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Synopsis: This is a meta-analysis of ten randomized controlled trials comparing operative and non-operative treatment for primary patellar dislocation.A total of 510 patients were included, and outcomes were recurrence (at 24-44 months and 72-86 months), function (at 24-44 months) and revision rate (at 72-84 months).A subgroup analysis was also performed on patients < 16 years old (at 24-168 months).Overall, operative management was significantly favoured in terms of recurrent dislocation and function at 24-44 months.There was a trend favouring surgery for recurrence and revision at 72-86 months, though this was non-significant. Read More »
Level 1 Meta Analysis
5%
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
2%
Synopsis: 32 patients (25 at last follow-up) with acute tarsometatarsal joint fractures or fracture dislocations were randomized to receive primary arthrodesis (PA) or primary open reduction and internal fixation (PORIF).This study evaluated whether the PA procedure produced improved functional outcomes and fewer secondary surgeries.The results at all-time points (3, 6, 12, 24 months) indicated that there were no physical function differences reported for Short Form-36 (SF- 36) and Short Musculoskeletal Function Assessment (SMFA) scores. The PA procedure... Read More »
Level 2 RCT
2%
Synopsis: 43 patients with unilateral primary osteoarthritis (OA) were randomized to receive either standard total hip arthroplasty (THA) or resurfacing total hip arthroplasty.The results of the study indicated that knee extensor, hip abductor and hip extensor strength were significantly higher at 52 weeks, in patients who received standard THA. Furthermore, it was... Read More »
Author verified Level 2 RCT
2%
Synopsis: Historically, there have always been perceived advantages to hip resurfacing rather than total hip arthroplasty.However, as newer generation hip arthroplasties with improved design have emerged, these previously established failure rate comparisons may no longer be valid.The current study used a meta-analysis to analyze current evidence on this subject. Findings revealed that pooled mechanical failure rates of the femoral component were lower in total hip arthroplasty when compared to the resurfacing, although these rates were low for both procedures. Acetabular and overall... Read More »
Level 1 Meta Analysis
2%
Synopsis: Use of cemented versus un-cemented implant fixation in total hip arthroplasty (THA) has long been an area of debate. Although cemented components have long had unsurpassed prosthesis survival rate, more and more THAs are being performed with un-cemented components. The current systematic review and meta analysis compared the pros and cons to cemented versus un-cemented fixation to determine which has a better overall performance. The study found that although the performance of un-cemented components is improving, cemented fixation continues to be unparalleled. Read More »
Author verified Level 1 Meta Analysis
2%
Synopsis: 41 patients with isolated acute or subacute primary ligamentous Lisfranc injuries were randomised to undergo either a primary open reduction and internal fixation procedure or a primary partial arthrodesis procedure.Short- and long-term functional and clinical outcomes were examined. The results indicated... Read More »
Level 2 RCT
2%
Synopsis: 40 patients undergoing hip arthroscopy were randomized to receive routine intravenous and oral narcotics or a femoral nerve block.Results indicated that the nerve block group required less time until discharge than the routine narcotics group.At post-operative day 1, significantly more patients in the nerve block group than in the routine narcotics group reported satisfaction with the method of pain control received. In addition, fewer... Read More »
Level 2 RCT
2%
Synopsis: 51 patients, including 52 hips, undergoing treatment for osteoarthritis were randomized to receive either reverse hybrid (cemented polyethylene cup with cementless femoral stem) or conventional cemented total hip replacement (both components cemented) to determine if there was a difference in outcome between the techniques.Clinical outcome, wear, component migration and bone remodeling were recorded over 2 years postoperatively.The results showed that there were no major differences between the two procedures. This study indicated... Read More »
Level 2 RCT
2%
Synopsis: 1715 patients undergoing total knee arthroplasty (TKA) were randomized to either receive patellar resurfacing during the operation or not, to determine whether patellar resurfacing provides significant benefits. The collection of clinical outcomes, complication rates, and health care costs over a 5 year period indicated that the addition of patellar resurfacing during TKA did not significantly change any of the results compared to those who did not receive resurfacing during surgery. Read More »
Level 2 RCT