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Synopsis: Sixty patients, over the age of 50, with acute, minimally displaced subcapital neck of femur fractures were randomly assigned into one of two groups to receive treatment with two-hole dynamic hip screws or cannulated screws.Results indicated that while both methods are effective in treating femoral neck fractures, neither one was superior. Functionality at 1... Read More »
Author verified Level 2 RCT
2%
Synopsis: 100 patients were randomized to total knee arthroplasty with either patient-specific instrumentation or conventional instrumentation.The purpose was to determine if patient-specific guides offered improved postoperative alignment over conventional methods. The results from... Read More »
Author verified Level 2 RCT
2%
Synopsis: 73 patients with rotator cuff tendinopathy were randomized to one of three study treatment groups: (1) hypertonic dextrose prolotherapy injection directly to affected entheses, (2) saline injection directly to affected entheses, or (3) saline injection superficial to affected entheses.The purpose of this study was to investigate the clinical benefits of dextrose prolotherapy when compared to control groups by observing improved patient-reported pain scores, patient satisfaction scores, and ultrasound grading of regenerative effect. Results demonstrated that... Read More »
Author verified Level 2 RCT
2%
Synopsis: 29 studies were included in this meta-analysis comparing operative and non-operative treatment for acute Achilles tendon ruptures.The primary outcome of interest was the rate of re-rupture.Secondary outcomes included the rate of complications, functional outcomes, time to return to sports and time to return to work.The results revealed a significantly lower rate of re-rupture, but a higher rate of complications, in the operative group compared to the non-operative group.Similar findings to the primary analyses were observed in the sensitivity analyses based on early and late weight bearing status, high quality studies and studies conducted after the year 2000.There were no significant differences in re-rupture rate in studies utilizing accelerated functional rehabilitation. There was no... Read More »
Level 1 Meta Analysis
2%
Synopsis: Five randomized controlled trials were included in this meta-analysis which sought to investigate the efficacy of mesenchymal stem cell injections in patients with knee osteoarthritis.Included studies featured various control groups, including placebo injection, hyaluronic acid injection, and no injection, as well as various concomitant treatments, including high tibial osteotomy, microfracture, platelet rich plasma injection and hyaluronic acid injection.Accordingly, clinical heterogeneity was assumed.Data was pooled from 12-24 month time points. Analyses on visual... Read More »
Level 2 Meta Analysis
2%
Synopsis: 220 patients with isolated pertrochanteric femoral fractures were randomized to receive surgical intervention with a short or long cephalomedullary nail.Primary outcomes of interest included the Short Form 36 (SF-36) questionnaire and the Harris Hip Score.Secondary outcomes of interest included implant failure, peri-implant failure, mortality, operative time, estimated blood loss and the incidence of re-operation.Outcomes were assessed up to 12 months post-operation.Results revealed significantly favourable 3 month Harris Hip scores, lower operative time and lower estimated blood loss in the short nail group compared to the long nail group. No significant differences... Read More »
Level 2 RCT
2%
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
1%
Synopsis: 79 patients with symptomatic medial compartment knee osteoarthritis (confirmed with a MRI) were randomized to a variable-stiffness footwear or a constant-stiffness footwear worn at least 4 hr/day for a period of 6 months. At 6 months,variable-stiffness shoes were found to be effective in reducing the peak knee adduction moment, as well as decreasing pain and improving function. Read More »
Level 2 RCT
1%
Synopsis: 104 patients with subacromial shoulder pain for at least three months were randomized to either a supervised exercise (SE) program or a group receiving radial extracorporeal shock-wave therapy (rESWT).Recent randomized trials indicated that SE interventions provided better short and medium term outcomes for this population.The results from this study, however, did not show superior outcomes at long term follow-up, with both groups showing improvements in both pain and functional scores. There was an... Read More »
Author verified Level 2 RCT
1%
Synopsis: 8 ACE Reports (7 randomized controlled trials and 1 systematic review and meta-analysis, n=694) from the OrthoEvidence database assessing the effectiveness of corticosteroid injections in comparison to control injections (either saline or local anesthesia) for the treatment of lateral epicondylitis were included in this review.The purpose of this review was to determine the impact of corticosteroid injections on pain and physical function in comparison to these control treatments.As such, information and data on platelet-rich plasma (PRP) injection efficacy as a treatment was not included from reports.Statistical pooling of VAS pain scores and Quick DASH scores exhibited that corticosteroid injections provided significant pain relief, compared to control injections only in the short-term (6-12 weeks), while having no functional benefits over control injections at any time point within a 6 month period. Similar results were... Read More »
ACE Review