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3%
Synopsis: 18 patients with a displaced (>2mm) base of the 5th metatarsal fracture were randomized to be treated with either open reduction and internal fixation (ORIF) or nonoperative management with a short leg cast.The purpose of this study was to compare clinical measures of pain and function, time to union, and restoration of injured metatarsal length between groups.Follow-up was performed for an average of 8.5 weeks.Results demonstrated no significant differences in pain or functional scores, despite a significantly shorter time to union in the operative group. Read More »
Level 2 RCT
3%
Synopsis: 1583 patients with symptomatic knee osteoarthritis were randomized to either glucosamine monotherapy, chondroitin monotherapy, combined glucosamine and chondroitin therapy, celecoxib 200mg daily, or placebo.Patients were assessed over 24 weeks of treatment.In the primary analysis, only the celecoxib group demonstrated a significantly higher rate of patients attaining the primary efficacy endpoint - a reduction of WOMAC pain by a minimum of 20% relative to baseline - compared to placebo. However, when only... Read More »
RCT
3%
Synopsis: 120 patients with Kellgren-Lawrence grade II-IV knee osteoarthritis were randomized to intraarticular injection with either a combination of hyaluronic acid and corticosteroid, or hyaluronic acid alone.Patients were followed-up for 6 months posttreatment for outcome related to pain on a visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).Between groups, bth VAS pain and WOMAC assessments significantly favoured the HA+CS group compared to the HA alone group at 1 week, 1 month, and 3 months; differences between groups at 6 months were not significant. However, when the... Read More »
Level 2 RCT
3%
Synopsis: 240 patients scheduled for short intramedullary nail fixation for an intertorchanteric fracture were randomized to one of three distal locking configurations: static locked, dynamic locked, or unlocked.Patients were assessed for intraoperative variables - including operative and fluoroscopy times, blood loss, and transfusion rate - and postoperative outcomes related to fracture healing, function, pain, and complications.Results demonstrated significant differences only in operative variables, with operative time, fluoroscopy time, and blood loss favoured in the unlocked group compared to the two distal locking groups. Postoperative outcomes did... Read More »
Level 2 RCT
2%
Synopsis: 7 randomized controlled trials were selected for inclusion in this meta-analysis which sought to compare outcomes of anterior cruciate ligament remnant preservation and resection in ACL reconstruction.Outcomes included clinical scores, knee stability measures, and incidence of complications.For clinical measures, no significant difference in IKDC subjective score was observed between techniques, though Lysholm scores significantly favoured remnant preservation.For knee stability, no significant differences between techniques were noted in the rates of negative pivot-shift and Lachman tests, while KT-1000/2000 arthrometer results significantly favoured remnant preservation. No significant difference... Read More »
Level 1 Meta Analysis
2%
Synopsis: 60 patients with type III-IV acromioclavicular joint dislocation were randomized to either surgical intervention with open reduction and tunneled suspensory device fixation (ORTSD group) or to nonoperative treatment.The purpose of this study was to compare disability and function over the first year of follow-up. Results on the... Read More »
Level 2 RCT
2%
Synopsis: 9 studies (8 RCTs, 1 controlled clinical trial) were selected for a systematic review of elderly patients with a proximal humerus fracture.The goal of this study was to determine whether surgical or nonoperative treatment is the optimal intervention in patients over the age of 60.Operative treatments identified in the included trials were the tension band technique, locking plates, pinning and hemiarthroplasty.The results of this review indicated that many studies did not find a significant difference in functional outcomes when comparing locking plates or tension bands to nonoperative treatment at 1 year.There was a significantly better health-related quality of life and Euroqol-5D in patients that received a hemiarthroplasty compared to the nonoperative group for patients with 4-part fractures.Complications were common in the operative treatment groups. This study highlights... Read More »
Level 2 Meta Analysis
2%
Synopsis: 360 patients with knee osteoarthritis were randomized to one of four groups: combined intraarticular platelet-rich plasma and hyaluronic acid injection, intraarticular platelet-rich plasma injection alone, intraarticular hyaluronic acid injection alone, or intraarticular placebo injection.Patients were assessed for the primary outcome measure of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score over 52-week follow-up. Reduction in WOMAC... Read More »
Level 2 RCT
2%
Synopsis: 120 patients with full thickness rotator cuff tears were randomized to receive either 3 weeks of post-surgery immobilization in a sling, or 6 weeks of immobilization in a brace (with an abduction pillow placing the arm in a neutral position).Follow-up was performed at the 6 week time-point, as well as at 3, 6 and 12 months post-surgery.Outcomes reported included the Western Ontario Rotator Cuff (WORC) index, Constant Murley (CM) score, range of movement (ROM), as well as MRI results and patient-reported satisfaction.Sling immobilization for a period of 3 weeks was found to be a non-inferior treatment compared to brace immobilization for a period of 6 weeks, according to primary outcome of WORC index at 12 months. Additionally, patient reported... Read More »
Level 1 RCT
2%
Synopsis: 59 patients with recurrent patellar dislocation and scheduled for medial patellofemoral ligament reconstruction were randomized to either concomitant lateral retinaculum plasty (LRP) or lateral retinaculum release (LRR).Patients were assessed over a minimum of 2 years follow-up for outcome primarily related to the medial patellar glide test and the apprehension test,, as well as the Kujala score and CT results.An overall significant difference between groups was observed in grading of the medial patellar glide test; more patients of the LRP demonstrated a test result of two quadrants movement, while a high number of patients in the LRR group demonstrated a test result of 3 or more quadrants movement. In addition, a... Read More »
Level 2 RCT