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We found 1979 reports published by T (Newest First)

Knee OA patients: lateral trunk lean gait walking expends more energy than normal walking

12 patients with medial compartment knee osteoarthritis participated in two treadmill interventions: one session of normal treadmill walking and one session of increased lateral trunk lean walking, in randomized order, to determine the effect of lateral trunk lean gait modification on energy expenditure. Results found that lateral trunk lean walkin...

Osteoarthritis Cartilage. 2014 Feb;22(2):203-9. doi: 10.1016/j.joca.2013.12.003. Epub 2013 Dec 12.

Infrapatellar fat pad excision vs. preservation in minimally invasive TKA

90 patients scheduled to undergo minimally invasive total knee arthroscopy were randomized to infrapatellar fat pad excision or preservation during operation. The purpose of this study was to determine whether removal of the fat pad would affect patella baja, anterior knee pain and functional outcome. Results up to 1 year postoperative indicated no...

Clin Orthop Relat Res. 2014 Feb;472(2):695-701. doi: 10.1007/s11999-013-3321-z.

Local infiltration analgesia comparable in outcome to femoral nerve block after ACLR

60 adult patients scheduled to undergo ACL reconstruction with semitendinosus and gracilis tendon grafts were randomized to receive either local infiltration analgesia (ropivacaine and epinephrine) or a femoral nerve block. The purpose of this study was to determine the efficacies of each treatment with respect to postoperative pain management and ...

Knee Surg Sports Traumatol Arthrosc. 2014 Feb;22(2):317-23. doi: 10.1007/s00167-013-2399-x.

Fewer ligament reconstruction failures with hinged external fixation for knee dislocations

100 patients with a total of 103 knee dislocations were randomized to receive either a hinged knee brace or external fixation with a Compass Knee Hinge as part of a postoperative rehabilitation protocol. This study aimed to determine whether an external fixator would provide equivalent knee range of motion and improve failure rate in comparison to ...

J Bone Joint Surg Am. 2014 Feb 5;96(3):184-91. doi: 10.2106/JBJS.L.01603.

Preoperative autologous blood donation appears unnecessary in non-anaemic patients for TKA

54 patients scheduled for TKA with primary arthritis, Hb levels >120g/L, and ASA I, II, of III were randomized to either preoperative autologous blood donation (PABD) at 14 days, 72 hours preoperatively, or no preoperative blood donation. The purpose of this study was to determine whether PABD was necessary, and if so, whether donation at 14 days p...

Int Orthop. 2014 Feb;38(2):341-6. doi: 10.1007/s00264-013-2185-x.

Alfredson protocol for Achilles tendinopathy: Similar outcome with lower number of reps

28 patients with Achilles tendinopathy were randomized to undergo eccentric heel-drop exercises, following either a do-as-tolerated protocol or the standard Alfredson protocol. The purpose of this study was to compare the two treatment approaches with respect to pain, function and satisfaction after 6 weeks. Results indicated that both study protoc...

J Orthop Sports Phys Ther. 2014 Feb;44(2):59-67. doi: 10.2519/jospt.2014.4720. Epub 2013 Nov 21.

RCT1: Knee in flexion following total knee arthoplasty reduces blood loss and transfusion

180 patients undergoing total knee arthroplasty were randomized to either have their operated knee placed in 120 degrees passive flexion for the first 6 hours postoperatively followed by flexion by placing over a pillow, or to full passive knee extension. The purpose was to determine the impact of keeping the knee in flexion postoperatively on bloo...

Bone Joint J. 2014 Feb;96-B(2):201-9

Comparing a 12-month home exercise program with usual care for post-TKA rehabilitation

108 patients with diagnosed knee osteoarthritis (OA) who had underwent total knee arthroplasty (TKA) were randomized to undergo, beginning 2 months post-surgery, either a 12-month home-based exercise program, or usual care. The purpose of this study was to determine whether this long-term exercise regimen improved pain, disability, quality of life ...

J Rehabil Med. 2014 Jan 30;46(2):166-72. doi: 10.2340/16501977-1242

Rehabilitation in home or community setting more cost-effective than in inpatient setting

29 studies with a total of 6746 patients were included in a systematic review comparing the cost of inpatient rehabilitation with alternative rehabilitation settings, using economic evaluations conducted alongside randomized controlled trials. Furthermore, the least expensive programs were assessed to determine if there were adverse effects on pati...

Arch Phys Med Rehabil. 2014 Jan;95(1):94-116.e4. doi: 10.1016/j.apmr.2013.03.017.

Arthroscopic simulators distinguish between novice and expert orthopaedic trainees

13 studies, consisting of randomized control trials and validation studies, were selected to investigate the role of arthroscopic simulators in improving the surgical skills of users. Systematic review revealed that the simulators discriminated between novice and expert trainees, but not between novice and intermediate trainees on completion time o...

Knee Surg Sports Traumatol Arthrosc. 2014 Jan;22(1):33-40. doi: 10.1007/s00167-012-2228-7. Epub 2012 Oct 2.

Post-meniscectomy medical exercise therapy is beneficial for degenerative meniscal tears

77 patients with an MRI-diagnosed degenerative meniscal tear undergoing arthroscopic partial meniscectomy were randomized to either undergo a 3-month medical exercise therapy (MET) program, or not. The purpose of this study was to examine the effects of this rehabilitation protocol on pain, function and mental health. Results indicated that the MET...

Knee Surg Sports Traumatol Arthrosc. 2014 Jan;22(1):200-6. doi: 10.1007/s00167-012-2354-2. Epub 2012 Dec 23

No significant difference between three manual therapy techniques for chronic neck pain

61 patients with mechanical neck pain were randomized to receive either sustained natural apophyseal glide (SNAG), mobilization, or high-velocity, low-amplitude (HVLA) techniques for manual therapy. The effectiveness of the three techniques were compared in terms of immediate and short-term outcomes of pain, disability, mobility, and the global rat...

Man Ther. 2014 Jan 11. pii: S1356-689X(13)00214-2. doi: 10.1016/j.math.2013.12.002.

Flexed femoral component offers greater postoperative knee flexion in knee arthroplasty

39 patients (40 knees) undergoing primary cruciate-retaining total knee arthroplasty were randomized to receive a femoral component either in a 4° flexion in anterior femoral resection (flexed group) or with neutral resection (0° angle) (control group). The purpose of this study was to determine if postoperative knee flexion was increased in the ...

Knee. 2014 Jan;21(1):257-63. doi: 10.1016/j.knee.2012.10.028. Epub 2012 Nov 24

Similar outcome using intramedullary nailing or plate fixation for distal radius fractures

152 patients with extra-articular distal radius fractures were randomized to have their fracture fixated using either an intramedullary nail, or a volar plate fixation technique. The purpose of this study was to compare the two methods with respect to functional and radiological outcomes. Results at the 2-year follow-up assessment indicated that pa...

Injury. 2014 Jan;45 Suppl 1:S3-8. doi: 10.1016/j.injury.2013.10.045. Epub 2013 Nov 4

Limited evidence on the effects of exercise for improvement of age-related hyperkyphosis

13 studies were evaluated in this systematic review determining whether exercise can improve kyphotic angle in adults at least 45 year old or older with preexisting hyperkyphosis. Measures of kyphosis or forward head posture were investigated, although meta-analysis was not performed due to heterogeneity in intervention techniques. 2 RCTs found sig...

Arch Phys Med Rehabil. 2014 Jan;95(1):129-40. doi: 10.1016/j.apmr.2013.06.022.

High-velocity versus low-velocity training in women with hip osteoarthritis

46 women with various severities of hip osteoarthritis were randomized to undergo an 8-week home-based training program of either high-velocity or low-velocity exercises. The purpose of this study was to determine if high-velocity training offered any advantages over low-velocity training. Physical performance measures, muscle strength, power, thic...

Clin Rehabil. 2014 Jan;28(1):48-58. doi: 10.1177/0269215513492161. Epub 2013 Jul 3

Predictors of treatment response to physical therapy for hip OA remain inconclusive

A secondary analysis was performed using data from a randomized controlled trial (RCT) comparing the efficacy of physical therapy-based interventions for 131 patients with hip osteoarthritis. Patients were randomized into three groups: exercise and manual therapy, exercise therapy alone, or a control group. Potential predictors of treatment respons...

Phys Ther. 2014 Jan;94(1):31-9. doi: 10.2522/ptj.20130173.

Electro-acupuncture reduces arthralgia in cancer patients taking aromatase inhibitors

67 women with non-metastatic breast cancer (Stage I-III) experiencing joint pain attributed to the use of aromatase inhibitor (AI) were included in this study. Subjects were randomized to an intervention group, or a wait list control (WLC) group. Those randomized to the intervention group were further randomly allocated to either electro-acupunctur...

Eur J Cancer. 2014 Jan;50(2):267-76. doi: 10.1016/j.ejca.2013.09.022. Epub 2013 Oct 24

All-inside versus conventional ACL reconstruction: impact on postoperative pain?

46 patients scheduled for anterior cruciate ligament reconstruction were randomized to undergo surgery using either the all-inside technique or conventional technique. The purpose was to compare postoperative pain between the two techniques at 1 month following surgery, and measures of radiographic and functional outcome at 6 months. The results in...

Knee. 2014 Jan;21(1):102-6. doi: 10.1016/j.knee.2013.09.006. Epub 2013 Oct 5

Quadriceps-sparing TKA reduced time to discharge vs standard minimally-invasive approach

102 patients undergoing total knee arthroplasty (TKA) were randomized to receive either a minimally-invasive quadriceps-sparing (MIS) approach or the standard medial parapatellar approach. Clinical, functional and radiological outcomes were compared during the immediate postoperative period and again at 2 years. Results indicated that patients trea...

Knee. 2014 Jan;21(1):189-93. doi: 10.1016/j.knee.2013.07.010. Epub 2013 Aug 2.

Potential improvement in vascularization following rotator cuff repair with L-PRF

20 patients with a chronic full-thickness rotator cuff tear were randomized to undergo arthroscopic repair either with or without the application of leukocyte- and platelet-rich fibrin (L-PRF). The purpose of this study was to determine if L-PRF increased vascularization of the rotator cuff over the first 3 postoperative months. The results at 6 we...

J Shoulder Elbow Surg. 2014 Jan;23(1):3-12. doi: 10.1016/j.jse.2013.08.017

Intra-articular mesenchymal stem cells possibly beneficial for meniscus regeneration

60 patients undergoing a partial meniscectomy were randomized to receive a single postoperative injection of allogeneic human mesenchymal stem cells (50x10^6 or 150x10^6 cell count) or a control vehicle injection of sodium hyaluronate, 7-10 days after surgery. The purpose of this study was to determine if a single intra-articular injection of mesen...

J Bone Joint Surg Am. 2014 Jan 15;96(2):90-8. doi: 10.2106/JBJS.M.00058

Adult stem cells do not appear to accelerate graft-to-bone healing in ACL reconstruction

43 patients undergoing anterior cruciate ligament (ACL) surgery using a hamstring graft were randomly assigned to a stem cell or a control group to evaluate the effect of stem cells on graft-to-bone healing. In the study, adult non-cultivated bone marrow stem cells were harvested from select patients and intra-operatively delivered in and around th...

Knee Surg Sports Traumatol Arthrosc. 2014 Jan;22(1):66-71. doi: 10.1007/s00167-012-2279-9. Epub 2012 Nov 2.

Cementless acetabular component fixation for THA does not differ with or without screws

Five studies (3 RCTs, 1 Cohort, 1 Case-control) were included in this analysis comparing fixation with and without screws in cementless acetabular component in total hip arthroplasty. Studies were included if they provided data on reoperation rates, component migration, or the incidence of osteolysis, as these were the primary outcomes of concern. ...

Int Orthop. 2014 Jan;38(1):7-12. doi: 10.1007/s00264-013-2075-2. Epub 2013 Aug 28

TKA: Patient-specific guides offer no accuracy benefit over conventional instrumentation

128 patients scheduled for total knee arthroplasty were randomized to intervention with either patient-specific guides (PSG) or conventional instrumentation. Participants allocated to PSG were managed with pre-operative planning using either Signature (Biomet Inc.), TruMatch (Depuy Inc.), Visionaire (Smith & Nephew Inc.), or Patient-Specific Instru...

Clin Orthop Relat Res. 2014 Jan;472(1):263-71. doi: 10.1007/s11999-013-2997-4

No effect of topical fibrinogen spray on blood loss and transfusion in TKA

200 patients scheduled for total knee arthroplasty with tourniquet use (inflated prior to incision and deflated before wound closure) were randomized to surgery with or without the application of a fibrinogen topical spray following the cementing of components. Hemostatic parameters of hemoglobin and hematocrit levels, total blood loss, and transfu...

Clin Orthop Relat Res. 2014 Jan;472(1):272-6. doi: 10.1007/s11999-013-3036-1

Adverse effects more frequent with bioabsorbable vs. metal screws in ACL reconstruction

This meta-analysis summarized results from eleven randomized control trials (RCTs) involving 878 randomly allocated patients to investigate the use of bioabsorbable interference screws compared to metal interference screws in single bundle primary anterior cruciate ligament (ACL) reconstruction. The study aimed to report adverse effects and clinica...

Knee Surg Sports Traumatol Arthrosc. 2014 Jan;22(1):142-53. doi: 10.1007/s00167-012-2340-8. Epub 2012 Dec 14.

Mobile bearing yields similar functional outcome as fixed bearing in TKA at two years

352 patients with knee osteoarthritis and scheduled to undergo total knee arthroplasty (TKA) were randomized to receive either a fixed or mobile bearing tibial component. Patients were further randomized to undergo patellar resurfacing or to have the patella retained. The purpose of this study was to compare these implants in terms of clinical outc...

Knee. 2014 Jan;21(1):151-5. doi: 10.1016/j.knee.2013.09.007. Epub 2013 Oct 7

de Quervain tenosynovitis: higher success rates with corticosteroid injection & thumb cast

67 patients with de Quervain tenosynovitis were randomized to receive treatment with a corticosteroid injection (CSI) alone or in combination with thumb spica casting (TSC). The effectiveness of each treatment was examined and compared in terms of success rate, pain intensity, and functional outcomes. Within 3 weeks, both groups experienced signifi...

J Hand Surg Am. 2014 Jan;39(1):37-41. doi: 10.1016/j.jhsa.2013.10.013.

Intraosseous administration of low-dose vanomycin leads to higher tissue concentrations

32 patients scheduled for total knee arthroplasty were randomized to received three different prophylactic antibiotic regimens: intraosseous administration of either 250mg or 500mg vanomycin, or 1g vanomycin administered intravenously. The purpose was to evaluate the effect of intraosseously administered vanomycin in terms of concentrations in subc...

Clin Orthop Relat Res. 2014 Jan;472(1):57-65. doi: 10.1007/s11999-013-3038-z

No significant benefits with computer navigation for THA acetabular component positioning

40 patients undergoing THA were randomized for operation with either a computer-assisted navigation method or the conventional method in the positioning of the acetabular component. One surgeon performed all surgeries. Postoperative CT scans were analyzed to compare the accuracy of both methods. Analysis of the operative anteversion and inclination...

J Arthroplasty. 2014 Jan;29(1):167-71. doi: 10.1016/j.arth.2013.04.017.

Preserving the ligamenta flava as much as possible is beneficial in lumbar microdiscectomy

97 patients with unilateral lumbar disc herniation were randomized to undergo lumbar microdiscectomy using either a traditional (control) or revised (test) technique, which focused on preserving as much of the ligamentum flavum as possible. The purpose of this study was to compare these two surgical approaches with respect to operative time, blood ...

Eur J Orthop Surg Traumatol. 2014 Jan;24(1):23-7. doi: 10.1007/s00590-012-1123-8. Epub 2012 Nov 24

Efficacy of ketamine, pregabalin, and combined analgesia in total hip arthroplasty

142 patients scheduled for total hip arthroplasty were randomized to receive treatment with ketamine infusion during anaesthesia, preoperative oral pregabalin, combined ketamine and pregabalin, or placebo of both. The purpose was to determine if the combination of drugs was more efficacious than either alone. All patients received patient-controlle...

Anaesthesia. 2014 Jan;69(1):46-52

ACLR with lateral plasty may improve lateral compartment laxity in advanced chronic laxity

120 patients with advanced chronic anterior laxity were randomized to receive ACL reconstruction (ACLR) with or without extra-articular ilio-tibial band tenodesis. The study aimed to examine ACLR outcomes and objective laxity when combined with lateral plasty. After 2 years, patients who underwent ACLR with lateral plasty experienced a greater impr...

Knee. 2014 Jan;21(1):58-65. doi: 10.1016/j.knee.2013.06.001.

Effect of arthroscopic simulator on operating room performance remains inconclusive

This systematic review analyzed 19 studies involving 465 participants with varying degrees of orthopaedic experience, to determine whether arthroscopic simulators improve simulator and operative technical skills. Common arthroscopic tasks assessed in these studies included throwing a suture, probing, hook manipulation, and shaving/burning. An analy...

Arthroscopy. 2014 Jan;30(1):121-33. doi: 10.1016/j.arthro.2013.09.084. Epub 2013 Nov 28.

The Chaos Clinic Falls Prevention Program effective for reducing falls in elderly patients

1314 patients (>70 years of age) were recruited to investigate the effect of the Chaos Clinic Falls Prevention Programme on fall prevention in older patients. Participants were randomized to either the Chaos Clinic Falls Prevention Programme or to a control intervention (general injury prevention brochure). Follow-up was conducted over 1 year, and ...

Injury. 2014 Jan;45(1):265-71. doi: 10.1016/j.injury.2013.03.010. Epub 2013 Apr 8

Knee aspiration provides only short-term benefits in the treatment of knee effusion

One hundred and sixty seven patients with acute knee joint effusion were randomized to either undergo knee aspiration or not, to determine whether this intervention is effective in improving clinical and functional outcomes. Results indicated that pain, edema, range of motion, analgesia intake, and knee function scores were significantly improved w...

Knee Surg Sports Traumatol Arthrosc. 2014 Jan;22(1):226-32. doi: 10.1007/s00167-013-2379-1. Epub 2013 Jan 19

Early motion vs. immobilization post-arthroscopic rotator cuff repair show similar outcome

One hundred and twenty four patients (under 65 years of age) with small to medium cuff tears undergoing arthroscopic rotator cuff repair were randomized to receive rehabilitation involving either early passive motion or immobilization. Pain relief, functional outcomes, and shoulder ultrasounds were assessed to determine the most effective protocol....

J Bone Joint Surg Am. 2014 Jan 1;96(1):11-9. doi: 10.2106/JBJS.M.00034.

Gamma nail more effective than sliding hip screw in unstable intertrochanteric fractures

Eighty patients with a 31-A2.2 or A2.3 AO/OTA multifragmentary intertrochanteric fracture were randomized to receive either a Gamma intramedullary nail or an AMBI sliding hip screw. Parker mobility, Barthel Index, and EuroQol-5D quality of life scores were primary outcomes. After 12 months, patients treated with a Gamma nail achieved higher outcome...

Int Orthop. 2014 Jan;38(1):155-61. doi: 10.1007/s00264-013-2196-7.

Similar outcome whether tourniquet was used throughout TKA or during cementation only

Seventy-one patients (79 knees) undergoing total knee arthroplasty (TKA) were randomized to either have the tourniquet inflated throughout the procedure or during the cementation phase only. The purpose of this study was to compare the two protocols with respect to operative time, blood loss, as well as postoperative clinical and functional outcome...

Clin Orthop Relat Res. 2014 Jan;472(1):169-74. doi: 10.1007/s11999-013-3124-2.

Custom cutting blocks vs conventional instrumentation in total knee arthroplasty

Eighty patients scheduled for primary total knee arthroplasty were randomized to instrumentation with custom cutting blocks or to conventional intramedullary and extramedullary instrumentation. Intraoperative data concerning operative time and blood loss were collected, and radiographic outcome was analyzed at 6 weeks postoperatively. The results i...

Knee. 2014 Jan;21(1):185-8. doi: 10.1016/j.knee.2013.08.003. Epub 2013 Aug 15

Pilot trial comparing accelerated and standard surgical care for hip fractures

Sixty patients with hip fractures were randomized to undergo surgical treatment using either an accelerated or the standard treatment protocol, in order to assess the feasibility of a true randomized controlled trial comparing these two approaches. Overall, feasibility targets were attained, with 60 patients recruited in less than 18 months, over 7...

CMAJ. 2014 Jan 7;186(1):E52-60. doi: 10.1503/cmaj.130901. Epub 2013 Nov 18

Surgical repair VS acromioplasty and physiotherapy in non-traumatic rotator cuff tear

Patients (180 shoulders) above 55 years of age with non-traumatic supraspinatus tears were analyzed one year post-intervention to determine if rotator cuff repair is superior to alternative treatment approaches. Patients were randomly allocated to a physiotherapy group, acromioplasty and physiotherapy group, or rotator cuff repair, acromioplasty an...

Bone Joint J. 2014 Jan;96-B(1):75-81. doi: 10.1302/0301-620X.96B1.32168.

Eicosapentaenoic and docosahexaenoic acid supplementation in breast cancer patients

38 postmenopausal women being treated with aromatase inhibitors for breast cancer were randomized in this trial to determine the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) on bone turnover and resorption. Participants were treated with capsules of either EPA+DHA or placebo (7 capsules/day) for 3 months, after which they we...

Nutr Cancer. 2014;66(1):68-76. doi: 10.1080/01635581.2014.847964. Epub 2013 Nov 25

Draw-back technique safe and effective in slip reduction for isthmic spondylolisthesis

94 adult patients with isthmic spondylolisthesis were randomized to be treated with either conventional in situ posterior lumbar interbody fusion (PLIF) or a draw-back technique, using pedicle screws to reduce vertebral slippage, combined with PLIF. The purpose was to determine the effect of slipped verterbrae reduction on clinical outcomes, radiog...

Eur Spine J. 2014 Jan;23(1):172-9. doi: 10.1007/s00586-013-2858-6. Epub 2013 Jun 14

Five-year follow-up of the effects of calcium supplementation in postmenopausal women

This investigation is a continuation of the 5 year Auckland calcium study, which randomly allocated healthy, post-menopausal women into a calcium or placebo group to compare fracture incidence, bone mineral density (BMD), and cardiovascular end-points between groups. The purpose of this extended follow-up was to investigate the post-trial effects o...

Osteoporos Int. 2014 Jan;25(1):297-304. doi: 10.1007/s00198-013-2526-z. Epub 2013 Oct 10.

Patient sense of coherence may play an important role in hip fracture rehabilitation

45 patients with a history of hip fracture were randomized to undergo either a 12-week individualized, progressive resistance training program or no intervention at all. The purpose of this secondary analysis was to examine the effect a patients sense of coherence (SOC) has on functional outcome upon completion of the intervention. Results indicate...

J Aging Phys Act. 2014 Jan;22(1):138-45. doi: 10.1123/japa.2012-0229. Epub 2013 Mar 26

Oral ibandronic acid inferior to IV zoledronic acid for metastatic breast cancer to bone

1404 patients with bone metastases from breast cancer were randomized to receive treatment with either oral ibandronic acid or intravenous zoledronic acid. The frequency and timing of skeletal-related events (SREs) was the primary non-inferiority endpoint. After 96 weeks of treatment, 50 mg of oral ibandronic acid given daily was inferior to 4 mg o...

Lancet Oncol. 2014 Jan;15(1):114-22. doi: 10.1016/S1470-2045(13)70539-4.

Home-based strength and stretching exercises for chronic neck pain yield similar outcomes

57 female patients with chronic neck pain were randomized to undergo either a home-based strength exercise program or stretching exercise program for one-year. The two interventions were compared with respect to changes in neck pain intensity and function. No significant difference was found in either neck pain intensity or function between the tre...

BMC Musculoskelet Disord. 2014 Jan 8;15(1):6. doi: 10.1186/1471-2474-15-6

Internal fixation VS hemiarthroplasty for hip fractures produce similar outcomes at 6 yrs

To determine the long term efficacy of surgical hip fracture techniques, 222 patients with displaced intracapsular femoral neck fractures were randomly allocated to undergo either hemiarthroplasty or internal fixation. Outcomes including patient pain, hip function, quality of life, survival, and frequency of re-operation were measured for a minimum...

Clin Orthop Relat Res. 2014 Jan;472(1):360-7. doi: 10.1007/s11999-013-3245-7. Epub 2013 Aug 24.

Cemented stem implantation: Finite element simulation vs. clinical bone densitometry

64 patients scheduled to undergo total hip arthroplasty were randomized to receive either a VerSys or ABG-II cemented femoral stem. Bone mineral density was monitored over a 5 year follow-up period and a finite element (FE) simulation was run concurrently, modelling stem mechanical behavior and measuring the biomechanical variations. At 5 years pos...

J Arthroplasty. 2014 Jan;29(1):90-100. doi: 10.1016/j.arth.2013.03.028.

No difference in darexaban taken qd or bid at 30 or 60 mg total in preventing VTE post-THA

1992 patients undergoing elective total hip arthroplasty were randomized to receive either oral darexaban (YM150) (at 15 mg bid, 30 mg qd, 30 mg bid, or 60 mg qd) or 40 mg enoxaparin qd. Incidence of VTEs or death was the primary outcome, and incidence of bleeding and adverse events were part of the safety analysis. No significant differences were ...

Thromb Haemost. 2014 Jan 29;111(2):213-25. doi: 10.1160/TH13-04-0296.

Manual therapy may be beneficial for patients with haemophilic ankle arthropathy

31 patients (56 ankles) diagnosed with either haemophilia A or B and haemophilic arthropathy in one or both ankles were randomized to either a manual therapy, educational or control group, to determine whether the interventions in question improve clinical and functional outcomes in this population. Results indicated that, although both physiothera...

Haemophilia. 2014 Jan;20(1):e71-8. doi: 10.1111/hae.12320. Epub 2013 Nov 20.

IV tranexamic acid reduces postoperative autologous blood retransfusion in THA and TKA

98 patients undergoing TKA or THA were randomized to receive a restrictive blood transfusion program either with an intraoperative intravenous 1.0 g dose of tranexamic acid (TXA) and a repeated dose 3 hours later or a placebo. Analysis revealed that a lower proportion of TXA patients required reinfusion of postoperatively collected autologous bloo...

Transfusion. 2014 Jan;54(1):31-41. doi: 10.1111/trf.12224.

Knee OA: NASHA intra-articular hyaluronic acid vs. methylprednisolone acetate

442 patients suffering from unilateral knee pain were randomized to evaluate the safety and efficacy of 26 weeks of a single-injection of intra-articular non-animal stabilized hyaluronic acid (NASHA) compared to methylprednisolone acetate (MPA). Following 26 weeks of blinded evaluation, patients were offered a second injection with NASHA and were f...

Osteoarthritis Cartilage. 2014 Jan;22(1):17-25. doi: 10.1016/j.joca.2013.10.009. Epub 2013 Nov 1.

AAHS 2014: Simple open vs. endoscopic decompression for cubital tunnel syndrome

18 studies (level II evidence and below) investigating the use of open simple or endoscopic release of idiopathic cubital tunnel syndrome were included in this systematic review to compare the clinical outcome and complication rates between these procedures. The results of the study demonstrated that open simple decompression and endoscopic decompr...

AAHS 2014: Trigger finger: Percutaneous release vs open surgery or steroid injection

26 studies were included in this meta-analysis to determine the optimal treatment for stenosing flexor tenosynovitis (trigger finger) by comparing percutaneous release (11 studies), open surgery (8 studies) and corticoid steroid injections (7 studies). The chance of success with percutaneous was 94%, compared to 92% in open release group and only 6...

AAHS 2014: The quality of current hand and elbow randomized controlled trials

63 RCTs completing research on hand or elbow orthopaedic topics were analyzed to determine if current randomized control trials, regarding hand and elbow treatment, are performed in a manner that allow for high quality evidence reporting. The results of the review indicated that although there has been an improvement in RCTs over the last decade, a...

Knee OA: An 8-week non-weightbearing strengthening program yields greatest pain reduction

Eight randomized controlled trials were included in this meta-analysis which investigated the difference between muscle strengthening and aerobic exercise for treatment of knee osteoarthritis. The included trials featured 11 intervention groups composed of either non-weightbearing strengthening, weightbearing strengthening, or aerobic exercise prot...

Clin Rehabil. 2013 Dec;27(12):1059-71

Intra-articular bone marrow-derived stem cell injection effective in high tibial osteotomy

56 patients with medial compartmental osteoarthritis and genu varum were randomized to undergo a high tibial osteotomy with or without an intra-articular injection of cultured autologous bone marrow-derived mesenchymal stem cells (MSC), administered 3 weeks post-treatment. The purpose of this study was to evaluate the clinical outcomes and MRI resu...

Arthroscopy. 2013 Dec;29(12):2020-8. doi: 10.1016/j.arthro.2013.09.074

Intertrochanteric fractures: Similar rate of reoperation using fixed or sliding side plate

163 patients with unstable intertrochanteric fractures were randomized to receive surgical treatment using either (1) a sliding hip screw and fixed side plate or (2) a sliding hip screw and a Medoff sliding side plate. The purpose of this study was to compare rates of re-operation and hip function scores following treatment with these two types of ...

Injury. 2013 Dec;44(12):1904-9. doi: 10.1016/j.injury.2013.06.017. Epub 2013 Jul 20

Postoperative antibiotic prophylaxis following ORIF for mandibular fractures

62 patients with mandibular fractures involving the alveolus and undergoing open reduction and internal fixation (ORIF) were randomized to receive either a 1- or 5-day course of postoperative antibiotics, to compare these two regimens with respect to postoperative infection rates in these patients. Results indicated that the incidence of postoperat...

Br J Oral Maxillofac Surg. 2013 Dec;51(8):803-7. doi: 10.1016/j.bjoms.2013.08.008. Epub 2013 Sep 3.

Local infusion analgesia using a double lumen catheter is safe and effective following TKA

40 patients with knee osteoarthritis undergoing primary total knee arthroplasty (TKA) were randomized to receive post-operative administration of local infusion analgesia (LIA) or saline using a double lumen catheter. The purpose of this study was to evaluate the effectiveness and safety of this modified LIA for pain relief following TKA procedures...

Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2680-4. doi: 10.1007/s00167-012-2004-8. Epub 2012 Apr 11

Oral tranexamic acid is safe and effective in reducing post-operative blood loss in TKA

53 patients scheduled to undergo total knee arthroplasty (TKA) were randomized to either receive or not receive oral administration of tranexamic acid. The purpose was to determine whether this intervention was safe and effective in reducing the amount of postoperative blood loss. Results indicated that the tranexamic acid group displayed significa...

Transfus Apher Sci. 2013 Dec;49(3):574-7. doi: 10.1016/j.transci.2013.09.005. Epub 2013 Oct 5

The effectiveness of physical therapy for lumbar spinal stenosis remains unknown

10 studies (5 RCTs, 2 controlled trials, 2 mixed-design studies, and 1 longitudinal cohort study) assessing the effectiveness of physical therapy interventions in patients with lumbar spinal stenosis were included in this review. The results from this study indicated that there is moderate-quality evidence suggesting pain and disability (but not wa...

Phys Ther. 2013 Dec;93(12):1646-60. doi: 10.2522/ptj.20120379. Epub 2013 Jul 25

Outcome similar with Integra, Cellonex or a split thickness skin graft in burn patients

10 patients with deep, third degree burns on the anterior side of the body requiring fascial excision were randomized to receive a split-thickness skin graft (STSG) on either Integra (and artificial dermal template), Cellonex (a cellulose sponge) or directly onto the fascia. The purpose of this study was to compare the histological and clinical out...

Burns. 2013 Dec;39(8):1577-87. doi: 10.1016/j.burns.2013.04.023. Epub 2013 Jul 20.

Alendronate & zoledronate both reduce hip and vertebral fracture risk compared to placebo

19 randomized controlled trials were included in this systematic review which investigated the effect bisphosphonates on decreasing fracture risk and increasing bone mineral density in osteoporotic and osteopenic postmenopausal women. 17 studies were used for quantitative synthesis. The two drugs which were evaluated were alendronate and zoledronat...

Gynecol Endocrinol. 2013 Dec;29(12):1005-14. doi: 10.3109/09513590.2013.813468. Epub 2013 Sep 25

Autologous conditioned plasma & ESWT may be beneficial in patients with plantar fasciitis

54 patients diagnosed with plantar fasciitis were randomized to undergo one of three treatment options: an autologous conditioned plasma (ACP) injection, extra-corporeal shock wave therapy (ESWT), or conventional treatment (i.e. stretching exercises). The purpose of this study was to compare pain, function and thickness of the plantar fascia betwee...

PM R. 2013 Dec;5(12):1035-43. doi: 10.1016/j.pmrj.2013.08.590. Epub 2013 Aug 22

Platelet-rich plasma with needling effective in treatment of chronic tennis elbow

230 patients presented with chronic tennis elbow were enrolled and randomized into either a platelet-rich plasma treatment group (PRP) or an active control group. This study was followed-up at 12 and 24 weeks to evaluate clinical efficacy based on pain and local elbow tenderness. At the 12-week follow-up, no significant differences were observed be...

Am J Sports Med. 2013 Dec 12.

Post-THA physical therapy exercises improve strength, gait speed and cadence

5 randomized trials evaluating the effect of post-discharge rehabilitation exercises following a total hip arthroplasty (THA) were included in this review. The purposes of this meta-analysis/systematic review were to (1) examine the effectiveness of physical therapy exercises following THA and (2) determine whether supervised and home-based exercis...

J Physiother. 2013 Dec;59(4):219-26. doi: 10.1016/S1836-9553(13)70198-X

SCI: No significant improvement in urine output, swelling, or spasticity with FES cycling

14 patients who had sustained a spinal cord injury within the previous 6 months underwent both an experimental and control phase using a randomized, cross-over design, and a 1-week washout period. The purpose of this study was to determine whether a 2-week functional electrical stimulation (FES) cycling program resulted in improved urine output, le...

J Physiother. 2013 Dec;59(4):237-43. doi: 10.1016/S1836-9553(13)70200-5

Neuromuscular electrical stimulation not effective for pain relief or ROM post-stroke

46 patients who had sustained a stroke resulting in paralysis or severe paresis in their upper limb, and a poor prognosis for functional recovery were randomized to undergo an 8-week treatment regimen of either neuromuscular electrical stimulation (NMES) and simultaneous passive range of motion stretches, or a sham treatment. This study was conduct...

J Physiother. 2013 Dec;59(4):245-54. doi: 10.1016/S1836-9553(13)70201-7

Collagen nerve guide conduit successfully treated nerve laceration in distal forearm

Forty-three patients with complete nerve lacerations of the median or ulnar nerves in the distal forearm were treated using either a Collagen Nerve Guide Conduit, in which the gap of the encased nerve is less than 6 mm, or a conventional repair (direct suture or nerve graft). The purpose was to compare the recovery of sensory and motor functions be...

J Hand Surg Am. 2013 Dec;38(12):2405-11

Computer navigation for soft tissue balancing in total knee arthroplasty

41 consecutive knee arthroplasties were randomized to either computer-navigated or non-navigated to investigate whether navigation improved soft-tissue balancing in the procedure. Mediolateral flexion and extension gaps were measured to determine the accuracy of balancing. The accuracy of bony cuts and limb alignment were also assessed. The results...

Knee. 2013 Dec;20(6):401-6. doi: 10.1016/j.knee.2013.06.007. Epub 2013 Jul 26

Adjunct vancomycin powder not effective in reducing infection rates in spinal surgery

907 patients undergoing open spine surgery were randomized to receive an application of vancomycin powder (a local antibiotic), in addition to the standard intravenous surgical prophylaxis, or not to determine whether the use of vancomycin powder decreases the incidence of infection rates in patients undergoing spinal surgery. After a minimum follo...

Spine (Phila Pa 1976). 2013 Dec 1;38(25):2149-55. doi: 10.1097/BRS.0000000000000015.

Beneficial effect on pain & ROM with periarticular multimodal drug injection in TKA & THA

21 randomized controlled trials were included in this meta-analysis which investigated the use of periarticular multimodal drug injection (PMDI) as a method of postoperative analgesia in total knee and total hip arthroplasty. Outcomes of interest included pain, opioid requirements, range of motion, length of hospital stay, and incidence of adverse ...

J Arthroplasty. 2013 Dec;28(10):1882-7. doi: 10.1016/j.arth.2013.06.031. Epub 2013 Aug 1

Patient-specific instruments may not be applicable to all total knee arthroplasty cases

100 patients were randomized to total knee arthroplasty with either patient-specific instrumentation or conventional instrumentation. The purpose was to determine if patient-specific guides offered improved postoperative alignment over conventional methods. The results from the analysis indicated that component alignment was similar between the two...

Clin Orthop Relat Res. 2013 Dec;471(12):3988-95. doi: 10.1007/s11999-013-3206-1. Epub 2013 Aug 2

Functional outcome improved with PRP treatment for knee osteoarthritis

Six studies (4 randomized controlled trials and 2 prospective cohort studies) were included in this quantitative systematic review which investigated the efficacy of platelet-rich plasma (PRP) injections versus hyaluronic acid (HA) or placebo injections. Pooling was performed on outcomes reported at a 24-week follow-up. The pooled results indicated...

Arthroscopy. 2013 Dec;29(12):2037-48. doi: 10.1016/j.arthro.2013.09.006

Improved knee ROM & functional outcome with both low load stretch device and manipulation

64 patients with persistent knee stiffness following total knee arthroplasty were randomized to management with either manipulation under anaesthesia or a computer-controlled low load stretching device for 6 weeks, both in addition to 6 weeks of standardized physiotherapy. The purpose of this study was to compare the two groups after 6 weeks for ac...

Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2751-8. doi: 10.1007/s00167-012-2152-x. Epub 2012 Aug 3

Meniscus healing similar between free and restricted rehabilitation after meniscus repair

60 patients with an isolated tear of the meniscus who underwent arthroscopic repair were randomized to determine the effect of a free rehabilitation (accelerated protocol) in comparison to restricted rehabilitation. Outcomes included percentage of nonhealed menisci, the Knee Injury and Osteoarthritis Outcome score (KOOS), and the Tegner score, whic...

Am J Sports Med. 2013 Dec;41(12):2753-8. doi: 10.1177/0363546513505079. Epub 2013 Oct 10

SImilar efficacy between intra- and periarticular injections for acromioclavicular joint

101 patients (106 shoulders) were randomized to investigate the efficacy of either an intra-articular injection or periarticular injection in the treatment of symptomatic acromioclavicular joints. Outcome measurements of pain and function were assessed up to 3 weeks post-injection. The results indicated that either injection provided similar, signi...

Arthroscopy. 2013 Dec;29(12):1903-10. doi: 10.1016/j.arthro.2013.08.027. Epub 2013 Oct 18

rhBMP-2 augmentation not recommended in intramedullary nailing of closed tibial fractures

387 patients with closed tibial fractures were randomized in this study to investigate the efficacy and safety of the local application of recombinant human bone morphogenetic protein 2 (rhBMP-2) within a calcium phosphate matrix (CPM) in the treatment of closed tibial fractures. Participants were subject to intramedullary nail fixation in 1 of 4 t...

J Bone Joint Surg Am. 2013 Dec 4;95(23):2088-96. doi: 10.2106/JBJS.L.01545

Does Semitendinosus regenerate following harvestation for ACLR?

50 patients who had undergone ACL reconstruction were randomized to undergo the procedure using either an ipsilateral quadrupled semitendinosus (ST) tendon graft, or an ipsilateral doubled semitendinosus/gracilis graft. The purpose of this study was to observe the regeneration of the ST tendon using ultrasonography in all participants and biopsy da...

Int Orthop. 2013 Dec;37(12):2475-81. doi: 10.1007/s00264-013-2034-y. Epub 2013 Aug 28

Fusion rates improved with rhBMP in lumbar spine fusion; clinical outcome similar to ICBG

207 patients were randomized to determine the impact of recombinant human bone morphogenetic protein-2 (rhBMP-2) on fusion rates following 1- or 2-level instrumented posterolateral lumbar fusion compared to standard iliac crest bone autografts (ICBG). Participants were undergoing surgery for degenerative disc disease. Fusion rates, along with clini...

Spine (Phila Pa 1976). 2013 Dec 1;38(25):2139-48. doi: 10.1097/BRS.0000000000000007

TKA prophylaxis: Risk-dependent anticoagulation safer than routine anticoagulation

673 patients undergoing primary or a staged bilateral total knee arthroplasty (900 procedures) were randomized to receive thromboprophylactic treatment either based on their level of risk for deep venous thrombosis (DVT), or according to a routine anticoagulation protocol. The purpose of this study was to compare these two protocols on the resultin...

J Arthroplasty. 2013 Dec;28(10):1868-73. doi: 10.1016/j.arth.2013.05.025. Epub 2013 Jun 21.

Arthroscopic partial meniscectomy & sham surgery similar for degenerative meniscal tear

146 patients with degenerative meniscal tears were randomized to determine the efficacy of arthroscopic partial meniscectomy. Participants underwent either arthroscopic partial meniscectomy or sham-arthroscopic partial meniscectomy, and were assessed for 12 months postoperatively. The results indicated that outcomes for the group receiving arthrosc...

N Engl J Med. 2013 Dec 26;369(26):2515-24. doi: 10.1056/NEJMoa1305189

Antibiotic use in low-velocity gunshot-induced fractures remains inconclusive

33 studies (2 of which were RCTs) reporting infection rates in patients suffering from a gunshot-induced fracture were included in this review. The purposes of this review were to examine the effect of antibiotics, additional gram-negative coverage, as well as the duration and method of antibiotic administration on infection rates. Results indicate...

Clin Orthop Relat Res. 2013 Dec;471(12):3937-44. doi: 10.1007/s11999-013-2884-z

Low- and high-dose TXA effective in reducing blood loss and transfusion needs in TKA

135 patients scheduled for total knee arthroplasty were randomized to three different hemostasis protocols with 2 hour postoperative drain clamping: 1) a 250mg intra-articular tranexamic acid (IA-TXA) injection (low-dose), 2) a 500mg IA-TXA injection (high-dose), or 3) a placebo injection. The purpose was to determine the effect of different TXA do...

BMC Musculoskelet Disord. 2013 Dec 5;14:340. doi: 10.1186/1471-2474-14-340

TKA: best outcome with tourniquet inflation before incision & deflation when cement harden

43 patients undergoing total knee arthroplasty were randomized to three different tourniquet protocols to determine which was optimal for blood loss and fit-to-discharge outcomes. The three tourniquet applications were as follows: inflation just prior to incision and deflation after cement hardening (Group 1), inflation just prior to cementing and ...

Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2790-9. doi: 10.1007/s00167-012-2221-1. Epub 2012 Sep 28

Femoral head diameter does not influence gait recovery or hip function in THA

Sixty female patients with unilateral primary hip osteoarthritis undergoing total hip arthroplasty (THA) were randomized to receive treatment using a prosthetic femoral head with a diameter of either (1) 28 mm, (2) 36 mm, or (3) between 42-48 mm). The purpose of this study was to determine whether the diameter of the femoral head used in THA affect...

Clin Orthop Relat Res. 2013 Dec;471(12):3830-7. doi: 10.1007/s11999-013-2926-6

Platelet-rich plasma injections improve degenerative knee cartilage functional outcomes

This 16 study meta-analysis/systematic review evaluated the ability of platelet-rich plasma (PRP) to improve functional outcomes of patients suffering from knee cartilage degeneration. The aim of the study was to determine the best course of care and treatment for patients with chondral degenerative knee lesions by comparing functional outcomes bef...

Arch Phys Med Rehabil. 2013 Nov 27. pii: S0003-9993(13)01212-4. doi: 10.1016/j.apmr.2013.11.006.

COA 2013: Cemented fixation superior to uncemented fixation in Total Hip Replacement

Data from randomized controlled trials was pooled to comparatively evaluate the efficacy of cemented versus uncemented fixation in total hip arthroplasty, in order to determine a superior intervention. The evidence presented in this study indicated that cemented fixation resulted in comparable outcomes of implant survival, mortality and complicatio...

COA 2013: Primary Arthroplasty; antibiotic-impregnated bone cement reduces deep infection

8 studies with 6381 patients were included in this meta-analysis to determine the effectiveness and safety of antibiotic-impregnated bone cement (AIBC) as a prophylactic method during primary total joint arthroplasty. The results indicated that deep infection rates were reduced with AIBC compared to plain cement or systemic antibiotics. However, su...

Ultrasound-guided steroid injection for carpal tunnel leads to reduced symptom severity

46 patients clinically diagnosed with primary moderately severe idiopathic carpal tunnel syndrome (defined as slowing of the sensory conduction velocity and abnormal distal motor latency), were randomly assigned into 1 of 2 groups to compare the safety and efficacy of ultrasound guided steroid injection to blinded steroid injection. The results of ...

Am J Phys Med Rehabil. 2013 Nov;92(11):999-1004

Treatment of the medial malleolus in bimalleolar and trimalleolar ankle fractures

100 patients undergoing open reduction and internal fixation of the lateral malleolus were randomized to evaluate the benefit of further internal fixation compared to no fixation (nonoperative) of the medial malleolus. Patients with minimally displaced (2 mm) fractures were evaluated over a median of 39 months. The evidence presented in this study ...

J Orthop Trauma. 2013 Nov;27(11):633-7

Ponseti method for club foot most effective with above-knee cast compared to below-knee

26 children (33 club feet) in the first 3 months of life with idiopathic club feet were included in this study to determine the risks and benefits of below-knee casting compared to standard above-knee casting for Ponseti's method. The outcomes included time to tenotomy or time to full correction when tenotomy was not required, risk of failure due t...

Bone Joint J. 2013 Nov 1;95-B(11):1570-4

Radial extracorporeal shock-wave therapy: no effect on chronic rotator cuff tendinitis

82 patients, between the ages of 18 and 67 years of age, showing clinical signs of chronic tendinitis for at least 6 months, were randomly assigned into one of two treatment groups (intervention or placebo) to test the effect of radial extracorporeal shock-wave therapy (rESWT) on patients with chronic tendinitis of the rotator cuff, 6 months after ...

Bone Joint J. 2013 Nov 1;95-B(11):1521-6

Tendon healing superior in double-row arthroscopic repair compared to single-row repair

90 patients with full-thickness supraspinatus tears were randomized to compare tendon healing rates associated with double- and single-row arthroscopic supraspinatus tendon repair, as determined by ultrasound diagnostics. Patients were evaluated over 17 months and the evidence presented in this study revealed significantly superior tendon healing r...

J Shoulder Elbow Surg. 2013 Nov;22(11):1480-7

Single- and double-bundle approaches to ACL reconstruction deemed equivalent

103 patients, over the age of 18, with a unilateral anterior cruciate ligament (ACL) injury were randomized to undergo single- or double-bundle ACL reconstruction to determine if one of these approaches resulted in superior clinical results. This two year study found similar improvements in the 1-legged hop test, square hop test, Lysholm knee scori...

Am J Sports Med. 2013 Nov;41(11):2484-91

Effect of early digit mobilization on function following distal radius fracture surgery

22 patients (over age 50) who had experienced a distal radius fracture and underwent fixation surgery were randomly assigned into one of two groups: either early digit mobilization or standard postoperative treatment. The purpose was to evaluate the effect of early digit mobilization on hand stiffness, function, and bone healing over the first 12 p...

Clin Rehabil. 2013 Nov;27(11):983-93

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