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You are viewing the most viewed ACE Reports by Orthopaedic Surgeons over the last 30 days in all specialties.
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Synopsis:
Fifteen studies involving a total of 353,169 patients undergoing knee or hip arthroplasty were included in this meta-analysis.Among them, 156,405 patients received Spinal Anaesthesia (SA), while 196,764 patients underwent General Anaesthesia (GA).The primary outcome assessed was the incidence of Postoperative Surgical Site Infections (SSIs).Outcomes were evaluated up to 30 days post-surgery. This meta-analysis reveals...
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Level 1 Meta Analysis
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Synopsis:
64 patients with primary frozen shoulder (adhesive capsulitis) were randomized to receive either a multisite (rotator interval, intraarticular, and subacromial bursa) triamcinolone injection (MCI; n=32) or a single-site triamcinolone injection (SRI; n=32).The primary outcomes of interest include range of motion in shoulder flexion, abduction, external and internal rotation and pain on a Visual Analog Scale (VAS).Secondary outcomes included patient satisfaction, American Shoudler and Elbow Surgeons (ASES) scores, Contant-Murley Score (CMS), and the incidence of palpitations.Range of motion in flexion, abduction, internal rotation at 8 weeks, ASES scores, CMS scores, and VAS pain at 4 & 8 weeks were all significantly better in the MCI group compared to the SRI group. All other outcomes...
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Level 1 RCT
Synopsis:
This abstract presents the 5-year follow-up results of a previously published prospective randomized controlled trial.30 patients with an International Cartilage Repair Society (ICRS) grade 3 to 4 chondral defect in the knee were randomized to receive costal chondrocyte–derived pellet-type autologous chondrocyte implantation (CCP-ACI; n=20) or microfracture (MFx; n=10).25 of these patients were followed-up at 5 years.Outcomes of interest included the Lysholm score, International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Visual Analog Scale (VAS) pain score, Magnetic resonance Observation of Cartilage Repair Tissue (MOCART) score, and treatment failure, all assessed at 5 years.In the CCP-ACI group, MOCART, Lysholm and KOOS scores improved significantly from baseline compared the the MFx group. One treatment failure...
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Conference Report
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Synopsis:
Two hundred eighteen patients with non-displaced femoral neck fractures in elderly individuals were randomized to receive internal fixation using either percutaneous compression plate (PCCP; n=97 analyzed) or parallel screws (PS; n=97 analyzed).The primary outcome of interest was the time to full weight-bearing, with secondary outcomes including operative time, intraoperative blood loss, hemoglobin level drop, postoperative hospital stay, reduction quality, fracture healing time, Harris hip score, and postoperative complications.Outcomes were assessed at 6 weeks, 3 months, 6 months, 9 months, and 1 year after surgery. The study reveals...
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Level 1 RCT
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Synopsis:
One hundred and seventy-seven patients with chronic knee pain from knee osteoarthritis (OA) were randomized to receive cooled radiofrequency ablation (CRFA; n=89) of the genicular nerves or a single intra-articular hyaluronic acid (HA; n=88).The primary outcome of interest was the number of patients who reported a =>50% reduction in pain scores from baseline after 6 months.Additional outcomes of interest included pain scores on a Numeric Rating Scale (NRS), the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index, WOMAC pain scores, WOMAC physical function scores, WOMAC stiffness scores, patient perception of treatment effect as reflected by the Global Perceived Effect (GPE) score, the Euro-Qol-5 Dimensions-5 Level (EQ-5D-5L) quality of life questionnaire, and the incidence of treatment-related and non-treatment related adverse events.Outcomes were assessed at 1, 3, and 6 months post-treatment.Results revealed a statistically significantly higher proportion of patients in the CRFA group who reported =>50% improvement in pain scores from baseline compared to the HA group (71% vs.38%, p<0.0001).NRS pain scores, WOMAC total scores, WOMAC pain scores WOMAC physical function scores, GPE scores, and EQ-5D-5L scores were statistically significantly in favour of the CRFA group at all time points compared to the HA group (p<0.05 for all).WOMAC stiffness scores were statistically significantly in favour of the CRFA group at 3 months (p=0.0022) and 6 months (p<0.0001) post-treatment. The incidence of...
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Author verified Level 1 RCT
Greater Quality of Life But Longer Operative Time With THA vs HA for Displaced Femoral Neck Fracture
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Synopsis:
Sixteen randomized controlled studies containing a total of 3084 patients were included in this meta-analysis including patients with displaced femoral neck fractures undergoing total hip arthroplasty (THA; n=1521) or hemiarthroplasty (HA; n=1563).Pooled outcomes of interest included the following: incidence of revision, functional outcomes (evaluated using the Harris hip score), incidence of mortality, health-related quality of life (QoL; evaluated using the EuroQol-5 Dimensions [EQ-5D] Index), incidence of periprosthetic fracture, incidence of dislocation, and operative time.Subgroup analyses was conducted by level of risk of bias.Revision surgery, incidence of mortality and dislocation were all analyzed at 12-60 months follow-up, where as the rest of the outcomes were assessed at 12-36 months.Pooled results revealed that health-related quality of life, evaluated using EQ-5D Index, was statistically significantly in favour of the THA group vs.HA (p=0.001).However, pooled operative time was statistically significantly shorter in the HA group vs THA (p=0.001). All other pooled...
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Author verified Level 1 Meta Analysis
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Synopsis:
Eleven studies, encompassing 749 patients with midshaft clavicle fractures, were included in this systematic review and meta-analysis, which compared the outcomes of intramedullary fixation versus plate fixation in midshaft clavicle fractures.The outcomes of interest included the incidence of postoperative wound infection, surgical incision length, operative time, blood loss, and hospital stay.The analysis revealed that intramedullary fixation demonstrated a lower risk of postoperative wound infection (OR, 5.92; 95% CI, 2.46, 14.27 p < 0.0001), smaller surgical incisions (MD, 6.57; 95% CI, 4.90, 8.25 p < 0.0001), shorter operative time (MD, 17.09; 95% CI 10.42, 23.77 p < 0.0001), less blood loss (MD, 63.62; 95% CI, 55.84, 71.39 p < 0.0001), and a shorter hospital stay (MD, 1.05; 95% CI, 0.84, 1.25 p < 0.0001). However, no statistical...
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Level 1 Meta Analysis
Synopsis:
61 patients with idiopathic frozen shoulder were randomized to receive either watchful waiting (WW; n=31) or physical therapy (PT; n=30).The primary outcome of interest was the American Shoulder and Elbow Surgeons score (ASES) questionnaire.Secondary outcomes of interest included pain scores on a Visual Analog Scale (VAS), the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, direct patient healthcare costs, and patient value (defined as the 12-month ASES score divided by healthcare costs).Outcomes were assessed at baseline, 6 weeks, and 3, 6, and 12 months.Both cohorts improved at each time point for all primary outcomes, but no significant differences in patient-reported outcomes (PROMs) between treatment modalities were found at any time point.WW patients incurred significantly lower direct costs than PT patients, with a normalized mean difference was of 1,635.67.Patients in the WW group also achieved greater patient value, with a normalized mean difference of -146.97. Both of these...
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Conference Report
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Synopsis:
Two hundred twenty-four patients with knee osteoarthritis were randomized to receive different tibial baseplate fixation methods during total knee arthroplasty (TKA).The patients were assigned to three groups: Group 1 received a cemented tibial component (n=97), Group 2 received a pegged porous cementless tibial component (n=87), and Group 3 received a cementless tantalum monoblock porous tibial component (n=90).The primary outcome of interest was survivorship, and secondary outcomes included functional measures such as the Oxford Knee Score, Knee Society Score, and radiological data.Outcomes were assessed up to 10 years post-operatively.The results indicated that, irrespective of tibial fixation method, the overall survivorship was excellent at 99.6%.One knee in Group 2 with cementless fixation and screws required revision for aseptic loosening at 3 years, resulting in a cumulative survivorship of 88% at the end of 10 years.Functional outcomes showed no statistically significant differences between groups. Additionally, radiological outcomes,...
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Level 1 RCT
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Synopsis:
32 adult patients undergoing femoral neck-cannulated screw fixation for femoral neck fractures were randomized to either laser-guided navigation (n=16) or a traditional freehand technique (n=16).Outcomes of interest included operative time, radiation time, total blood loss, pain on a Visual Analog Scale (VAS), Harris Hip Score (HHS), time to healing, and the incidence of success on the first attempt.Operative time, radiation exposure time, and total blood loss were significantly shorter in the laser group compared to the freehand group.The first success rate was also significantly higher in the laser group.VAS pain, HHS, and time to fracture healing were similar between the two groups. Implementing an innovative...
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Level 1 RCT