent gaseous cryotherapy, cryotherapy using a gel pack, or cryotherapy using a Cryocuff water circulating device several times daily for 7 days following surgery. Results between the... Read More »
Author verified Level 2 RCT
2%
RHA superior to ORIF with both metal and biodegradable implant for displaced radial head fractures
②
Synopsis: 4 out of 20 studies from this study were included in the network meta-analysis comparing radial head arthroplasty (RHA), open reduction and internal fixation with a biodegradable implant (ORIF-B), and ORIF with a metal implant (ORIF-M) for the treatment of displaced radial head fractures (RHF).The outcomes of interest included the odds of complications and of a 'good' or 'excellent' Broberg-Morrey score.The results from this study found favourable odds of both complications and of a 'good' or 'excellent' Broberg-Morrey score in the RHA group compared to both the ORIF-B and ORIF-M groups. The ORIF-B group... Read More »
Level 2 Meta Analysis
2%
Short vs. long cephalomedullary nails for treatment of pertrochanteric fractures of the femur
②
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
2%
TightRope vs screw fixation for treatment of fibular fracture and tibiofibular syndesmosis injuries
②
Synopsis: 103 patients with fibular fractures proximal to an associated syndesmosis injury were randomized to receive internal reduction and fixation with either a knotless TightRope device or screw fixation.Outcomes of interest included radiographic outcomes, the Foot and Ankle Disability Index (FADI), the EQ-5D quality of life questionnaire, the Olerud-Molander (OM) Ankle score, the rate of unplanned re-operation, the rate of malreduction, and the Work Productivity and Impairment (WPAI) score.Follow up was performed at 3 months post-operation for radiographic outcomes, and up to 12 months for clinical outcomes.Results revealed significantly lower rates of unplanned re-operation and lower rates of malreduction in the TightRope group compared to the screw fixation group.Additionally, patients in the TightRope group had a significantly favourable WPAI daily activity rating at 6 weeks compared to the screw fixation group, although total scores were not significantly different. No significant differences... Read More »
Level 2 RCT
1%
Usual care versus exercise therapy for geriatric hip fracture
②
Synopsis: 180 elderly females with hip fractures were randomized to receive traditional care either with or without or an additional home-based exercise program to determine if the intervention can better restore function and strength.The results from this study indicate that there was a significant increase the activity level of the patients receiving the home-based exercise program in addition to traditional treatment. Bone mineral density,... Read More »
Author verified Level 2 RCT
1%
No significant difference between two prostheses in total knee arthroplasty
②
Synopsis: 107 female patients received bilateral simultaneous total knee arthroplasty with a posterior cruciate-sacrificing mobile-bearing prosthesis in one knee and a posterior-stabilized mobile-bearing prosthesis in the contralateral knee.This study was performed in order to compare the clinical and radiographic results of the two prosthetic designs. The participants were... Read More »
Author verified Level 2 RCT
1%
Differences in outcomes between standard and high-flexion knee prosthesis in TKR
②
Synopsis: 127 consecutive patients with 170 primary osteoarthritic knees, scheduled to undergo the total knee arthroplasty procedure, were randomized to the two variants of implant components: one with a high-flexion posterior-stabilized rotating platform mobile bearing prosthesis and another with a standard PFC implant device.Following the same surgical technique and rehabilitation protocol, the aim was to determine if the specially-designed implant met the high demands of flexibility for sitting and squatting for the treatment group. In the two... Read More »
Author verified Level 2 RCT