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You are viewing the most viewed ACE Reports by Primary Care Physicians over the last 30 days in all specialties.
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①
Synopsis:
Nine hundred fourty one patients with carpal tunnel syndrome (CTS) were randomized to receive initial surgical decompression (n=470) or initial corticosteroid injection (n=471); further interventions were allowed in both arms as needed.The primary outcome was recovery at 18 months (CTS-6 <8).Secondary outcomes included time to recovery, serial CTS-6, upper-limb function (QuickDASH), palmar pain and pain-related limitation, global perception of recovery, satisfaction, additional treatments, and adverse events.Outcomes were assessed through 18 months at prespecified intervals.Overall, the results of the study revealed that 61% in the surgery group versus 45% in the injection group recovered, and median time to recovery was shorter with surgery (9.0 vs 18.0 months).Patients starting with surgery also had better 18-month QuickDASH, global recovery, and satisfaction, while palmar pain was more frequent early after surgery but comparable by later follow-up. These findings suggest...
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Level 1 RCT
15%
Platelet-Rich Plasma Injections Are Inferior to Corticosteroid Injections for Short-Term Pain Relief
①
Synopsis:
Fifty-two patients with symptomatic KL II–III knee osteoarthritis (OA) were randomized to receive platelet-rich plasma (PRP) (n=26) or corticosteroid (CS) (n=26).The primary outcome was change in VAS pain.Secondary outcomes were NPRS pain, KOOS JR, and WOMAC.Outcomes were assessed at baseline, 6 weeks, and 3 months.Overall, the results of the study revealed that CS produced significantly larger pain reductions than PRP at 6 weeks and met MCIDs for both VAS and NPRS, whereas groups were similar by 3 months and showed comparable functional gains at both time points. These findings suggest...
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Level 1 RCT
11%
①
Synopsis:
Seventy-two patients with unilateral plantar fasciitis were randomized to receive extracorporeal shock‐wave therapy (ESWT)(n=36) or Low-Dye taping (LDT) with sham ESWT (n=36).The primary outcome of interest was pain (VAS).Secondary outcomes included FAOS subscales (Symptoms, Pain, Activities of Daily Living, Sport & Recreation, and Quality of Life).Outcomes were assessed at baseline, immediately post-treatment, and at six-week follow-up.Overall, the results of the study revealed significant within-group improvements in both arms for VAS and all FAOS subscales, with no between-group differences at any time point. The study concludes...
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Level 1 RCT
7%
①
Synopsis:
Seventy-five patients with isolated ACL rupture were randomized to bone–patellar tendon–bone (BPTB), single-bundle quadrupled hamstring tendon (HT), or over-the-top HT plus lateral extra-articular tenodesis (HT+LET) (n=25 per arm initially).At final assessment (mean 23.0±1.1 years), 61 completed PROMs, 37 underwent clinical testing, and 35 had radiographs.The primary outcomes were clinical failure/revision and long-term knee function; secondary outcomes included instrumented laxity (KT-1000; pivot-shift), and tibiofemoral/patellofemoral Osteoarthritis (OA) on standardized radiographs.Overall, the results of the study revealed no between-group differences for most PROMs; Tegner activity was slightly higher with HT+LET vs BPTB, AP laxity was lower with BPTB vs HT, and patellofemoral OA was more frequent after BPTB vs HT+LET.There were no differences in tibiofemoral OA or objective IKDC grades. In sum, all...
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Level 1 RCT
7%
①
Synopsis:
Forty-two sport-active patients with chronic insertional Achilles tendinopathy were randomized to low tendon compression rehabilitation (LTCR; n=20) or high tendon compression rehabilitation (HTCR; n=22).The primary outcome was VISA-A at 12 and 24 weeks.Secondary outcomes included patient satisfaction, return-to-sport, pain on hopping (VAS-HOP) and during ADLs (VAS-ADL), single-leg heel-raise repetitions, and ultrasound tendon thickness; outcomes were assessed at baseline, 12, and 24 weeks.Overall, the results of the study revealed larger VISA-A gains with LTCR at both 12 weeks and 24 weeks, alongside higher satisfaction and better pain metrics. In short, limiting...
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Level 1 RCT
7%
①
Synopsis:
Two hundred fifteen patients with inflammatory knee osteoarthritis (OA) and MRI effusion-synovitis were randomized to methotrexate up to 15 mg weekly (n=108) or identical placebo (n=107).The primary outcome of interest was change in knee VAS pain and effusion-synovitis maximal area over 52 weeks.Secondary outcomes of interest included WOMAC (pain, stiffness, function, total), MRI effusion-synovitis volume, infrapatellar fat pad signal metrics, OMERACT-OARSI response, PHQ-9, SF-12, and structural MRI scores.Outcomes were assessed repeatedly to 52 weeks, with MRI at baseline and week 52. Overall, the results...
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Level 1 RCT
3%
②
Synopsis:
103 patients (age range 15-75) with 119 digits undergoing zone-II flexor tendon repairs within 48 hour of injury by Strickland four-strand tendon repair technique were randomized to post surgical rehabilitation methods of either active or passive motion therapy.At 1 year, digit range of motion was significantly greater with smaller flexion contracture and higher satisfaction scores in patients receiving active motion therapy versus passive motion therapy. However, patient-assessed outcomes...
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Level 2 RCT
3%
①
Synopsis:
Six studies involving 517 patients with neck pain were included in this systematic review and meta-analysis, comparing cervical manipulations to thoracic or cervicothoracic manipulations.Pooled outcomes of interest included pain intensity, neck disability, and cervical range of motion.The analysis revealed no significant differences in pain reduction, disability improvement, or cervical range of motion between the intervention groups. Moderate to very...
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Level 1 Meta Analysis
3%
Synopsis:
One hundred ninety-six patients undergoing aseptic or septic revision total hip arthroplasty were randomized to receive either closed incision negative-pressure therapy (ciNPT) (n=105) or a silver-impregnated dressing (n=91).The primary outcome of interest was the rate of wound complications.Secondary outcomes included type of wound complications, need for reoperation due to wound issues, and comparison of perioperative variables.Outcomes were assessed at 90 days postoperatively.Overall, the results of the study revealed no significant difference in wound complication rates between the ciNPT and control groups (11.7% vs.12.9%, p=0.95), nor in reoperations for wound-related issues (3.9% vs.1.1%, p=0.37). These findings suggest...
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Conference Report
3%
①
Synopsis:
Thirty-two patients with acute anterior shoulder dislocation were randomized to FARES (n = 17) or Spaso (n = 15) reduction without sedation.The primary outcome was first-attempt (≤2 tries) success.Secondary outcomes included overall success when switching to the alternative method after two failures, reduction time, peri-reduction VAS pain, and follow-up events (recurrence, surgery).Outcomes were assessed during the ED visit and at a mean 5.3 ± 2.2 years.Overall, the results revealed similar first-attempt success, but when FARES failed initially, switching to Spaso yielded 100% overall success in that arm, whereas switching from Spaso to FARES yielded no additional successes.Pain decreased during and after reduction in both groups, with no significant between-group differences; reduction times were also similar. These findings suggest...
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Level 1 RCT