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Synopsis: 14 studies (9691 patients) were included in this meta-analysis comparing single-dose antibiotics vs.multi-dose antibiotics for infection prophylaxis in patients undergoing an orthopedic procedure involving an implant placement.The primary outcome of interest was the incidence of surgical site infection.Results revealed no significant difference in the incidence of surgical site infection between single-dose and multi-dose antibiotic use. In the sub-group... Read More »
Level 1 Meta Analysis
2%
Synopsis: 147 patients scheduled for a primary total knee arthroplasty for arthritis were randomized to receive the same cruciate-retaining implant with either cemented fixation or cementless, biological fixation.The primary outcome of interest was the Oxford Knee Score (OKS).Secondary outcomes of interest included the Knee Society Score (KSS), the Forgotten Joint Score (FJS), the percentage of normal knee function, overall health rating, satisfaction with overall function, radiographic outcomes, the incidence of of failure or component subsidence, and the incidence of revision.Follow up was performed at 4-6 weeks, 1 year and 2 years post-operation.Results revealed no significant differences in OKS, KSS, FJS, or the percentage of normal knee function between the two groups at all time points.There were no significant differences in overall health rating or the satisfaction with overall function at 2 years.No cases of failure or component subsidence were reported.1 case of revision was reported in the cemented group. The mean thicknesses... Read More »
Level 2 RCT
2%
Synopsis: 88 patients, aged 60 or above, with proximal humeral fractures were randomized to receive surgical intervention with a Philos locking plate or non-operative treatment.The primary outcome of interest was the Disability of the Arm, Shoulder and Hand (DASH) score at 2 years.Secondary outcomes of interest included the Constant-Murley Score, pain on a Visual Analog Scale (VAS), the 15D quality of life questionnaire, the EQ-5D questionnaire, the Oxford Shoulder Score (OSS), and the incidence of adverse events.Follow up was performed up to 2 years post-operation. Results of the... Read More »
Level 2 RCT
1%
Synopsis: 75 patients with a 3- or 4-part humerus fracture were randomized to fixation with either a locking intramedullary nail or locking compression plate.Patients were assessed over a minimum of 24 months after surgery for clinical scores, radiographic outcome, and incidence of complications and reoperation.Clinical scores, including visual analog pain scores, the Constant Score, and the American Shoulder and Elbow Surgeons (ASES) score, demonstrated no significant differences between the two groups.Rates of malunion/nonunion and avascular necrosis development were also similar between groups. A lower rate... Read More »
Conference Report
1%
Synopsis: 42 patients with complete anterior cruciate ligament (ACL) tears were randomized to receive an ACL reconstruction with either a quadrupled hamstring tendon (QHT) graft (semitendinosus and gracilis tendon) or a bone-patellar tendon-bone (BPTB) graft.Outcomes of interest included functional outcomes measures (Lysholm, Cincinnati scores), anterior knee pain, and instability assessments (Lachman, anterior drawer and pivot shift tests).Follow up was performed at 2 weeks, 6 weeks, 3 months, 6 months and 1 year.No significant differences were observed in both Lysholm and Cincinnati scores at 2 weeks, 6 weeks, 3 months, 6 months and 1 year post-operation.However, significant differences in several Cincinnati sub-scores (pain, overall activity level, running activity) were observed between the two groups.The proportion of patients who reported anterior knee pain was similar between the two groups.Similarly, the proportion of patient who reported altered sensation over the anterolateral aspect of the proximal leg was not significantly different between groups. Lachman test, anterior... Read More »
Level 2 RCT
1%
Synopsis: 48 patients scheduled for a hip hemiarthroplasty or total hip replacement were randomized to receive said surgery beginning in the morning (8AM) or the afternoon (1-2PM).The primary outcomes of interest were the levels of cortisol, interleukin-6 (IL-6) and interleukin-8 (IL-8).Secondary outcomes of interest included pain on a Visual Analog Scale (VAS) and the length of hospitalization.Follow up was performed up to 48 hours post-operation.Results revealed significantly higher levels of cortisol at 24 and 48 hours, IL-6 at 12, 24 and 48 hours, and IL-8 at 12 and 24 hours in the morning group compared to the afternoon group.Similarly, the proportion of patients who returned to initial cortisol levels was significantly lower in the morning group at both 24 and 48 hours. No significant differences... Read More »
Level 2 RCT
1%
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
1%
Synopsis: 14 randomized controlled trials were included in this meta-analysis which sought to investigate the impact of autologous bone marrow-derived mesenchymal stem cell (MSC) administration alongside core decompression on outcomes in treatment of patients with osteonecrosis of the femoral head. Pooled analyses of pain scores from 6 months to 2 years, function from 1 to 2 years, and incidence of eventual total hip arthroplasty, ranging from 1 to 5 years in the same analysis, all significantly favoured MSC groups compared to control groups. Read More »
Level 1 Meta Analysis
1%
Synopsis: This is a follow-up to a previously published multi-centre randomized controlled trial.The authors randomized 461 patients undergoing surgery for distal radius fractures to Kirschner wire fixation versus plate fixation.They report outcomes (function and quality of life) at five years post-operatively.There was no significant difference between the two groups at any of the yearly follow-ups between one and five years as measured on the Patient-Related Wrist Evaluation (PRWE) and EuroQol Five-Dimension Three-Level (EQ-5D-3L). Read More »
Level 2 RCT
1%
Synopsis: 100 elderly patients with fresh femoral neck fractures (Garden Grade III-IV) were randomized to receive a hemi-arthroplasty via a SuperPath approach (with the associated prostheses) or a traditional posterior approach.Outcomes of interest included pain on a Visual Analog Scale (VAS), the Harris Hip Score and the Barthel Index.Peri-operative outcomes were additionally reported.Follow up was performed at 1 week, 3 months and 2 years post-operation.Results revealed significantly favourable VAS pain scores, Harris Hip Scores and Barthel Index scores at 1 week in the SuperPath group compared to the posterior approach group.Furthermore, Barthel Index scores at 3 months were significantly in favour of the SuperPath group. Peri-operatively, blood loss,... Read More »
Level 2 RCT