LOGIN
PeerView
You are viewing the most viewed ACE Reports by Primary Care Physicians over the last 30 days in all specialties.
Displaying
100%
23%
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...
Read More »
Level 1 RCT
19%
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...
Read More »
Level 1 RCT
9%
②
Synopsis:
Nine studies (6 randomized controlled trials and 3 prospective comparative studies) were selected to examine the effects of leukocyte-poor platelet rich plasma and leukocyte-rich platelet rich plasma in knee osteoarthritis treatment.Due to the presence of only one direct comparison between LP-PRP and LR-PRP at the time of the study, studies which compared either to hyaluronic or placebo were included, and network meta-analysis was undertaken.Primary outcome was the incidence of local adverse events, while secondary efficacy outcomes included the change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores and International Knee Documentation Committee (IKDC) scores.Incidence of local adverse events was higher with LP-PRP or LR-PRP compared to HA or placebo, and both were ranked at approximately 20% of being the best treatment for the outcome.Nevertheless, the difference between LP-PRP and LR-PRP for incidence of local adverse events was not significant. LP-PRP was ranked...
Read More »
Author verified Level 2 Meta Analysis
9%
①
Synopsis:
Sixty athletes with MRI-confirmed grade 2 hamstring injuries were randomized to receive ultrasound-guided Platelet-Rich Plasma (PRP) injections plus standard therapy (n=30) or standard therapy alone (n=30).The primary outcome of interest was time to return to play.Secondary outcomes included MRI healing at 21 days, re-injury rates, and adverse events, with follow-up extending to 24 months.Overall, the results of the study revealed that PRP significantly accelerated return to play, improved MRI healing at 21 days, and trended toward lower re-injury rates.No adverse events occurred. These findings suggest...
Read More »
Level 1 RCT
4%
②
Synopsis:
Six randomized controlled trials were included in this meta-analysis which compared the effects of romosozumab to placebo, teriparatide, and alendronate in postmenopausal osteoporosis treatment.The change in bone mineral density at the lumbar spine, total hip, and femoral neck significantly favoured romosozumab versus both placebo and active controls. Fracture rates after...
Read More »
Level 2 Meta Analysis
4%
①
Synopsis:
Six randomized controlled trials including 348 patients with painful knee osteoarthritis were included in this systematic review and meta-analysis comparing intraarticular botulinum toxin type A (BTA) vs.corticosteroid vs.hyaluronic acid (HA).Pooled outcomes of interest included pain measured by visual analog scale (VAS), total and individual components of the Western Ontario McMaster Universities Arthritis Index (WOMAC) scores.The pooled results suggested that intraarticular BTA is as effective as corticosteroids in improving pain and function but is more effective than HA in reducing knee pain. These findings suggest...
Read More »
Level 1 Meta Analysis
4%
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...
Read More »
Level 1 Meta Analysis
4%
①
Synopsis:
One hundred thirty-two patients with Kellgren-Lawrence grade 1-3 knee osteoarthritis were randomized to receive three weekly intra-articular injections of either LR-PRP (n=66) or LP-PRP (n=66).The primary outcome was the change in the International Knee Documentation Committee (IKDC) subjective score at 12 months.Secondary outcomes included pain, function, and quality of life assessed through various scales (KOOS, WOMAC, VAS, EQ-5D, Tegner activity scale), as well as objective measures such as range of motion and quadriceps circumference.Outcomes were evaluated at baseline and at 2, 6, and 12 months.Overall, both groups showed significant improvement in subjective and objective outcomes, with no significant differences except for a transient greater improvement in IKDC at 2 months in the LR-PRP group, and minor differences in ROM and quadriceps circumference at specific time points.No severe adverse events were reported, and the rate of treatment failure was similar. The study concluded...
Read More »
Level 1 RCT
4%
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...
Read More »
Conference Report
4%
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...
Read More »
Level 1 RCT