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24%
16%
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13%
11%
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100%
7%
Synopsis: 48 patients with a trimalleolar fracture featuring a posterior fragment with >25% articular involvement, >2mm displacement, and ankle instability were included in this study.Patients were randomized to the management of the posterior malleolus fragment using indirect reduction and anteroposterior fixation or direct reduction and posteroanterior fixation.The outcomes assessed over the 12-month follow-up included the quality of reduction, range of motion deficit, and complications.All fractures had healed completely by 3 months.The quality of reduction was significantly better with direct reduction and posteroanterior fixation. There was no... Read More »
Level 2 RCT
5%
Synopsis: 97 patients with an acute syndesmotic injury were randomized to surgical stabilization with either a suture button device or a syndesmotic screw.Patients were followed-up for results on function, pain, and radiological outcome over a 2-year follow-up.Results demonstrated that the suture button device was significantly favoured over a syndesmotic screw for functional outcome from 6 months to 2 years, for dynamic pain scores from 1 year to 2 years, and the rate of malreduction (ie. loss of reduction... Read More »
Author verified Level 2 RCT
3%
Synopsis: 477 patients who had previously undergone internal fixation for a fracture of the foot, ankle, or lower leg were randomized to either prophylactic cefazolin or saline during routine implant removal.The primary outcome was the development of surgical site infection within 4 weeks of implant removal. Overall, no significant... Read More »
Author verified Level 1 RCT
1%
Synopsis: 82 patients with a displaced intraarticular calcaneal fracture were randomized to either minimally invasive plate osteosynthesis using closed reduction and percutaneuous plate introduction, or a standard (conventional) approach for open reduction and plate fixation. Patients were assessed for surgical outcomes, length of stay, pain and functional outcome, and radiographic results.Operative time and length of hospital stay were both significantly shorter in the MIPO group compared to the conventional approach group, and the incidence of wound complications was significantly less frequent in patients who had received MIPO.Additionally, pain at 1 week after surgery significantly favoured the MIPO group. AOFAS ankle-hindfoot score... Read More »
Level 2 RCT
1%
Synopsis: 70 patients scheduled for total hip arthroplasty were randomized to either the direct anterior approach or the direct lateral approach.Patients were followed up for biomarkers of muscle damage (myoglobin, creatine kinase, and lactate dehydrogenase), surgical outcomes including operative time and blood loss, pain and pain management outcomes, and complication rates.The only significant difference in biomarkers observed between groups was a smaller increase in myoglobin at 24 hours in the DDA group.Operative time for the series was on average significantly longer in the DAA group.Blood loss measures did not significantly differ between groups. Pain scores for... Read More »
Level 2 RCT
1%
Synopsis: 87 patients undergoing a non-cemented primary total hip arthroplasty for non-inflammatory degenerative joint disease (NIDJD) were randomized to comparatively evaluate the efficacy of the direct anterior approach (DAA) compared to the postero-lateral approach (PA), over 12 months.Patients were primarily assessed for the ability to climb stairs normally and walk unlimited, along with several other secondary outcomes. The evidence presented... Read More »
Level 2 RCT
1%
Synopsis: This 16 study meta-analysis/systematic review evaluated the ability of platelet-rich plasma (PRP) to improve functional outcomes of patients suffering from knee cartilage degeneration.The aim of the study was to determine the best course of care and treatment for patients with chondral degenerative knee lesions by comparing functional outcomes before and after the use of PRP injections, HA injections, and placebo controls.Results revealed that the injection of PRP improved function and was more effective compared to HA administration. Additionally, patients with... Read More »
Author verified Level 3 Meta Analysis
1%
Synopsis: 60 patients (84 knees) with Kellgren-Lawrence III-IV knee osteoarthritis undergoing total knee arthroplasty were included in this study to compare early postoperative outcomes between two different surgical approaches in an Asian population.Knees were randomized to undergo the procedure using a midvastus approach or a medial parapatellar approach.Patients were assessed for perioperative outcomes (tourniquet time, the number of lateral releases, postoperative blood loss volume, and time to discharge) and clinical outcomes over a 1-year follow-up (Knee Society Scores, knee pain, and function). The results of... Read More »
Level 2 RCT
1%
Synopsis: A meta analysis was performed to determine the safety and efficacy of various venous thromboembolism prophylaxis agents.The results of fifty-two trials (n =10929) utilizing bilateral venography to assess the presence of DVT among different treatment groups were used. The results showed... Read More »
Level 1 Meta Analysis
1%
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