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We found 2559 reports published by T (Newest First)

Dynamic versus static brace for postoperative management of idiopathic clubfeet

30 patients with either unilateral or bilateral idiopathic clubfoot were randomly assigned to receive a dynamic abduction brace or a static abduction brace, in combination with Mitchell shoes. Patients were treated with the Ponseti method. This trial aimed to compare the rate of recurrence between a dynamic and a static brace, however the findings ...

J Pediatr Orthop B. 2014 Nov;23(6):501-4

Tranexamic acid decreases blood loss & transfusion needs compared to knee flexion post-TKA

60 patients undergoing total knee arthroplasty for primary knee osteoarthritis were randomized to either mechanical knee flexion, pharmacological treatment using tranexamic acid, or a control group. The purpose of this study was to compare blood loss and rate of blood transfusion between treatment groups. The pharmacological group decreased blood l...

Knee Surg Sports Traumatol Arthrosc. 2014 Nov;22(11):2756-62.

Advanced cryotherapy does not reduce pain and narcotic use after TKA

116 patients who underwent primary total knee arthroplasty were quasi-randomized to either receive advanced cryotherapy or the use of cold packs (control) to compare VAS pain, narcotic consumption, range of motion, swelling, and blood loss postoperatively between groups. The purpose of this study was to determine whether or not computer-assisted cr...

Clin Orthop Relat Res. 2014 Nov;472(11):3417-23.

Transfer-validity of arthroscopic knee surgery skill using virtual-reality simulator

54 postgraduate third-year orthopaedic residents completed arthroscopic knee surgery training using a simulator or traditional methods. The purpose of this trial was to determine if simulator-trained residents performed arthroscopic knee surgery in the operating room with greater thoroughness and accuracy in less time compared to residents trained ...

J Bone Joint Surg Am. 2014 Nov 5;96(21):1798-1806.

No benefit of angular stable locking for intramedullary nailing of distal tibial fractures

142 patients who suffered a distal tibial fracture were randomized to undergo intramedullary nailing locked with an angular stable locking system or conventional locking screws. The intent of this study was to determine which locking method achieved earlier full weight-bearing with minimum pain. Follow-up was performed up to 12 months postoperative...

J Bone Joint Surg Am. 2014 Nov 19;96(22):1889-97.

Total knee arthroplasty with and without circumpatellar electrocautery

Six studies (5 randomized controlled trials and 1 comparative retrospective study) were included in this meta-analysis to evaluate total knee arthroplasty with and without circumpatellar electrocautery. The primary purpose of this analysis was to determine the effect of patellar denervation with electrocautery on anterior knee pain. The rate of ant...

Knee Surg Sports Traumatol Arthrosc. 2014 Nov;22(11):2648-54.

Adductor canal block for management of postoperative pain after revision knee arthroplasty

36 patients scheduled to undergo revision total knee arthroplasty were randomly assigned to adductor canal block with ropivacaine or placebo. The purpose of this study was to evaluate whether an adductor canal block reduced postoperative pain to a significant degree. The primary outcome of interest was VAS pain during knee flexion at 4 hours postop...

PLoS One. 2014 Nov 11;9(11):e111951

Gabapentin improves in-hospital rehabilitation but not post-discharge outcomes after TKA

179 patients undergoing total knee arthroplasty (TKA) were randomized to receive a four day perioperative regimen of either gabapentin or placebo as an adjunct to celecoxib. The primary intent of this trial was to determine whether gabapentin improves in-hospital rehabilitation and physical function 4 days, 6 weeks, and 3 months after surgery. No s...

Br J Anaesth. 2014 Nov;113(5):855-64.

Dry needling and manual therapy offer similar short-term outcomes for neck pain

94 patients with chronic mechanical neck pain were randomized to undergo two sessions of either trigger point (TrP) dry needling (DN) or TrP manual therapy (MT) to compare the short-term efficacy of both interventions. Pain, function, pressure pain sensitivity, and cervical range of motion were evaluated up to 2 weeks post-treatment. Results reveal...

J Orthop Sports Phys Ther. 2014 Nov;44(11):852-61.

Double-row repair significantly reduced recurrence, especially in partial-thickness tears

Six randomized controlled trials comparing single- and double-row rotator cuff repairs were included in this meta-analysis. The primary outcome of interest was recurrence and the secondary outcomes were functional scores: American Shoulder and Elbow Surgeons shoulder score, the Constant shoulder score, and the University of California, Los Angeles ...

Orthopedics. 2014 Nov 1;37(11):e1006-13

Mobilization vs manual therapy in the treatment of ankle hemophilic arthropathy

9 adult patients (18 ankles) with hemophilic arthropathy of the ankle were randomized to undergo a mobilization or manual therapy regimen for 6 weeks in this quasi-experimental pilot study. The intent of this study was to determine the effectiveness and safety of both physiotherapy interventions. Both therapies improved all ankle movements from pre...

Physiother Theory Pract. 2014 Nov;30(8):534-9.

MRI- and CT-templated Patient-Specific Instruments compared to conventional instruments

90 patients diagnosed with primary osteoarthritis were randomly assigned to undergo total knee arthroplasty using either conventional instrumentation, MRI-based patient-specific instrumentation, or CT-based patient-specific instrumentation. Patients were assessed after surgery for coronal alignment (mechanical axis, femoral component, and tibial co...

Clin Orthop Relat Res. 2014 Oct;472(10):2913-22

OTA 2014: Negative-pressure wound therapy not favourable to gauze dressing for ORIF

151 patients who underwent open reduction and internal fixation (ORIF) for a hip, pelvis, or acetabular fracture were randomly assigned to receive negative-pressure wound therapy (NPWT) or standard gauze dressing over the closed incisions. Postoperative surgical wound drainage, risk of infections, and hospital duration were assessed. Findings revea...

OTA 2014: Aspiration vs. sham aspiration of hemarthrosis in acute ankle fracture

109 patients with an ankle fracture (OTA type 44) and presenting within 24 hours of injury were randomized to undergo either ankle aspiration or sham treatment (control) where no fluid was removed. This study aimed to examine whether or not aspiration of hemarthrosis would reduce pain and use of narcotic pain medication in patients with acute ankle...

OTA 2014: Comparable outcomes for plate and pin fixation for dislocated clavicle fracture

120 adult patients with a dislocated midshaft clavicle fracture were randomly assigned to undergo surgical intervention via plate fixation or intramedullary nailing. Shoulder function was assessed pre- and post-operatively, with final follow-up at 12 months after surgery. Findings reported similar outcomes between both treatment groups, with no sig...

OTA 2014: Brachial plexus blocks vs general anesthesia for distal radius fracture fixation

40 patients with acute distal radius fractures and undergoing surgical fixation were randomly allocated to brachial plexus blockade (BPB) or general anesthesia (GA), with the purpose of determining which method offers better pain control. BPB provided better pain relief in the immediate postoperative period (<2 hours), while general anesthesia (GA)...

OTA 2014: Hinged vs no knee bracing after tibial plateau fractures yield similar results

49 patients who underwent open reduction and internal fixation of tibial plateau fracture were randomly allocated to receive or not receive a hinged knee brace after surgery. Those allocated the brace usage wore the brace for 6 weeks postoperatively. The purpose of this trial was to compare radiographic, functional, and subjective outcomes between ...

OTA 2014: Continuous popliteal SNB reduces rebound pain vs. single-shot in ankle fractures

50 patients scheduled to undergo operative fixation of ankle fractures were randomly allocated to receive popliteal sciatic nerve block either through a single injection or a continuous infusion. The purpose of the study was to investigate whether continuous anesthetic infusion or single injection would reduce rebound pain (reoccurring pain between...

OTA 2014: Plate fixation & intramedullary nailing similar for midshaft clavicular fracture

59 patients with midshaft clavicular fractures were randomly assigned to receive either reconstruction plate fixation or elastic stable intramedullary nailing (ESIN) fixation. This trial aimed to compare the clinical, functional, and radiographic outcomes of both treatment methods up to 12 months postoperatively. The findings indicated that plate f...

OTA 2014: Supra- vs infrapatellar tibial nailing yields equal clinical/functional results

41 patients with tibial shaft fractures were randomly allocated to undergo surgical fixation with infrapatellar (IP) or suprapatellar (SP) intramedullary nailing. The purpose of this pilot trial was to compare clinical and functional outcomes of the knee between the two approaches up to 12 months post-surgery. IP and SP nailing yielded similar clin...

OTA 2014: Syndesmotic fixation offers no benefit in SER IV ankle fractures

A total of 140 patients diagnosed with Lauge-Hansen supination-external rotation (SER) IV ankle fractures were identified in this prospective randomized trial. 24 patients were identified as having an unstable syndesmosis (external rotation stress test) comparatively to the ipsilateral ankle, and were randomly allocated to either receive syndesmoti...

OTA 2014: Enrollment difficulty to compare ORIF & arthroplasty for acetabular fracture

A randomized study at a single trauma center was conducted to determine if it would be feasible to perform a full-scale randomized controlled trial comparing open reduction and internal fixation (ORIF) with total hip arthroplasty (THA) and concomitant ORIF in patients over 60 with an acetabular fracture. Patients presenting to the trauma center wer...

OTA 2014: Infection rate not significantly reduced with postoperative cefazolin after ORIF

229 patients undergoing open reduction and internal fixation (ORIF) of a closed limb fracture, with standard preoperative and intraoperative prophylactic antibiotic administration, were randomized to receive 23 hours of postoperative prophylactic cefazolin or placebo. The primary purpose of this trial was to compare infection rates between these tw...

OTA 2014: Early mobilization favourable to immobilization for simple elbow dislocations

100 adult patients with simple elbow dislocations were randomly assigned to early mobilization or plaster immobilization after closed reduction. This study aimed to compare the functional and clinical outcomes of both treatment methods at 12 months post-intervention. The findings from this trial suggested better functional outcomes in patients who ...

OTA 2014: Functional recovery similar between locking plates and K-wires for displaced DRF

461 adult patients with acute, dorsally displaced fractures of the distal radius were randomly assigned to undergo either Kirschner wire fixation or locking-plate fixation. This trial aimed to evaluate the functional and cost-effectiveness of both treatments over the first year after surgery, with follow-up conducted at 3, 6, and 12 months. The pri...

OTA 2014: High-dose vitamin D vs. placebo in deficient patients with long bone fracture

89 of 102 enrolled patients with long bone fracture were identified as vitamin D deficient and randomized to receive a single dose of oral 100,000 IU vitamin D within the initial 2 weeks post-injury or a placebo. The purpose of this trial was to investigate the rate of nonunion in this patient population and assess the feasibility of using acute hi...

OTA 2014: Surgeon, clinical, and radiographic factors in recommending surgery for DRF

252 orthopaedic surgeons from various countries participated in a web-based randomized study investigating the impact of surgeon, patient, and radiographic factors on the recommendation for surgery in cases of distal radius fracture. Surgeons were randomized to receive both radiographs and clinical information, or to receive radiographs only. Based...

OTA 2014: Surgery vs. cast immobilization for elderly patients with distal radius fracture

185 elderly patients with an intra-articular distal radius fracture were randomly allocated to either surgical treatment with volar locking plate fixation or closed reduction and 6-week cast immobilization. This study aimed to determine whether operative treatment was more effective than cast immobilization for elderly patients with an intra-articu...

OTA 2014: Early results of a blood plasma bone putty encouraging in open tibial fractures

30 patients with an open tibia fracture (Gustilo type II, IIIA, IIIB) were included and randomized. Ten patients were randomized to nonaugmented fixation, and 20 were allocated to receive the application of a novel plasma-based bone putty to the fracture site during reduction and fixation. The purpose of this study was to compare bone and soft tiss...

OTA 2014: Short arm favourable to long arm casting for A2-OTA type distal radius fracture

100 patients with A2-OTA type fracture of the distal radius were randomly assigned to receive either long or short arm casting. The purpose of this trial was to compare elbow function between both casts at 6 and 18 weeks post-intervention. Results revealed fewer patients who received the short-arm cast demonstrated limited forearm range of motion (...

Periarticular injections vs. no injection for analgesia after high tibial osteotomy

70 patients scheduled for medial opening-wedge high tibial osteotomy were randomized to either periarticular multimodal drug injections or to no injection. The purpose of this study was to investigate the efficacy of periarticular multimodal injections on reducing postoperative pain up to 14 days after treatment. All patients received patient contr...

Arthroscopy. 2014 Oct;30(10):1261-8

Shoulder pain: more patients achieve remission with corticosteroids than with NSAIDs

6 randomized controlled trials comparing nonsteroidal anti-inflammatory drugs (NSAIDs) to corticosteroid injections in patients with shoulder pain were included in this systematic review and meta-analysis. The purpose of this study was to compare the treatment efficacy of both interventions in hopes of determining an optimal conservative option for...

Arch Phys Med Rehabil. 2014 Oct;95(10):1824-1831.

Efficacy of ACL reconstruction using spinal anesthesia with or without femoral nerve block

32 patients with a tear of the anterior cruciate ligament (ACL) and scheduled for reconstruction under spinal anaesthesia were randomized to the procedure with and without a femoral nerve block. The purpose of this study was to compare clinical outcomes between the two groups up to 7 days postoperatively. Patients who received the femoral nerve blo...

Knee. 2014 Oct;21(5):911-5.

Two-year migration and micromotion comparable between CR and PS Triathlon TKA designs

60 patients undergoing total knee arthroplasty were randomized to surgery with either the Triathlon cruciate-retaining (CR) total knee system or the Triathlon posterior-stabilized (ie. cruciate-sacrificing; PS) total knee system. The purpose of this study was to evaluate migration and micromotion of the tibial tray between the two devices for up to...

Knee. 2014 Oct;21(5):949-54

Lumbosacral decompression with or without Wallis implant offers similar functional results

60 adult patients with confirmed symptomatic spinal stenosis were randomized to undergo primary lumbosacral decompression with or without a second generation Wallis implant. The purpose of this trial was to determine if there is a clinical benefit of Wallis ligament insertion on functional recovery. Although patients with Wallis implants demonstrat...

Eur Spine J. 2014 Oct;23(10):2156-60.

Mini-incision versus standard posterior approach for THA

16 studies (12 RCTs and 4 non-RCTs) comparing the mini-incision posterior approach to the standard posterior approach in primary total hip arthroplasty (THA) were included in this systematic review/meta-analysis. The primary outcome of interest was the incidence of dislocation. Pooled data revealed that the rate of hip dislocation did not differ be...

J Arthroplasty. 2014 Oct;29(10):1970-1982.

Floseal hemostatic agent reduces blood loss but not transfusion needs in TKA patients

108 patients undergoing unilateral primary total knee arthroplasty were randomly allocated to either receive a thrombin-based topical hemostatic matrix or to a control group who did not receive the hemostatic agent. The study sought to determine the effects of the hemostatic sealant on inblood loss, as well as the need for transfusion. Results reve...

J Arthroplasty. 2014 Oct;29(10):1950-5.

ADVANCE medial-pivot system offers similar 9-year survivorship to cemented TKA designs

Eight studies (3 retrospective cohort, 3 prospective cohort, 2 prospective randomized; n=1146 knees) were included in this systematic review/meta-analysis investigating mid- to long-term outcomes of total knee arthroplasty with the ADVANCE medial-pivot total knee system (MicroPort Orthopaedics Inc.). Survivorship data over 9-years was compared betw...

Bone Joint Res. 2014 Oct;3(10):297-304.

Femoral nerve block + periarticular infiltration analgesia provides pain relief post-TKA

49 patients scheduled to undergo elective unilateral total knee arthroplasty due to osteoarthritis were randomized to receive a femoral nerve block in combination with either periarticular infiltration analgesia (PIA) or sciatic nerve block (SNB). The purpose of this study was to compare the analgesic effect of both treatments within 36 hours post-...

J Anesth. 2014 Oct;28(5):696-701.

Radiostereometric analysis of humeral head resurfacing implant for shoulder osteoarthritis

32 adult patients with shoulder osteoarthritis were included in this trial to compare two humeral head resurfacing implants (HHRI): the Copeland HHRI and the Global C.A.P. HHRI. Implant migration, periprosthetic bone mineral density (BMD), and length of glenohumeral offset (LGHO) were assessed via radiostereometric analysis (RSA), in addition to cl...

J Shoulder Elbow Surg. 2014 Oct;23(10):1427-36.

Proximal opening wedge vs. proximal chevron osteotomy for hallux valgus

75 adult patients suffering from hallux valgus with an increased intermetatarsal angle were randomly allocated to undergo proximal opening wedge osteotomy with wedge-plate fixation or proximal chevron osteotomy of the first metatarsal. This trial aimed to compare clinical and radiographic results of both procedures using the American Orthopaedic Fo...

J Bone Joint Surg Am. 2014 Oct 1;96(19):1585-92

Rotator cuff repair yields similar functional results with or without platelet-rich plasma

75 patients with complete supraspinatus tears were randomized to undergo arthroscopic rotator cuff repair with or without the injection of platelet-rich plasma (PRP). The purpose of this study was to compare functional and structural results between groups up to 24 months post-surgery. The UCLA score was significantly higher in the PRP group than i...

Am J Sports Med. 2014 Oct;42(10):2446-54.

Reverse shoulder arthroplasty superior to HA for acute proximal humeral fractures

62 elderly patients with acute complex proximal humeral fracture were randomized to either undergo reverse shoulder arthroplasty (RSA) or hemiarthroplasty. This study aimed to compare the short-term outcomes of both operative fixation methods in terms of pain and function. Results revealed that the RSA group had significantly better mean University...

J Shoulder Elbow Surg. 2014 Oct;23(10):1419-26.

Similar union rate after Reamer-Irrigator-Aspirator bone graft or iliac crest bone graft

133 adult patients who had a nonunion or a posttraumatic bone defect were randomly assigned to undergo fixation using either an iliac crest bone graft (ICBG) or a graft harvested via Reamer-Irrigator-Aspirator (RIA). The purpose of this trial was to compare clinical, radiographic, and operative outcomes between groups up to 2 years post-surgery. Th...

J Orthop Trauma. 2014 Oct;28(10):584-90.

Morphine vs. mutlimodal acetaminophen/oxycodone for analgesia in painful acute fracture

153 patients with painful acute fracture were randomized to analgesia through either intravenous morphine sulfate or a multimodal regimen with acetaminophen and oral oxycodone. The purpose of this study was to examine pain decrease within the first hour after administration in both groups, as well as to document any adverse events. Average pain sev...

Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1305-9

The efficacy of tourniquets in total knee arthroplasty

13 randomized controlled trials (n = 859 TKAs) were included in this meta-analysis to examine the safety and efficacy of using a pneumatic tourniquet in primary unilateral total knee arthroplasty and to determine the most appropriate protocol. TKA with tourniquet was associated with lower intraoperative blood loss and an approximate 5 minute reduct...

Arch Orthop Trauma Surg. 2014 Oct;134(10):1469-76.

Prestige CDA maintains successful outcome at 7 years compared to ACDF

541 patients diagnosed with single-level cervical disc disease with radiculopathy were randomized to either undergo anterior cervical discectomy and fusion (ACDF) or cervical disc arthroplasty (CDA) with the Prestige Cervical Disc. The purpose was to investigate the long-term efficacy and safety of cervical disc replacement with the Prestige prosth...

J Neurosurg Spine. 2014 Oct;21(4):516-28.

Liberal vs restrictive allogeneic red blood cell transfusion strategy after hip revision

66 adult patients scheduled to undergo elective hip revision surgery were randomly allocated to receive a liberal or restrictive allogeneic red blood cell transfusion strategy. The primary purpose of this trial was to compare the time required to complete the Timed Up and Go-test (TUG) between transfusion groups. Patients assigned to a liberal haem...

BMC Anesthesiol. 2014 Oct 10;14:89.

Similar outcomes for Sanders IV calcaneal fractures with ORIF vs. ORIF and ankle fusion

31 patients with a Sanders IV displaced intraarticular calcaneal fracture were randomized to undergo open reduction and internal fixation (ORIF) alone or in combination with primary subtalar arthrodesis (PSTA). Long-term general health outcomes in both groups, as measured by the Short From 36 version 2, Musculoskeletal Functional Assessment Survey,...

J Orthop Trauma. 2014 Oct;28(10):577-83.

Survivorship of cementless components in total knee arthroplasty

37 articles were included in this systematic review and meta-analysis investigating survivorship of cementless component in total knee arthroplasty (TKA). Four RCT's were available for meta-analysis comparing cementless and cemented fixation in total knee arthroplasty. Pooled survivorship for various postoperative time intervals up to a minimum of ...

J Knee Surg. 2014 Oct;27(5):369-76.

Thoracic interbody fusion vs posteroanterior fusion for thoracolumbar fracture-dislocation

61 patients with thoracolumbar fracture-dislocations were randomized to undergo either transforaminal thoracic interbody fusion (TTIF) or posteroanterior (P-A) fusion, with the primary purpose of comparing clinical outcomes between treatment groups. Thoracic interbody fusion (TTIF) reduced blood loss, operative time, and complication rate compared ...

Spine (Phila Pa 1976). 2014 Oct 1;39(21):E1284-90.

CT-based Patient Specific Instrumentation offers no additional benefit to conventional TKA

112 adults with advanced osteoarthritis who were scheduled to undergo primary uncemented total knee arthroplasty (TKA) were randomly allocated to computed tomography (CT)-based patient-specific instrumentation (PSI) or conventional instrumentation. Radiographic evaluation was performed 12 months postoperatively, and findings revealed no statistical...

Int Orthop. 2014 Oct;38(10):2099-107

Fusion offers no benefit in pedicle screw fixation of thoracolumbar/lumbar burst fracture

58 patients with thoracolumbar or lumbar burst fracture undergoing short-segment pedicle screw fixation were randomized to either additional fusion with autograft or no additional fusion. The purpose of the study was to evaluate the radiographic and clinical outcomes between fusion and non-fusion cohorts. At a minimum of 10 years postoperatively, r...

J Bone Joint Surg Am. 2014 Oct 15;96(20):1724-31.

Displaced proximal humeral fracture: conservative similar to surgical treatment at 2 yrs

50 patients over sixty years of age with severe displaced unstable three- or four-part proximal humeral fracture were randomized to undergo open reduction and internal fixation using an angular stable implant, or conservative treatment using a sling bandage. The aim of this study was to compare functional outcome and health-related quality of life ...

Eur J Orthop Surg Traumatol. 2014 Oct;24(7):1067-73.

Extensible vs. inextensible lumbosacral orthoses for patients with low back pain

98 low back pain (LBP) patients who all participated in standard care (SC) (medication and physical therapy) were randomized to either receive support from an extensible lumbosacral orthoses (eLSO), inextensible lumbosacral orthoses (iLSO), or no additional assistance. This study aimed to examine the effect of the two LSO designs on self-rated pain...

Spine (Phila Pa 1976). 2014 Oct 1;39(21):1733-42.

Melatonin does not reduce the incidence of delirium among elderly hip fracture patients

452 elderly patients undergoing emergent surgical treatment of hip fracture were randomized to receive melatonin or placebo for a duration of five days after admission. The purpose of this trial was to determine the short-term effects of melatonin on the incidence, duration, and severity of delirium commonly seen in this patient population. Periope...

CMAJ. 2014 Oct 7;186(14):E547-56.

No long-term efficacy of 12-week acupuncture in cases of chronic knee pain

282 patients with chronic knee pain were randomized to 1 of 4 groups: needle acupuncture, laser acupuncture, sham laser acupuncture, or a control group. In this Zelen-design RCT, patients were randomized prior to informed consent. The participants that declined remained in an observational cohort. Patients in the acupuncture groups were treated in ...

JAMA. 2014 Oct 1;312(13):1313-22

Navigation-guided versus fluoroscopy-controlled THA: leg length and global/femoral offset

125 patients were randomized to use of either fluoroscopy or imageless navigation for the placement of a total hip arthroplasty (THA). The purpose of the study was to investigate whether use of imageless navigation improves accuracy, increases precision or reduces outliers in leg length and global/femoral offset restoration when compared to fluoros...

Clin Orthop Relat Res. 2014 Oct;472(10):3150-8.

Saphenous block provides similar analgesia to femoral nerve block in ACL reconstruction

80 patients scheduled to undergo anterior cruciate ligament (ACL) reconstruction with patellar tendon autograft were randomly assigned to receive femoral nerve block (FNB) or subsartorial saphenous nerve block (SSNB). The purpose of this trial was to compare the analgesic effectiveness of both nerve blocks with respect to pain relief, total narcoti...

HSS J. 2014 Oct;10(3):245-51.

Biophysical stimulation offers improved outcomes for talar osteochondral lesions

30 patients with grade III and IV osteochondral lesions of the talus suitable for arthroscopic bone marrow-derived cells transplantation were randomly allocated to pulsed electromagnetic fields (PEMF) or control. The aim of this trial was to compare clinical outcomes between groups using the American Orthopaedic Foot and Ankle Society (AOFAS) score...

Foot Ankle Int. 2014 Oct;35(10):981-7.

Aquatic exercise effectively manages symptoms associated with lower limb OA

11 randomized controlled trials (N=1092) comparing therapeutic aquatic exercise (TAE) with no intervention in patients with lower limb osteoarthritis (OA) were included in this systematic review/meta-analysis. The purpose of this study was to evaluate the effects of TAE on symptoms and function associated with lower limb OA. The outcomes of interes...

Phys Ther. 2014 Oct;94(10):1383-95.

Syndesmotic screw fixation vs. no fixation in supination-external rotation ankle fractures

24 patients undergoing surgical treatment for a supination-external rotation (SER) IV (Weber B) ankle fracture and intraoperatively confirmed syndesmosis disruption were randomized to syndesmotic screw fixation or no syndesmotic screw fixation. The purpose of this mid-term follow-up was to compare pain, function, and radiological results between tr...

Foot Ankle Int. 2014 Oct;35(10):988-95.

No difference between uniform and weighted dosing of TXA for hemostasis after TKA

44 patients undergoing total knee arthroplasty were randomized to a single uniform 1g dose of tranexamic acid or a single weighted 20mg/kg dose of tranexamic acid. The purpose was to determine if there was a difference between the two dosing regimens for reducing blood loss and transfusion requirements. Results demonstrated that there were no signi...

J Arthroplasty. 2014 Sep;29(9 Suppl):186-8

Aquatic exercise for musculoskeletal conditions comparable to land-based exercise

26 studies (24 randomized controlled trials and 2 quasi-randomized controlled trials) comparing aquatic exercise to no exercise and/or land-based exercise in the treatment of osteoarthritis, rheumatoid arthritis, fibromyalgia, low back pain, or osteoporosis patient populations were included in this meta-analysis. The purpose of this study was to in...

Arch Phys Med Rehabil. 2014 Sep;95(9):1776-1786

Rotator Cuff Repair: Double-row versus single-row appproach

This systematic review examined 8 meta-analyses (4 including Level I evidence and 4 including both Level I and Level II evidence) to determine whether double-row (DR) or single-row (SR) rotator cuff repair (RCR) resulted in superior clinical and structural healing outcomes. The findings of this systematic review of overlapping meta-analyses reveale...

Arthroscopy. 2014 Sep;30(9):1156-1165.

Hyperglycemic response appears attenuated by spinal anaesthesia in total hip arthroplasty

70 nondiabetic and diabetic patients undergoing elective total hip replacement were randomly allocated to undergo spinal or general anesthesia in preparation for surgery. The purpose of this study was to determine if spinal anesthesia offered improved glucose homeostasis compared to general anesthesia. Results revealed both nondiabetic and diabetic...

J Clin Anesth. 2014 Sep;26(6):455-60.

Bicompartmental & total knee arthroplasty achieve similar knee function 2 yrs post-surgery

50 patients with knee osteoarthritis in the medial and patellofemoral compartments were randomly allocated to undergo bicompartmental (BKA) or total knee arthroplasty (TKA). The purpose of this study was to compare functional and clinical outcomes between groups up to two years after surgery. At final follow-up, bicompartmental and total knee arthr...

J Arthroplasty. 2014 Sep;29(9):1790-4.

Immediate weight-bearing after Achilles tendon rupture similar to delayed weight-bearing

60 patients with an Achilles tendon rupture and treated conservatively were randomized to either immediate or delayed weight-bearing. Immediate weight-bearing allowed patients to bear full weight starting on day one of treatment, whereas the other group underwent nonweight-bearing for 6 weeks after the injury. Follow-up was scheduled at 6 and 12 mo...

J Bone Joint Surg Am. 2014 Sep 17;96(18):1497-503

Faster recovery from basal thumb arthroplasty with bone tunnel creation

79 women aged 40 years and older diagnosed with severe stage IV osteoarthritis (OA) were randomly assigned to undergo ligament reconstruction and tendon interposition (LRTI) of the basal thumb joint using either the Burton-Pellegrini (BP) or the Weilby technique. The BP technique uses a bone tunnel at the base of the thumb, while the Weilby techniq...

J Hand Surg Am. 2014 Sep;39(9):1692-8

Augmented BPTB autograft performs no better than standard autograft in ACL reconstruction

201 patients undergoing ACL reconstruction with a single-bundle bone-patellar tendon-bone autograft were randomized to either receive or not receive an augmentation device applied to the graft. The purpose was to compare clinical and functional outcome between the two techniques. Follow-up was conducted for 4 years postoperatively, and for 12 years...

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2109-20

Limited, short-term benefits of exercise on self-reported measures for hand OA

130 patients with hand osteoarthritis (OA) were randomly allocated to undergo a 12-week exercise program or standard care, with the primary purpose of determining the impact of exercise on self-reported hand activity performance. Overall, the exercise program was well tolerated among patients with hand OA, but it only produced small, short-term imp...

Osteoarthritis Cartilage. 2014 Sep;22(9):1224-33.

Web-based follow-up after THA/TKA: more feasible, cost-efficient and clinically effective

256 patients who underwent primary total hip/knee arthroplasty at least 12 months prior were randomized to participate in either a web-based follow-up or an in-person appointment, with the purpose of determining the feasibility and efficacy of web-based follow-up. Web-based follow-up appeared to be more feasible, cost-efficient and clinically effec...

J Arthroplasty. 2014 Sep;29(9):1723-8.

Effective pain management with IA clonidine for up to 4 hours after knee arthroscopy

Seven randomized controlled trials were included in this meta-analysis to investigate the efficacy of clonidine for postoperative pain management following knee arthroscopy. Included trials compared clonidine to placebo in the immediate postoperative period. Pooled estimates revealed significantly lower pain in those who received clonidine at 1, 2,...

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2076-84

Microdiscectomy improves clinical outcome compared to open surgery for slipped lumbar disc

200 patients with large uncontained lumbar disc herniation were randomized to either open (OPEN) or microendoscopic discectomy (MED). The purpose was to compare clinical outcomes of both techniques over an 8 year period. Clinical measures included the Numerical Rating Scale (NRS) for leg and back pain, as well as the Oswestry Disability Index (ODI)...

Eur Spine J. 2014 Sep;23(9):1992-9

Opening- vs closing-wedge osteotomy for medial compartment knee osteoarthritis

92 patients with medial compartment knee osteoarthritis were randomized to undergo opening- or closing-wedge osteotomy, with the purpose of comparing radiographic results, clinical outcomes, and survival rates between techniques 6 years post-surgery. There was no significant difference between groups with respect to radiographic or clinical outcome...

J Bone Joint Surg Am. 2014 Sep 3;96(17):1425-32. doi: 10.2106/JBJS.M.00786.

No difference in linear wear rate between oxinium and cobalt-chrome femoral heads in THA

80 adult patients undergoing total hip arthroplasty (THA) were randomly assigned to one of four bearing surfaces: cobalt-chrome (CoCr) and ultra-high molecular weight polyethylene (UHMWPE), CoCr and oxidized zirconium and cross-linked polyethylene (HXLPE), Oxinium and UHMWPE, and Oxinium and HXLPE. The purpose of this study was to investigate the c...

J Arthroplasty. 2014 Sep;29(9 Suppl):164-8

No added benefit of vitamin C on functional outcomes or healing of distal radial fractures

336 adult patients with an acute displaced or nondisplaced unilateral distal radial fracture were randomized to receive a 500 mg Vitamin C or placebo capsule daily for 50 days after the fracture. The purpose of this trial was to determine if the oral administration of Vitamin C after distal radius fracture improves functional outcomes. There was no...

J Bone Joint Surg Am. 2014 Sep 3;96(17):1451-9. doi: 10.2106/JBJS.M.00268.

Manipulation from 1-7 days after CCH injection is feasible for Dupuytren contractures

43 patients (46 digits) with Dupuytren contracture were randomly allocated to undergo manipulation at 1 or 7 days after collagenase Clostridium histolyticum (CCH) injection, with the purpose of comparing the efficacy and side effects of postponing manipulation. At 30 days follow-up, the efficacy of CCH was preserved in the 7-day manipulation group,...

J Hand Surg Am. 2014 Oct;39(10):1933-1941.e1. doi: 10.1016/j.jhsa.2014.07.010. Epub 2014 Sep 4.

THA via direct anterior approach results in quicker ambulation without assistive devices

54 patients undergoing primary total hip arthroplasty (THA) for primary degenerative arthritis of the hip were randomly assigned to undergo THA via a direct anterior approach or mini-posterior approach. The purpose of this study was to investigate if any differences in functional outcomes, SF-12, WOMAC, and HSS scores existed between the approaches...

J Arthroplasty. 2014 Sep;29(9 Suppl):169-72

Barbed sutures reduce cost and closing time compared to standard sutures in TKA

411 patients undergoing primary total knee arthroplasty (TKA) were randomized to receive either barbed running or knotted interrupted suture closure, with the purpose of comparing these two different layered closure techniques. The use of barbed running sutures resulted in shorter closing time and reduced cost. Aside from experiencing more intra-op...

J Arthroplasty. 2014 Sep;29(9 Suppl):135-8

Similar efficacy of radial & focused shockwave therapy for treating patellar tendinopathy

43 patients (57 tendons) with patellar tendinopathy were randomly allocated to undergo 3 sessions of radial or focused shockwave therapy, with the purpose of comparing the efficacy of the two shockwave treatments. Both therapies improved Victorian Institute of Sport Assessment-Patella (VISA-P) questionnaire scores and pain scores up to 14 weeks pos...

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2026-32. doi: 10.1007/s00167-013-2522-z. Epub 2013 May 12.

Lack of evidence to support routine use of patient-specific instrumentation in TKA

9 publications comparing standard instrumentation with patient-specific instrumentation for total knee arthroplasty were included in this review and meta-analysis. This study aimed to compare both sets of instrumentation in terms of coronal and sagittal alignment, operative time, intraoperative blood loss, and cost. Findings reported patient-specif...

J Arthroplasty. 2014 Sep;29(9):1709-12

Similar efficacy of EZLoc & Bone Mulch Screw femoral fixation in ACL reconstruction

110 patients undergoing anterior cruciate ligament (ACL) reconstruction were randomized to receive femoral fixation of the hamstring tendon graft using an EZLoc Femoral Fixation Device or a Bone Mulch Screw. The purpose of this study was to compare the efficacy of the two femoral fixation devices. Both devices achieved similar clinical results, kne...

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2153-62. doi: 10.1007/s00167-013-2652-3. Epub 2013 Sep 5.

Early surgery vs prolonged conservative treatment for sciatica patients with motor deficit

150 patients with 6-12 weeks of sciatica due to a lumbar disc herniation and moderate to severe motor deficit were randomly allocated to undergo early surgery or prolonged conservative treatment. This subgroup analysis of a previously published randomized controlled trial aimed to compare motor deficit recovery between groups. Patients allocated to...

Spine J. 2014 Sep 1;14(9):1817-24.

The effect of opioid therapy on osteoarthritis progression

200 patients with hip or knee osteoarthritis (OA) were randomized to conservative treatment with loxoprofen, tramadol/acetaminophen, or transdermal fentanyl. The purpose of this study was to compare rate of OA progression in the three treatments. Patients were treated for 12 weeks with the allocated therapy, then radiographically followed-up. The r...

Yonsei Med J. 2014 Sep;55(5):1379-85

Calcifying tendinitis of shoulder: high- vs low-energy extracorporeal shock wave therapy

This meta-analysis/systematic review identified 5 randomized controlled trials (359 patients) that compared high- to low-energy extracorporeal shock wave therapy (ESWT) for calcifying tendinitis of the shoulder. The aim of this analysis was to investigate functional outcome using Constant-Murley scores and radiologic resorption of calcium deposits ...

Clin Orthop Relat Res. 2014 Sep;472(9):2816-25. doi: 10.1007/s11999-014-3680-0. Epub 2014 May 29.

Periarticular injection for pain relief and early knee flexion angle after TKA

111 adult patients undergoing unilateral total knee arthroplasty were randomly assigned to periarticular injection or epidural analgesia for postoperative pain management. The purpose of this study was to compare the efficacy of each pain management technique in terms of pain relief and the frequency of opioid-related adverse effects. Results indic...

J Bone Joint Surg Am. 2014 Sep 3;96(17):1433-8

Time to anaesthesia similar between proximal & distal adductor canal block insertion sites

50 patients undergoing primary unilateral knee arthroplasty with an adductor canal block were randomized to either proximal or distal adductor canal catheter insertion. The purpose was to compare time to anaesthesia onset between the two insertion sites, and the effect each had on motor block. The results demonstrated no significant differences bet...

J Ultrasound Med. 2014 Sep;33(9):1653-62

Plate vs intramedullary nail fixation for distal metadiaphyseal tibial fractures

8 studies (N=455, 4 prospective randomized and 4 retrospective cohort or matched) were included in this meta-analysis/systematic review to determine if there are advantages to using plate fixation over intramedullary nailing for the treatment of distal meta-diaphyseal tibial fractures. Pooled analysis revealed plating of distal tibial fractures is ...

J Orthop Trauma. 2014 Sep;28(9):542-8.

Comparison of primary tendon repair vs physiotherapy treatment for rotator cuff tears

103 patients with a rotator cuff tear (less than 3 cm) were randomly assigned to primary tendon repair or physiotherapy treatment. The purpose of this trial was to compare surgical to non-operative treatment methods for rotator cuff tears. The primary outcome of interest was the Constant score. Findings indicated superior outcomes in Constant score...

J Bone Joint Surg Am. 2014 Sep 17;96(18):1504-14

Ferric carboxymaltose vs oral ferrous glycine sulphate for postoperative anaemia after TKA

122 adult patients with anaemia, iron deficiency, or both following total knee arthroplasty were randomly allocated to receive intravenous ferric carboxymaltose (FCM) or oral ferrous glycine sulphate (FS), with the purpose of comparing changes in hemoglobin (Hb) levels from postoperative day 4 to 30. Patients who received intravenous FCM experience...

Br J Anaesth. 2014 Sep;113(3):402-9.

Stellate ganglion block for upper limb surgery reduces pain and tramadol consumption

Thirty patients undergoing upper limb othropedic surgery were randomized to receive a stellate ganglion block injection of either lidocaine or saline. This randomized controlled trial aimed to determine the analgesic effect of a pre-operative stellate ganglion block on postoperative pain relief following orthopaedic surgery on the upper limb. Pre-o...

Anaesthesia. 2014 Sep;69(9):954-660

No significant advantage in neck coordination exercises in women with chronic neck pain

One hundred and eight female patients suffering from chronic, non-specific neck pain were randomly assigned to neck coordination exercises, strength training for the neck and shoulders or massage therapy. The purpose of this trial was to evaluate the sensorimotor effects of neck coordination exercises using a newly developed training device. The pr...

J Rehabil Med. 2014 Sep 30;46(9):908-14

Intensive strengthening and endurance exercise improves QoL after lumbar discectomy

Nintey eight patients with single-level lumbar disc herniation and scheduled for microdiscectomy were randomized to one of two groups postoperatively. One group underwent an intensive strengthening and endurance program, while the other group simply received an education session about back care. The purpose was to compare improvement between groups...

Clin Rehabil. 2014 Sep;28(9):892-901

Re-rupture rate appears similar between IT band and BPTB autografts in ACL reconstruction

60 patients scheduled for primary anterior cruciate ligament (ACL) reconstruction were randomized to receive either an iliotibial band autograft (ITB) or bone-patella-tendon-bone (BPTB) autograft. This study aimed to investigate whether an ITB autograft is a reliable long-term alternative to a bone-patella-tendon-bone (BPTB) autograft in ACL recons...

Knee Surg Sports Traumatol Arthrosc. 2014 Sep;22(9):2094-101.

Eccentric exercise beneficial over concentric in treating chronic lateral epicondylitis

One hundred and twenty patients with chronic lateral epicondylitis were randomized to undergo a 3-month home-based eccentric or concentric graded exercise regimen. The purpose of this study was to compare the impact of eccentric versus concentric exercise on elbow pain and function up to 12 months post-intervention. Eccentric graded exercise reduce...

Clin Rehabil. 2014 Sep;28(9):862-72.

No difference between one- and two-injection corticosteroid treatments for trigger finger

Ninety-seven adult patients suffering from stenosing tenosynovitis, also known as trigger finger, were randomly allocated to treatment using either two staged corticosteroid injections or a single injection. Disabilities of the Arm, Shoulder and Hand (DASH) scores were used to assess effectiveness of treatment; no significant differences in DASH sc...

Hand (N Y). 2014 Sep;9(3):340-5

Early ankle movement vs immobilization after ankle fracture surgery

This meta-analysis/systematic review contained 14 randomized or quasi-randomized controlled trials investigating early ankle movement compared to immobilization after ankle fracture surgery. Pooled analysis revealed the effect of early ankle movement on short-term functional outcomes remained unclear compared to immobilization, while no observable ...

J Orthop Sports Phys Ther. 2014 Sep;44(9):690-C7.

Similar outcomes in ultrasound and low-level laser therapy for myofascial trigger points

Sixty patients suffering from at least one myofascial trigger point in the upper trapezius muscle were randomly assigned to one of five different intervention groups: active ultrasound, placebo ultrasound, active low-level laser therapy, placebo low-level laser therapy, and no treatment. The purpose of this study was to evaluate the effectiveness o...

Physiother Res Int. 2014 Sep;19(3):166-75

Immobilization and passive motion yield similar tendon healing after rotator cuff repair

Data from 3 randomized controlled trials (265 patients) investigating early passive motion versus immobilization after arthroscopic rotator cuff repair was pooled in this meta-analysis in order to determine which rehabilitation protocol led to superior postoperative tendon healing. The pooled analysis revealed there were no significant differences ...

Arch Orthop Trauma Surg. 2014 Sep;134(9):1279-85.

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