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17%
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11%
9%
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100%
4%
Synopsis: Seven randomized controlled trials evaluating operative and nonoperative management of Achilles tendon ruptures were included in this meta-analysis.The purpose was to determine if the two treatment options differed in functional outcome over 2 years postintervention.The results indicated that while functional outcome was significantly better following surgery at 3 months, there was no significant difference between operative and conservative management at 6, 12, and 24 months.There also was no significant difference observed between groups regarding range of motion. The incidence of... Read More »
Conference Report
3%
Synopsis: 120 patients over the age of 60 with an acute vertebral fracture were randomized to undergo either vertebroplasty or a sham procedure designed to simulate vertebroplasty.The purpose of this study was to compare patient-reported pain, disability and quality of life over 14-day and 6-month follow-ups. Results demonstrated significant... Read More »
Level 2 RCT
2%
Synopsis: 582 patients scheduled for primary or revision total knee arthroplasty or total hip arthroplasty were randomized to preoperative skin preparation the night before surgery with 2% chlorhexidine gluconate-impregnated cloths or a bath with standard antibacterial soap and water.Patients were assessed for deep periprosthetic infection occurring within the first 30-90 days after surgery.Overall, the incidence of deep periprosthetic infection was significantly lower among patients who used the 2% chlorhexidine gluconate-impregnated cloths. The largest difference... Read More »
Level 2 RCT
2%
Synopsis: 144 patients with acute Achilles tendon ruptures were randomized to receive nonoperative treatment with an accelerated functional rehabilitation program or operative treatment followed by the same rehabilitation program.Functional and clinical outcomes measured at 3, 6, 12 and 24 months included re-rupture rate, isokinetic strength, range of motion, calf circumference, and complications. The results showed... Read More »
Level 2 RCT
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: 74 patients with plantar fasciitis were randomized to treatment with either extracorporeal shockwave therapy (ESWT) or botulinum toxin type A (BoNT-A) injections.The purpose of this study was to compare pain on a visual analog scale (VAS), Roles and Maudsley pain scores, plantar fasciitis thickness on ultrasound, and the incidence of adverse events.Patients were followed-up at 1 month.The ESWT group demonstrated a greater reduction in VAS pain at rest and on the Roles and Maudsley score compared to the BoNT-A injections. No significant difference... Read More »
Author verified Level 2 RCT
2%
Synopsis: 56 patients scheduled for total hip arthroplasty were randomized to either a 36-mm femoral head and the corresponding highly cross-linked polyethylene liner, or a 28-mm femoral head and the corresponding highly cross-linked polyethylene liner.The purpose of this study was to evaluate if the 36mm group had noninferior steady-state wear over 3-year follow-up when compared to the 28mm group. Results demonstrated noninferior... Read More »
Level 2 RCT
2%
Synopsis: 140 patients with symptomatic knee osteoarthritis (Kellgren-Lawrence grade II-III) and ultrasonographic evidence of synovitis were included in this trial to determine the effects of prolonged corticosteroid use on cartilage loss and pain.Patients were randomized to injections of triamcinolone acetonide or saline every 12 weeks for a period of two years.The outcomes assessed included cartilage loss and damage (MRI), pain, function, and adverse events. The results of... Read More »
Level 1 RCT
2%
Synopsis: 604 patients with symptomatic knee osteoarthritis were randomized to treatment with either chondroitin sulfate, celecoxib, or placebo over a 6 month period.Patients were assessed for pain, function, perceived improvement and adverse events over the 6 months.The results from this study indicated that all three groups demonstrated a significant improvement from baseline over the 6 months.Both the chondroitin sulfate group and the celecoxib group demonstrated significantly greater improvement in pain and function compared to the placebo group after 6 months.There were no significant differences between the chondroitin sulfate group and the celecoxib group for pain or function. Incidence of adverse... Read More »
Author verified Level 2 RCT
1%
Synopsis: Seven randomized controlled trials were included in this study investigating the difference in outcome between arthroscopic surgery and nonoperative treatment in patients with degenerative meniscal tears and mild if any concurrent knee osteoarthritis.Patient-related outcome measures of function and pain were pooled at short-term (<6 months) and long-term (<24 months).Results of the analyses demonstrated no clinically relevant differences in functional improvement or pain relief in either the short or long term between arthroscopic meniscal debridement and nonoperative/sham treatment. Read More »
Author verified Level 1 Meta Analysis