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Synopsis: A total of 124 elderly patients with displaced displaced proximal humeral fractures (PHFs) were randomized to receive a reverse shoulder arthroplasty (RA) (n=64) or plate fixation (n=60).The primary outcome of interest was the Constant score at 2-years follow-up.The secondary outcomes of interest were the Oxford Shoulder Score and radiological outcomes.The results demonstrated that a statistically significant difference in Constant scores at 2 years, favour of the reverse shoulder arthroplasty group.Stratified by OTA/AO fracture classification, Constant scores were statistically significantly in favour of the reverse arthroplasty group in type C2 proximal humeral fractures. However in type... Read More »
Conference Report
4%
Synopsis: A total of 285 randomized controlled trials published in the Journal of Bone and Joint Surgery between 2001 and 2013 were assesses for study quality using the Detsky quality of reporting index, and a modified Cochrane Risk of bias tool.Mean transformed Detsky scores improved significantly over time (p<0.001).Categories of concern with regard to the Detsky score were 'randomization', 'eligibility criteria', and 'reasons for patient exclusion'.Studies with an epidemiologist as a first author reported statistically significantly favourable transformed Detsky scores compared to those with surgeons as the first author (p<0.001).Additionally, non-surgical trials reported statistically significantly favourable transformed Detsky scores compared to surgical trials (p<0.001).Transformed Detsky quality scores were statistically significantly better in the included studies compared to studies published between 1988 and 2000.Modified risk of bias scores for trials published between 2001 and 2013 significantly increased over time, as per regression analysis (p<0.001). Trials assessing fracture... Read More »
Level 3 Meta Analysis
2%
Synopsis: 11 teams from one Italian basketball club were cluster randomized to the use of the FIFA 11+ sports injury prevention warm-up program to determine if this program is effective in reducing injuries in elite male basketball players. The results from this trial indicate that players in the FIFA 11+ exercise group had a significantly reduced injury rate in comparison to controls over the period of a 9 months season. Read More »
Author verified Level 2 RCT
2%
Synopsis: 227 patients with chronic non-specific low back pain (LBP) were randomized to undergo an active rehabilitation program focused on active physical treatment, cognitive-behavioural treatment, a combination of both, or placed on a waiting list (control group).The primary outcome were subjective variables in pain and function.Results indicated that the two intervention treatments and the combined treatment were effective compared to the control group. No significant clinical... Read More »
Level 2 RCT
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Synopsis: 351 patients with a meniscus tear and knee osteoarthritis (OA) were randomized to either undergo arthroscopic partial meniscectomy (APM) followed by a physical therapy program or physical therapy alone, in order to compare clinical and functional outcomes. Following treatment over a 12 month period, all patients improved similarly in WOMAC physical-function score, KOOS pain score, and SF-36 physical-activity score. Read More »
Author verified Level 2 RCT
2%
Synopsis: Six ACE Reports were identified from the OrthoEvidence database which compared intra-articular injection(s) of hyaluronic acid to corticosteroid in the treatment of osteoarthritis of the knee.All of the included studies were randomized controlled trials which reported pain and/or functional outcomes within 6 months of intervention.Pooled analysis of pain on a visual analog scale indicated that pain relief was significantly better with hyaluronic acid injections at both 3 and 6 months follow-up; however, this finding was strongly influenced by two studies of lower methodological quality. No significant differences between hyaluronic acid and corticosteroid injections were observed in any functional outcome measurement.Due to incomplete or lack of reporting adverse events, an assessment of safety could not be performed along with this review. Furthermore, these findings... Read More »
ACE Review
2%
Synopsis: Data from 12 studies (4 RCTs; 8 cohort studies), spanning 610 patients was analyzed in order to compare joint-preserving techniques and arthroplasty in the treatment of 3- and 4-part proximal humerus fractures.The evidence presented in this meta-analysis/systemic review indicated that joint-preserving treatments demonstrated higher Constant scores than arthroplasty.It is important to note that the included studies exhibited significant heterogeneity. Constant scores were... Read More »
Author verified Level 2 Meta Analysis
2%
Synopsis: 8 ACE Reports (all randomized controlled trials) from the OrthoEvidence database were included in this review/meta-analysis examining the effect of arthroscopic surgery and physical therapy in the treatment of degenerative tears of the meniscus and knee osteoarthritis.The purpose of this review was to determine if any differences in outcome were demonstrated between arthroscopy followed by physical therapy versus physical therapy alone, regarding pain, function, satisfaction, adverse events, or osteoarthritis progression.Pain results were pooled at 3 different time point: 2-3 months, 6 months, and 12-24 months postintervention.At short-term (2-3 months) and long-term (12-24 months) follow-up, pain was similar between groups, with no significant difference observed.There tended to be less pain experienced at 6 months following arthroscopy, however this only reached significance in the KOOS pain outcome and the clinical importance of this observation is unknown.Assessments of functional outcome, either pooled or qualitative, suggested no significant difference between groups as well. The rate of... Read More »
ACE Review
2%
Synopsis: 416 male youth football (soccer) players in Africa were randomized to evaluate the injury-prevention efficacy of the FIFA11+ programme, when compared against routine training over 6 months.Players were evaluated primarily based on time-loss injury to players, injuries by type of exposure (match or training) and all injuries to lower extremities (LE), along with further injury analysis.The evidence presented in this trial demonstrated that FIFA11+ players sustained an overall reduction rate of injury of 41%, and a reduction in lower extremity injury of 48%.Injury incidence was significantly lowered in FIFA11+ players compared to those in the control group with the exception of injury sustained during training- which was similar between groups. Other evaluated outcomes... Read More »
Author verified Level 2 RCT
2%
Synopsis: 28 patients with a grade II hamstring injury were allocated to undergo daily home-based rehabilitation exercises, and randomized to either receive or not receive an injection of platelet-rich plasma upon presentation to the sports medicine clinic.Participants were followed-up for time to return to play, as well as improvement of pain. Mean time to... Read More »
Author verified Level 2 RCT