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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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①
Synopsis:
In this meta-analysis, fifteen randomized controlled trials were included to compare operative (ORIF with locked plates, locked IMN, cemented, uncemented, nonmodular or modular hemiarthroplasty, and reverse shoulder arthroplasty) versus non-operative treatment for proximal humeral fractures.Outcomes of interest were normalized function, pain on the Visual Analog Scale (VAS), and the incidence of reoperation.In the pooled analysis comparing operative treatment with nonoperative treatment, no differences were found between all outcomes. When comparing ORIF...
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Level 1 Meta Analysis
12%
①
Synopsis:
Thirty patients with partial-thickness tears of the supraspinatus tendon were randomized to receive a platelet-rich plasma injection (n=15) or corticosteroid injection (n=15).The primary outcome of interest was tear size.The secondary outcome of interest was functional outcomes, measured with the American Shoulder and Elbow Surgeons (ASES) score and the Constant Murley (CM) score.Outcomes were measured at 6 months post-injection.The improvement from baseline in tear size at 6 months in the coronal and sagittal views was significantly greater in the platelet-rich plasma group. Similarly, ASES and...
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Level 1 RCT
8%
①
Synopsis:
Three hundred and three patients with ankle osteoarthritis were randomized to receive either total ankle replacement (n=152) or ankle arthrodesis (n=151).The primary outcome of this trial was the change in the Manchester-Oxford Foot Questionnaire walking/standing (MOXFQ-W/S) from baseline to one year.Other outcomes of interest were MOXFQ-W/S, -pain and social interaction at 26 and 52 weeks, Foot and Ankle Ability Measure - activities of daily living (FAAM-ADL), and sport subscale scores at 26 and 52 weeks.Quality of life was also assessed using the EuroQoL 5-Dimension 5-Level questionnaire at 12, 26, and 52 weeks. Both groups saw...
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Level 1 RCT
8%
①
Synopsis:
34 geriatric patients with distal femoral fractures were randomized to receive double plating fixation (n=18) or distal femoral replacement (n=16).Outcomes of interest included functional, radiological, and safety outcomes measured up to 12 months.Range of motion at 1 month was better in the replacement group.However, KSS knee scores and range of motion at 12 months were significantly better in the double-plating group compared to the replacement group. No differences in...
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Level 1 RCT
8%
①
Synopsis:
50 patients with chronic biceps tendinopathy undergoing a subpectoral biceps tenodesis were randomized to receive the procedure with the elbow and forearm positioned in pronation-supination (n=25) or in a neutral position (n=25).Outcomes of interest included pain on a Visual Analog Scale (VAS), the American Shoulder and Elbow Surgeons (ASES) score, Constant scores, and flexion and supination force.Outcomes were measured up to 12 months post-operation.The results of this study found that placing the forearm in pronation-supination during the procedure significantly improved pain and functional outcomes (VAS; ASES) in the first 6 months compared to a neutral position. However, a statistically...
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Level 1 RCT
4%
Synopsis:
This systematic review identified 5 studies (four RCTs and one cohort study: total of 365 patients for all studies) that assessed which treatment modality - surgical or conservative - was the optimal treatment for acute, displaced midshaft clavicle fractures.Results indicated that the surgical treatment led to a better functional outcome (measured with the Constant score) and lower mal- and non-union rates compared to conservative treatment. However, clinical relevance...
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Author verified Meta Analysis
4%
Synopsis:
22 RCTs containing 2047 patients with mid-third clavicle fractures were included in this network meta-analysis examining the optimal treatment with regards to functional outcomes and non-union rate.MEDLINE, EMBASE and PUBMED were searched for relevant articles.Results revealed favourable DASH score, Constant scores, and non-union rate with surgical intervention compared to non-surgical intervention. Specifically, the anterior...
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Conference Report
4%
①
Synopsis:
Two-hundred and fourteen elderly patients (75+ years old) with dorsally displaced distal radius fractures were randomized to receive cast immobilization (n=107) or open reduction and internal fixation with anterior plating (n=107).The primary outcome of interest was the patient-rated wrist evaluation (PRWE) score at 12 months.Secondary outcomes of interest included quality of life (Short-Form 12 [SF-12]), the Quick Disability of the Arm, Shoulder and Hand (qDASH) score, Mayo wrist score, grip strength, and range of motion.Tertiary outcomes included adverse events and radiological alignment outcomes.Outcomes were assessed at 3 and 12 months follow-up.Results revealed no significant differences between the two groups in all primary and secondary outcomes at 12 months follow up.However, at 3 months, range of motion in extension and Mayo wrist scores were in favour of the casting group, and qDASH scores were in favour of the anterior plating group.Radiological alignment outcomes were superior in the anterior plating group at 3 and 12 months. As well, a...
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Level 1 RCT
4%
①
Synopsis:
One hundred and twenty patients undergoing total hip arthroplasty using the direct anterior approach were randomized to receive either closed incisional negative pressure therapy (ciNPT; n=60) or a silver-impregnated hydrofiber dressing (n=60).The primary outcomes of this trial were wound healing and surgical site complications 90 days postoperation.Additional outcomes such as debridement, the use of antibiotics, return to OR, and aspiration of a hematoma or seroma were also assessed.No significant differences in overall surgical site complication rate were observed, however, significantly more patients in the control group had a superficial surgical site infection, and more patients in the control group required topical antibiotics vs.
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Level 1 RCT
4%
①
Synopsis:
Two hundred and ninety-six patients with middle-third clavicular fractures were randomized to receive either a figure 8 bandage (n=152) or a broad-arm sling (n=144).Outcomes that were assessed were function, radiological outcomes, and pain scores.Shoulder function was assessed using the Disability of Arm, Shoulder, and Hand (DASH), Constant score, and Nottingham Clavicle Score.Pain was measured using the 10mm Visual Analog Score (VAS).Significant differences in pain scores at 1 and 4 weeks were apparent with better scores in the figure 8 bandage group and broad arm sling group, respectively. The number of...
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Author verified Level 1 RCT