Loading...
Visit our Evidence-Based Covid-19 Website and Stay Up to Date with the latest Research.
To focus on specific sub specialties check/uncheck boxes on left
31%
16%
14%
10%
8%
7%
3%
2%
2%
2%
2%
2%
<1%
Displaying
100%
4%
Synopsis: Forty-nine thousand, five hundred and ninety-seven patients aged 60 years or older from Ontario who underwent either total hip arthroplasty or hemi-arthroplasty for the treatment of displaced femoral neck fractures were included in this retrospective study examining clinical outcomes and associated factors with each procedure.A matched cohort of 9,238 patients was used to compare clinical outcomes.Outcomes of interest included the risk of hip dislocation, revision surgery, and death.Results of the study found a higher risk of 1-year revision surgery and dislocation in the total hip arthroplasty group compared to the hemi-arthroplasty group. The risk of... Read More »
Conference Report
4%
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
4%
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
4%
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
3%
Synopsis: 111 patients with either unilateral or bilateral hip osteoarthritis were randomized to be treated with one of three injection protocols; platelet rich plasma, hyaluronic acid, or combined platelet rich plasma and hyaluronic acid.Patients were administered three weekly intra-articular injections of the allocated treatment, were followed-up for 12 months post-injection and assessed clinically using a visual analog scale for pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the Harris Hip Score (HHS). Results demonstrated significantly... Read More »
Level 2 RCT
2%
Synopsis: A total of forty-five patients were randomized to either receive the traditional posterior approach for patients undergoing Total Hip Arthroplasty (THA) or the Supercapsular Percutaneously-Assisted Total Hip (SuperPATH) approach which is a new and less invasive procedure causing less blood loss and scarring.This was a prospective randomized controlled trial conducted between April 2017 to March 2019 and patients were followed-up 12 months after surgery.The primary outcome consisted of patients ability to return to function, measured with the Timed Up and Go test, Timed Stair Climb test and Oxford Hip Scores.Secondary outcomes of interest consisted of pain measures (e.g., narcotic consumption, Visual Analogue Scale (VAS)).Peri-operative measures were also included (e.g., length of stay, blood loss, components position, operative time, time before discontinuation of mobility aids, return to work, and complications).Results demonstrated that return to work was earlier by 2 weeks in the SuperPATH approach, as well as the time to discontinuation of mobility aids.In addition, despite relatively similar pain scores in the 2 approaches, the patients who had undergone the SuperPATH approach consumed less opioids. Operative time was... Read More »
Conference Report
2%
Synopsis: 38 patients scheduled for total knee arthroplasty were randomized to have the procedure completed with the use of either patient-specific instrumentation (PSI) or conventional intra- and extramedullary instrumentation.The purpose of this study was to compare alignment outcomes, operative time and blood loss between the two groups. Radiographic results demonstrated... Read More »
Level 2 RCT
2%
Synopsis: 3427 patients who had undergone either total knee or hip arthroplasty with a 5-day course of rivaroxaban 10mg postoperatively were randomized to extended thromboprophylaxis with either aspirin 81mg daily or continued rivaroxaban 10mg daily.Patients were assessed for the incidence of venous thromboembolism, major bleeding events, and clinically relevant nonmajor bleeding events over the first 90 days after surgery.Noninferiority analysis for efficacy demonstrated that extended aspirin was noninferior to extended rivaroxaban. Groups also demonstrated... Read More »
Level 1 RCT
2%
Synopsis: 357 patients with hip osteoarthritis were randomized to a single intraarticular injection of either hylan G-F 20 or placebo saline.Patients were assessed over 26-week follow-up for outcome on improvement in the first question of the WOMAC Pain subscale (WOMAC A1), response rate on the WOMAC A1 (minimum 2-pt improvement), the WOMAC Pain subscale overall, the WOMAC Function subscale, and the incidence of adverse events. Results at all... Read More »
Level 2 RCT
2%
Synopsis: Femoral neck fractures, a type of hip fracture, are a common and disabling injury, particularly given an ageing population in many countries.Throughout the past half-century, multiple different treatments have evolved for the treatment of these fractures, and these include sliding hip screws, cannulated screws, hemiarthroplasty (HA), and total hip arthroplasty (THA).Given that femoral neck fractures have the potential to compromise blood flow to the femoral head, arthroplasty options have gained prominence in recent years.However, it remains unclear which of the two options (THA or HA) is optimal in this population.Thus, in this definitive, landmark randomized controlled trial, which is by far the largest of its kind to date, the investigators randomized 1495 patients 50 years of age older with a displaced femoral neck fracture to undergo HA or THA.The trial was conducted across 80 centres in 10 different countries.Primary outcome was a secondary hip procedure within 24 months.Secondary endpoints included death, serious adverse events, hip-related complications, health-related quality of life, function, and overall health.There was no significant difference between the two groups in terms of revision rate, mortality, serious adverse events, revision procedures, EQ-5D, timed up and go test, or Short-Form 12 scores.There was a trend toward higher dislocation rates in THA, though this was not statistically significant.There was a significant difference in favour of THA on the WOMAC total and sub-scores, though this difference fell below the minimal clinically important threshold.Overall, in the absence of a convincing indication for THA, HA is a comparable treatment for femoral neck fracture which does not result in a significant difference in revision rate.There may be a slightly higher rate of serious adverse events with THA, and slightly better function with THA, though these differences may not reach clinical significance. Read More »
Level 1 RCT