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You are viewing the most viewed ACE Reports by Orthopaedic Resident/Interns over the last 30 days in all specialties.
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9%
Synopsis:
58 adult patients with isolated Weber Type B ankle fractures were randomized to receive either open reduction and internal fixation (ORIF; n=29) or casting (n=29).Outcomes of interest included the American Orthopaedic Foot and Ankle Society (AOFAS) score and radiographic assessment for fracture union.No significant differences were reported in AOFAS scores between the two groups. Fracture union was...
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Conference Report
6%
①
Synopsis:
Thirteen randomized controlled trials comparing the efficacy of platelet-rich plasma (PRP) against a control group in patients with Achilles tendinopathy (AT) or Achilles tendon rupture (ATR) were included in this meta-analysis.Outcomes of interest included the Victorian Institute of Sport Assessment (VISA-A) score, Achilles tendon thickness, pain on a Visual Analog Scale (VAS), and patient satisfaction.Subgroup analyses were also performed to assess heel raise height, calf circumference, range of motion, return to sport, and incidence of adverse events in patients with ATR. All outcomes at...
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Level 1 Meta Analysis
3%
②
Synopsis:
154 patients with Dupuytren's disease were randomized to receive hand therapy either with or without nightly splinting for 6 months following fasciectomy or dermofasciectomy, in order to determine if splinting provided a beneficial effect to patients 1 year postoperatively.Patients were primarily assessed with the Disabilities of the Arm, Hand, and Shoulder questionnaire, and secondarily through total active flexion, total active extension, and patient satisfaction.The results of the study reflected no significant differences between the primary outcome or any of the secondary outcomes, and that there was no beneficial effect of nightly splinting combined with hand therapy.
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Author verified Level 2 RCT
3%
②
Synopsis:
247 patients with lumbar spinal stenosis, with or without spondylolisthesis, were randomized to decompression plus fusion or decompression alone.The purpose of this study was to evaluate clinical outcomes according to the Oswestry Disability Index, the National Swedish Register for Spine Surgery questionnaire, the Zurich Claudication Questionnaire, and the European Quality of Life-5 Dimensions (EQ-5D) score, patient satisfaction, global assessment of back and leg pain, and the 6-minute walk test. Results at 2...
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Author verified Level 2 RCT
3%
②
Synopsis:
66 patients scheduled for operative management of single-level stenosis and grade 1 spondylolisthesis were randomized to either laminectomy plus fusion, or laminectomy alone.Patients were followed-up at 6 weeks, 3 and 6 months, and 1, 2, 3, and 4 years postoperatively for general health-related quality of life using the Short Form 36-Item General Healthy Survey Physical Component Score (SF-36 PCS) and the Oswestry Disability Index.Results for the SF-36 PCS demonstrated a significantly greater improvement in scores after 2, 3, and 4 years in the fusion group compared to laminectomy alone. Results on the...
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Level 2 RCT
3%
①
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...
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Level 1 Meta Analysis
3%
Greater leg pain relief with lumbar microdiscectomy vs nonsurgical treatment for persistent sciatica
①
Synopsis:
One hundred and twenty-eight patients with persistent sciatica due to lumbar disc herniation were randomized to receive either surgical treatment via lumbar discectomy or standard non-surgical treatment involving education, exercise, physiotherapy, oral analgesics and epidural glucocorticoid injections.The primary outcome of interest was leg pain intensity measured on a numeric rating scale, 6 months post-treatment.Secondary outcomes of interest included back pain, the Oswestry Disability Index (ODI), the Short Form 36 (SF-36) mental and physical component scores (MCS, PCS), employment status and patient satisfaction.Follow up occurred at 6 months and 12 months post-treatment.Results revealed significantly lower leg pain intensity at 6 months in the surgical group compared to the conservative group. Secondary outcomes of...
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Author verified Level 1 RCT
3%
①
Synopsis:
One hundred and forty-six patients 35–65 years of age with knee symptoms consistent with a degenerative medial meniscus tear were randomized into receiving arthroscopic partial meniscectomy (APM) or a sham surgery (diagnostic knee arthroscopy).Primary outcomes of interest included radiographic knee osteoarthritis through using the Kellgren and Lawrence knee osteoarthritis grading and the Osteoarthritis Research Society International (OARSI) instrument, as well as patient-related outcomes via the Western Ontario Meniscal Evaluation Tool (WOMET), the Lysholm knee score, and knee pain after exercise.Outcomes of interest were assessed 5 years post-operation.No significant differences between the APM and placebo groups were observed in all three patient-relevant outcomes, 5 years post-operation.A slight increase in the risk of radiographic knee osteoarthritis progression was observed in the APM group, however this was not significantly different.A significantly higher risk of mechanical symptoms was observed in the APM group. Otherwise, outcome comparisons...
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Author verified Level 1 RCT
3%
①
Synopsis:
Four hundred and thirty-nine patients with bicortical scaphoid waist fracture were randomized to receive an open or percutaneous surgical fixation, or cast immobilization for 6-10 weeks.The primary outcome of interest was the Patient Rated Wrist Evaluation (PRWE) total score at 52 weeks post-treatment.Secondary outcomes of interest included PRWE pain and function sub-scale scores, Short Form 12 (SF-12) mental and physical component scores, degree of bone union, range of motion, grip strength, and the incidence of adverse events.Whilst significantly favourable PRWE total scores at 12 weeks, PRWE function scores at 6 and 12 weeks, and grip strength at 6 weeks were significantly in favour of the surgery group (during the period when the cast was still being worn), no significant differences were observed between the groups in all outcomes at 52 weeks. The exception included...
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Level 1 RCT
3%
①
Synopsis:
Two hundred and sixty seven patients with lumbar spinal stenosis and degenerative spondylolisthesis were randomized to undergo decompression surgery (n=134) or decompression surgery with instrumented fusion (n=133).The primary outcome of interest was the percentage of patients achieving a reduction in score of 30% or greater from baseline to 2-year follow-up on the Oswestry Disability Index (ODI).Secondary outcomes of interest included the mean change in ODI score, the Zurich Claudication Questionnaire, leg and back pain, the duration of surgery and hospital stay and reoperation within 2 years.The percentage of patients meeting the predetermined reduction in ODI scores was similar between groups demonstrating non-inferiority of decompression alone.Surgical time and length of stay was shorter in the decompression group.Reoperation rates were similar between the decompression alone group compared to the fusion group (12.5% vs.
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Author verified Level 1 RCT