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Synopsis: 255 Japanese patients undergoing primary unilateral cementless total hip replacement (THR) were randomized into three groups to assess the efficacy of current prophylactic treatments for venous thromboembolisims (VTE).This study examined the the use of mechanical prophylactics separately and in conjunction with current pharmacological prophylactics (Fondaparinux and Enoxaparin). The results illustrated... Read More »
Level 2 RCT
2%
Synopsis: The findings of 70 publications, focusing on total joint replacement (TJR) which used some form of thromboprophylaxis, were combined to assess the effect of throboprophylaxis on mortality and proportion of deaths due to a known or suspected pulmonary embolism (PE) in modern TJR.99441 patients were categorized into 7 groups based on the type of throboprophylaxis.Death occurred in 373 of the patients analysed; these deaths were then grouped by cause, including cardiopulmonary (excluding PE), pulmonary embolism (PE), bleeding, CNS, gastrointestinal and other.Results indicated that there was a very low mortality rate, regardless of thromboprophylaxis in TJR. The use of... Read More »
Author verified Level 1 Meta Analysis
1%
Synopsis: 71 patients with an acute rupture of the anterior cruciate ligament (ACL) were randomized to receive either a bone-patellar tendon (BPT) or a quadruple hamstring tendon (HT) for ACL reconstruction, using an anatomic, non-press fit (non implant) technique.Clinical results from the international knee documentation committee and results from kneeling, knee walking and a single-leg hop test demonstrated superior results from the HT group, although quadriceps strength was superior in the BPT group. Other outcome measures... Read More »
Author verified Level 2 RCT
1%
Synopsis: 70 patients scheduled for simultaneous bilateral total knee arthroplasty were randomized to pain management through either intraoperative periarticular injection or postoperative epidural analgesia.The purpose of this study was to evaluate whether periarticular injection reduced pain postoperatively when compared to epidural analgesia.Pain was assessed on a visual analog scale (VAS) from 4 hours postoperatively to 72 hours postoperatively.Area under the curve analysis identified significantly lower pain from 4-24 hours in the periarticular injection group compared to the epidural analgesia.Difference between groups from 24-72 hours was not statistically significant. Read More »
Author verified Level 2 RCT
1%
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
<1%
Synopsis: 129 elderly patients presenting with displaced subcaptial hip fractures were randomized to three forms of surgical treatment to determine their effects on functional performance post-operatively.At 4 year follow-up, total arthroplasty provided the best functional results compared to both internal fixation and hemiarthroplasty. Functional results strongly... Read More »
Level 2 RCT
<1%
Synopsis: 4 trials (randomized controlled trials and clinical controlled trials) consisting of 968 patients were evaluated to determine whether metal-on-metal hip resurfacing arthroplasty (MMHRA) provided better long-term clinical results, compared to standard total hip arthroplasty (THA) in young active patients with end-stage hip disease.Results indicated that patients undergoing MMHRA had significantly higher revisions rates and incidences of component loosening, compared to the THA group. However, there were... Read More »
Level 1 Meta Analysis
<1%
Synopsis: 28 patients (30 fractures) with open tibial fractures or high-energy-induced complex tibial fractures were randomized after surgery to undergo low-intensity pulsed ultrasound (LIPUS) stimulation therapy or sham treatment.The purpose was to compare short-term clinical and radiological outcomes between groups.Patients treated with LIPUS had significantly earlier tenderness relief, full weight-bearing, external fixator removal, and appearance of bridging bone calluses.Additionally, LIPUS achieved a significantly higher percentage change in bone mineral content and plasma bone-specific phosphatase activity at various follow-up time points. Read More »
Level 2 RCT
<1%
Synopsis: 84 patients scheduled for revision total hip arthroplasty were randomized to administration of either combined intravenous and topical tranexamic, or intravenous tranexamic acid administration alone during the procedure.The purpose of this study was to compare transfusion rate, blood loss parameters, and the incidence of venous thromboembolic complications between groups.Results demonstrated significantly lower transfusion rate, smaller maximum hemoglobin drop, and lower postoperative and total blood loss volume in the combined TXA group compared to the IV TXA group.The incidence of deep vein thrombosis was low, with only one case documented in the combined group. No patient in... Read More »
Level 2 RCT
<1%
Synopsis: 20 patients were randomized to examine the effect of platelet-rich plasma (PRP) on acute Achilles tendon rupture (ATR) regeneration.Patients that were non-operatively treated received either PRP or control injection in clinic, while PRP gel was applied in the ruptured gap for operatively treated patients during percutaneous repair. The follow-up at... Read More »
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