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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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100%
22%
①
Synopsis:
One hundred and twenty-one patients undergoing a hip arthroscopy procedure were randomized to receive 90 days of automated text messages on post-operative instructions and general health guidance (n=57) or no added intervention (n=64).Outcomes of interest included pain and physical function on the Hip Disability Osteoarthritis Outcome Score (HOOS), patient compliance, and patient satisfaction with the intervention.Results revealed no significant differences between the two groups in pain, physical function, or compliance at 90 days. Patients who received...
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Level 1 RCT
12%
①
Synopsis:
Four hundred and thirty eight patients undergoing inpatient primary TKA at 11 centers were randomized to receive 4 mg (n = 146), 8 mg (n = 147), or 16 mg (n = 145) of intraoperative IV dexamethasone, all within an identical multimodal analgesia/anesthesia protocol including neuraxial anesthesia, adductor canal block, periarticular injection, and standardized oral analgesics.The primary outcome was cumulative opioid consumption in oral morphine milligram equivalents (MME) over the first 48 hours postoperatively.Secondary outcomes included daily opioid use to 7 days, pain at rest and with activity, nausea scores, vomiting episodes, sleep duration, postoperative day 1 (POD1) glucose, length of stay, and 90-day complications.Outcomes were assessed with a 7-day patient diary and chart review through 90 days.Overall, the results of the study revealed that 16 mg IV dexamethasone modestly reduced early opioid consumption (particularly vs 8 mg), improved pain at rest and reduced vomiting within 24 hours, but increased POD1 glucose in a dose-dependent fashion without increasing short-term complication rates. These findings suggest...
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Level 1 RCT
9%
①
Synopsis:
Five hundred thirty-five patients undergoing elective primary Total Hip Arthroplasty (THA) were randomized to cutaneous closure with staples (n=268) or sutures (n=267).The primary outcome was SSI (<6 weeks).Secondary outcomes included prosthetic joint infection (PJI, <1 year), other wound complications (prolonged discharge, dehiscence, necrosis; <6 weeks), and length of stay.Outcomes were assessed during admission, at discharge, then at 2 weeks (removal), 6 weeks, 3 months, and 1 year.Overall, the results of the study revealed a higher—nearly significant—SSI rate with staples and a clearly higher rate of early wound complications, driven by prolonged discharge; PJI did not differ. These findings suggest...
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Level 1 RCT
6%
①
Synopsis:
6 studies (363 patients) examining outcomes of surgical and nonsurgical treatments of undisplaced or minimally displaced scaphoid waist fractures were evaluated through pairwise meta-analysis.An additional 3 trials were also identified for inclusion in a network meta-analysis.Following assessments of fracture union, complications, range of motion, grip strength, and osteoarthritis between patients who underwent either surgical or non-surgical treatment, there was a non-significant trend to increased union with surgical treatment. However this method...
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Author verified Level 1 Meta Analysis
6%
①
Synopsis:
One hundred and sixteen patients with displaced femoral neck fractures were randomized to receive hemiarthroplasty via the anterior approach (AA) (n=58) or the lateral approach (LA) (n=58).The primary outcome was function at 6 weeks on the Barthel-20 Index.Secondary outcomes included EQ-5D, pain (VAS; plus 5-day opioid use), length of stay (acute and to rehab discharge), complications (medical and implant-related), readmissions/ED visits, and mortality.Outcomes were assessed at 2, 6, 12, and 24 weeks.Overall, the results revealed no between-group differences for the primary outcome (both groups mean 15.8 at 6 weeks; P=0.98) or for secondary patient-reported outcomes, resource use, complications, readmissions, or mortality; operative time was modestly longer with AA and cement mantle quality was worse. In short, AA...
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Level 1 RCT
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...
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ACE Review
3%
②
Synopsis:
74 patients scheduled for total knee arthroplasty were randomized to undergo the procedure with or without patellar resurfacing.The purpose of this study was to compare short-term functional performance measures, and mid-term patient reported outcome measures of pain, satisfaction, and disease-related quality of life between groups. No significant differences...
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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:
One hundred and nineteen patients with insertional Achilles tendinopathy were randomized to received extracorporeal shockwave therapy with eccentric exercise (ESWT +EE) (n=58) or eccentric exercise (EE) and sham therapy (n=61).The primary outcome was function measured by the Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A).Secondary outcomes of interest included pain scores, the Foot and Ankle Outcome Score (FAOS), the Short Form Health Survey (SF-12), recurrence and failure of treatment.Both groups demonstrated significant improvements from baseline.No differences in the VISA-A, FAOS or SF-12 were found at any time point between groups. The EWST+EE group...
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Level 1 RCT
3%
①
Synopsis:
One hundred fifty-eight patients with displaced fifth metacarpal neck fractures were treated with either K-wire pinning (KP; n=60), intramedullary pinning (IP; n=50), or combined intramedullary pinning with K-wire pinning (IPKP; n=48).The primary outcome was radiological correction (angulation and shortening).Secondary outcomes included range of motion (TAM), Quick-DASH scores, cosmetic scores, and complication rates.Outcomes were assessed preoperatively, postoperatively, and at 1-year follow-up.Overall, the study found that IPKP achieved significantly better angulation, less shortening, and higher cosmetic scores.Functional outcomes were similar, though stiffness occurred only in the KP and IP groups. These findings suggest...
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Level 1 RCT