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25%
19%
13%
7%
7%
6%
6%
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4%
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100%
8%
Synopsis: 160 patients with a Robinson type 2B1-2 displaced midshaft clavicle fracture were included in this multicenter randomized controlled trial to compare outcomes between operative and nonoperative treatment methods.Patients were evaluated for nonunion, constant shoulder score, disabilities of the arm, shoulder, and hand (DASH) score, pain, secondary operations, and cosmetic result.At one year the rate of nonunion was significantly higher in the nonoperative group as was the rate of secondary plate fixation to manage nonunion.However, there was no difference in the total number of secondary procedures between groups.Additionally, there were no differences in constant and DASH scores between the groups. Read More »
Author verified Level 2 RCT
5%
Synopsis: 107 patients scheduled for two-stage revision hip or knee arthroplasty due to periprosthetic infection have been included in this randomized controlled trial to evaluate the efficacy of a 3-month course of oral antibiotics in reducing the rate of reinfection.The results reported in this summary are from a planned interim analysis conducted when the trial reached half of its planned sample size.Patients were randomized to a receive an additional 3-month course of oral antibiotics tailored to the original infecting organism or no additional antibiotic treatment.The incidence of reinfection was significantly lower in the oral antibiotics group compared to the control group (p=0.0162), suggesting that a course of oral antibiotics following two-stage revision hip and knee arthroplasty may reduce the risk of recurrent periprosthetic infection. However, given that... Read More »
Author verified RCT
3%
Synopsis: 109 patients with a moderate, dorsally displaced distal radius fracture (Colles') were randomized to two different conservative management protocols after closed reduction.One group was treated with plaster cast immobilization for 10 days followed by elastic bandaging, while the other group was treated with 1 month (range 4-5 weeks) of plaster cast immobilization. Radiographic results found... Read More »
Author verified Level 2 RCT
2%
Synopsis: Ten randomized controlled trials were included in this meta-analysis comparing blood loss and range of motion following total knee arthroplasty between knee positioning in flexion versus extension.Results demonstrated significantly lower calculated total blood loss and hidden blood loss with flexion protocols, but no significant difference in postoperative blood drainage volume. Transfusion rate was... Read More »
Level 1 Meta Analysis
2%
Synopsis: 111 patients with Kellgren-Lawrence grade I-IV symptomatic knee osteoarthritis were randomized to three weekly intraarticular injections of either leukocyte-poor platelet-rich plasma (LP-PRP) or hyaluronic acid.Patients were assessed for pain and function over a 52-week follow-up.The primary outcome measure, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, demonstrated no significant difference between groups at any time point.In contrast, pain scores on a visual analog scale (VAS) demonstrated significantly lower pain in the LP-PRP group compared to the HA group at 24- and 52-week follow-up. Similarly International Knee... Read More »
Author verified Level 2 RCT
2%
Synopsis: 14 randomized controlled trials were included in this systematic review and meta-analysis to evaluate the use of corticosteroid injections in the management of rotator cuff tendinosis in comparison to a placebo.The primary outcome of interest for this meta-analysis was pain assessed at 3 months (12 weeks).A subgroup analysis was also performed to compare the efficacy of single vs multiple injections.The results of this study indicated that corticosteroid injections provided greater reductions in pain at 4 and 8 weeks compared to placebo, however, these differences were small and not clinically relevant.There were no differences observed between groups at 12 weeks.Additionally, there were no differences observed between single and multiple injections of a corticosteroid. Read More »
Author verified Meta Analysis
1%
Synopsis: 1543 patients undergoing knee arthroscopy (POT-KAST trial) and 1519 patients undergoing casting of the lower leg (POT-CAST trial) were randomized to receive or not anticoagulant therapy.The aim of these studies was to examine the efficacy of thromboprophylaxis in these groups of patients.The result of these trials indicated that the use of low-molecular-weight heparin did not reduce the rate of symptomatic venous thromboembolism in either patient population compared to no anticoagulant treatment. Read More »
Level 2 RCT
1%
Synopsis: Five randomized controlled trials were included in this meta-analysis investigating the efficacy and safety of combined intravenous-intraarticular tranexamic acid administration to that of intravenous tranexamic acid alone.Pooled results demonstrated significantly lower total blood loss, smaller postoperative hemoglobin drop, and lower incidence of transfusion in combined intravenous-intraarticular TXA groups compared to intravenous TXA alone groups. Incidence of thromboembolic... Read More »
Level 1 Meta Analysis
1%
Synopsis: 110 patients with a humeral shaft fracture were randomized to either operative treatment through minimally invasive plate osteosynthesis or nonoperative treatment through functional bracing.The purpose of this study was to compare functional, clinical, and radiographic outcomes between groups, as well as the incidence of severe and minor complications.The primary outcome was the Disabilities of the Arm, Shoulder, and Hand (DASH), questionnaire.The only significant difference in DASH scores between groups was observed at 6 months favoring the MIPO group.The MIPO group also has a lower incidence of nonunion and lower anteroposterior angular displacement compared to the functional brace group. Other clinical/functional outcomes,... Read More »
Level 2 RCT
1%
Synopsis: Twenty-six (26) randomized controlled trials were included in this systematic review and meta-analysis evaluating the efficacy of spinal manipulative therapy (SMT) compared to either active control comparators or sham treatment in the management of acute low back pain.Observational studies were also included to evaluate the safety of SMT.Results demonstrated significant effects in favour of SMT at 3-6 weeks for both pain and function.Eight of the 26 RCTs from the efficacy analyses were included in comparison of adverse events, and complemented by another 3 RCTs and 5 prospective cohort studies which only reported data on adverse events.There was high-quality evidence that transient musculoskeletal pain adverse events may be experienced following SMT, though a few studies which compared rates between treatment groups suggested similar incidences between manual therapy with and without SMT, or between SMT and sham treatment. No serious adverse... Read More »
Level 1 Meta Analysis