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100%
7%
Synopsis: One hundred and ninety seven patients who underwent operative fixation of an ankle syndesmotic injury were randomized to receive routine removal (n=93) or on-demand removal (104) of their syndesmotic screw after surgery.The primary outcome was function as measured by the Olerud-Molander Ankle Score (OMAS). Secondary outcomes of... Read More »
Level 1 RCT
7%
Synopsis: 316 patients with non-acute anterior cruciate ligament (ACL) injuries and persistent instability were randomized to receive immediate surgery (n=156) or rehabilitation (n=160).The primary outcome of interest was the Knee Injury and Osteoarthritis Outcome Score - 4 domain (KOOS4).Secondary outcomes of interest included quality of life measures, the Tegner activity score, resource use, complications and patient satisfaction.Primary follow-up occurred at 18 months.The results of this study found that, whilst both groups showed improvement, patients who received immediate surgery had significantly better knee function, pain, patient satisfaction, and Tegner activity scores compared to the rehabilitation group.Surgery was found to have a 72% chance of being cost-effective vs. Read More »
Author verified Level 1 RCT
5%
Synopsis: One hundred and seven patients with medial compartment osteoarthritis were randomized to receive unicompartmental knee arthroplasty (UKA; n=57) or total knee arthroplasty (TKA; n=50).The primary outcomes of this trial were to assess patient-reported outcomes such as Knee Injury and Osteoarthritis Outcome Score, Joint Replacement (KOOS, JR), Knee Society Score (KSS), Forgotten Joint Score (FJS), range of motion (ROM), and VR-12 global health scores at 6 weeks and 6 months follow-up.Radiographic and surgical complications were also recorded.The results of this trial showed no significant differences in KOOS, JR, KSS, and FJS at 6 weeks and 6 months follow-up. Significant differences were... Read More »
Level 1 RCT
3%
Synopsis: Thirty patients undergoing an arthroscopic double-bundle anterior cruciate ligament reconstruction were randomized in this non-inferiority trial to receive an EndoButton CL (n=15) or TIghtRope RT (n=15) device for graft fixation on the femoral side.The primary outcome of interest was graft elongation at 6 months.Secondary outcomes of interest included the single leg hop test index, anterior translation of the tibia, Lachman test and lateral pivot shift test, and Lysholm score.Graft elongation was assessed at 3, 6 and 12 months, and secondary outcomes were assessed 12 months post-operation.Results revealed no significant differences in all outcomes between the two groups, at all time-points. However, the non-inferiority... Read More »
Level 1 RCT
3%
Synopsis: Thirty six patients with primary bone tumors of the distal femur undergoing limb salvage surgery and endoprosthetic reconstruction were randomized to receive a custom antibiotic cement coated prosthesis (n=16) or a standard prosthesis (n=18).The primary outcome of interest was periprosthetic joint infection.Secondary outcomes of interest function and patient survival.The antibiotic cement coated group demonstrated significantly lower infection rates and higher survival rates at final follow-up. The antibiotic cement... Read More »
Level 1 RCT
3%
Synopsis: Seventy-two patients with end-stage knee osteoarthritis were randomized to receive either robot-assisted total knee arthroplasty (RA-TKA; n=37) or conventional manual total knee arthroplasty (CM-TKA; n=35).Outcomes that were assessed in this trial were functional outcomes such as knee flexion-extension range of motion (ROM), American Knee Society Score (KSS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at 90 days post-op.Radiological outcomes were also assessed at 90 days of follow-up.Functional outcomes (KSS, WOMAC, & ROM) were similar between the two groups at 90 days. Significant differences in... Read More »
Level 1 RCT
1%
Synopsis: 13 ACE reports (4 reviews/ meta-analyses, 9 RCTs) were included from the OrthoEvidence database that compared operative versus nonoperative or operative versus operative treatments for displaced midshaft clavicle fractures.The findings of this review demonstrated that surgical procedures led to a lower rate of nonunion and malunion with better functional outcome when compared to nonoperative treatment. Comparisons of operative treatments indicated that an optimal surgical procedure - between plate fixation, nailing, and pin fixation - could not be determined based on union rates or functional outcome. The results of... Read More »
ACE Review
1%
Synopsis: 128 children with a displaced metaphyseal both-bone fracture of the distal forearm underwent reduction and stabilisation.Patients were randomized to wear an above-elbow cast either with or without percutaneous fixation using Kirschner wires, to determine whether the wires helped prevent the need for re-displacement.Following 6 months of evaluations, Kirschner wire stabilisation with above-elbow casts reduced the number of patients observed with re-displacement in comparison to patients only wearing above-elbow casts.Stabilisation with the wires also significantly lowered the limitation of pronation and supination. However, it should... Read More »
Level 2 RCT
1%
Synopsis: 56 patients with a degenerative, full-thickness rotator cuff tear were randomly assigned to receive either conservative treatment or mini-open repair in order to compare outcomes between treatment methods.Follow-up was performed for 12 months post-intervention.No significant differences were observed between overall groups in any outcome measure.In a subgroup analysis of the few patients with an intact rotator cuff (successful surgical repair/no re-tear), significantly better Constant-Murley score (CMS), Visual analogue scale (VAS) pain and VAS disability scores were noted compared to the conservative group.Nonetheless, the re-tear rate was high following mini-open repair in this study (~75%). Read More »
Level 2 RCT
1%
Synopsis: 228 patients scheduled for total knee or hip arthroplasty and identified as Staphylococcus aureus (S.aureus) carriers upon preoperative screening were randomized to a preoperative nasal decolonization protocol in addition to standard antibiotic prophyalaxis, or standard prophylaxis alone.The purpose of this randomized trial was to evaluate the efficacy of the preoperative decolonization protocol in reducing infection rate postoperatively.An additional 800 patients who were identified as noncarriers upon screening were assessed to estimate the prevalence of S.aureus carriers among patients undergoing total joint arthroplasty, and the incidence of postoperative infection. The results of... Read More »
Level 2 RCT