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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:
16 randomized controlled trials assessing operative versus nonoperative management for distal radius fractures were included in this systematic review and meta-analysis.The primary outcome of interest was Patient-Rated Wrist Evaluation (PRWE) at 12 months.Secondary outcomes of interest included Disabilities of the Arm, Shoulder, and Hand (DASH) score, grip strength, complications, and radiographic outcomes. Both PRWE and...
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Conference Report
3%
Synopsis:
843 patients were included in this study consisting of a randomized trial (n=555) and natural experiment (n=288), aiming to compare posterolateral and direct lateral hemiarthroplasty approaches for the treatment of hip fracture.The primary outcome of interest was health-related quality of life at 6 months, measured with the EuroQol 5-Dimensions (EQ-5D-5L) questionnaire.Secondary outcomes of interest included dislocation, fear of falling, activities of daily living, pain, and re-operation.Data from the randomized trial and natural experiment were fused, and pooled effects were reported.The pooled results showed a significantly higher odds of dislocation with the posterolateral approach compared to the direct lateral approach (OR 12.31 [95%CI 2.77, 54.7]).No difference in quality of life scores were observed between the two groups. The rate of...
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Conference Report
2%
Synopsis:
90 acute tibial shaft fractures were included in this randomized trial comparing intramedullary nailing via a suprapatellar approach (n=42) or infrapatellar approach (n=48).The primary outcomes of interest included anterior knee pain on a Visual Analog Scale (VAS) and knee function on the Kujala scale, measured at 6 weeks and 12 months.Secondary outcomes of interest included radiographic alignment, radiation exposure, and non-union.Patients who received suprapatellar intramedullary nailing reported significantly less anterior knee pain and better knee function at both 6 weeks and 12 months (p<0.05 for all). Moreover, significantly less...
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Conference Report
2%
①
Synopsis:
83 elderly patients with femoral neck fractures were randomized to receive a bipolar hip hemiarthroplasty via a direct anterior approach (DAA; n=40) or an anterolateral approach (ALA; n=43).The outcomes of interest included mobility measured with the Barthel Index, pain on a Visual Analog Scale (VAS), and heterotopic ossification occurrence, all measured up to 1 year post-operation.Pain scores in the first 2 weeks were significantly lower in the DAA group compared to the ALA group.While mobility was significantly better on post-operative day 1 in the DAA group, the ALA group showed superior mobility from week 6 to end of follow-up (1 year post-operation).The rate of heterotopic ossification was also significantly higher in the ALA group in the first 3 months post-operation.The results suggest that DAA may provide superior outcomes in the early post-operative phase, particularly with respect to early mobilization and pain scores. However, mobility may...
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Level 1 RCT
2%
Synopsis:
124 elderly patients (65 completed 5 year follow-up) with displaced proximal humeral fractures were randomized to receive a total shoulder arthroplasty (n=64) or a plate fixation (n=60).The primary outcome of interest was the Constant score.Secondary outcomes of interest included the Oxford Score and radiological outcomes, which were not reported in the conference abstract.Outcomes were assessed at 2 and 5 years post-operation.The results of this study found reverse total shoulder arthroplasty to result in significantly better Constant scores at 5 years post-operation compared to plate fixation.The sub-group analyses found that reverse total shoulder arthroplasty particularly outperformed plate fixation in patients with Type C2 fractures and patients aged 65-74.
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Conference Report
2%
Synopsis:
42 patients with femoral neck fractures were randomized to receive either tranexamic acid (TXA; n=21) or normal saline (n=21).Outcomes of interest included blood loss, drain output within 48 hours, hemoglobin values, and complications at 6 months. TXA significantly reduced...
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Conference Report
2%
Synopsis:
218 patients with open tibia or femur fractures were randomized to receive irrigation using a colloidal silver solution, a bleach solution, or a normal saline solution.The primary outcome of interest was surgical site infection, measured over 1 year follow-up.No significant differences were observed between the three groups, suggesting that bleach solution could be a cost-effective alternative to more conventional irrigation solutions in resource-constrained environments. Time to debridement...
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Conference Report
2%
Synopsis:
40 patients undergoing total knee arthroplasty were randomized to an extended oral tranexamic acid post-operative protocol or a placebo protocol.The outcomes of interest included pain on a Visual Analog Scale (VAS), knee function and health scores (Knee Injury and Osteoarthritis Outcomes Score Joint Replacement [KOOS JR]), knee flexion, terminal knee extension, hemoglobin levels, and adverse events.Follow-up was performed up to 6 weeks post-operation.The extended tranexamic acid group demonstrated lower pain scores at 2 and 6 weeks, improved knee flexion at 6 weeks, and better KOOS JR scores at 2 and 6 weeks compared to the placebo group. No differences in...
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Conference Report
2%
Synopsis:
1022 adult patients undergoing primary total knee arthroplasty (TKA) were randomized to receive either intra-wound vancomycin powder (n=507) or no vancomycin powder (n=515).The primary outcome of interest included the peri-prosthetic joint infection (PJI) rate.The secondary outcomes of interest included surgical site infection (SSI) rates, the incidence of revision for PJI/SSI, and the incidence of wound complications.Intra-wound vancomycin powder showed no differences vs. no vancomycin powder...
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Conference Report
1%
①
Synopsis:
Twenty-seven randomized controlled trials that compared the safety and efficacy of platelet-rich plasma (PRP), bone marrow aspirate concentrate (BMAC), and hyaluronic acid (HA) were included in this meta-analysis.Outcomes of interest included the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), pain on a Visual Analog Scale (VAS), International Knee Documentation Committee (IKDC), and Lequesne Index Score (LEQ).WOMAC, IKDC, and VAS scores favored PRP against HA.Similarly, in the network meta-analyses comparing BMAC and HA, WOMAC, IKDC, and VAS scores favored BMAC. No differences were...
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Author verified Level 1 Meta Analysis