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We found 2298 reports published by T (Newest First)

COA/AOA: Locked plates versus retrograde nails in distal femur fracture treatment

126 patients, ranging from 16-90 years of age, with fracture of the distal femur were randomized to internal fixation through either locked plating or retrograde intramedullary nailing. Participants were followed-up for 12 months for radiographic, functional, and physical outcomes. Both methods of internal fixation demonstrated a comparable rate of...

Radiation exposure to surgeon reduced during pedicle screw insertion with 3-D navigation

Twenty one patients scheduled for lower thoracic, and lumbar posterior stabilization with transforanimal interbody fusion were randomized to either a navigated or non-navigated procedure to compare radiation exposure to the surgeon and patient. Results indicated significantly lower radiation exposure to the surgeon with navigation (intraoperative 3...

Spine (Phila Pa 1976). 2014 Jun 1;39(13):1004-9. doi: 10.1097/BRS.0000000000000351.

The effect of continuous passive motion on patients following TKA

One hundred and sixty patients, between the ages of 18 and 90 years of age, who were scheduled to undergo primary total knee arthroplasty (TKA), were randomly assigned into 1 of 3 groups to determine the effect that continuous passive motion (CPM) had on clinical outcomes following surgery. Patients either received stationary CPM as an adjunct to p...

J Arthroplasty. 2014 Jun;29(6):1158-62

Sciatic nerve block vs. posterior capsule local anesthetic infiltration after TKA

One hundred patients undergoing total knee arthroplasty (TKA) were randomized to either femoral nerve block (FNB) alone, FNB combined with a sciatic nerve block (SNB), or FNB combined with posterior local anesthetic infiltration (P-LIA) to evaluate the analgesic efficacy of each. Patients were assessed over 3 months based on pain and function. The ...

J Arthroplasty. 2014 Jun;29(6):1149-53

Facet joint radiofrequency denervation may be efficacious in pain reduction for LBP

Nine studies (randomized/quasi-randomized clinical trials) were included in this systematic review and meta-analysis evaluating the efficacy of facet joint radiofrequency denervation (FJRD) when compared to nerve blockade, anaesthetic or corticosteroids, and placebo, in treatment of low back pain. Pooled results indicated a significant reduction in...

Spine (Phila Pa 1976). 2014 Jun 15;39(14):E842-9. doi: 10.1097/BRS.0000000000000337.

Improved cartilage volume in patients with knee OA with high tibial osteotomy receiving HA

Forty patients with medial compartment knee osteoarthritis (OA) and who underwent high tibial osteotomy (HTO) were randomized to investigate the effect of adding two courses of postoperative intra-articular hyaluronic acid injections. Patients either received either the HA injections or no treatment, and were monitored over 1 year with regards to c...

Knee Surg Sports Traumatol Arthrosc. 2014 Jun;22(6):1415-23

Intramedullary nail vs minimally invasive plate osteosynthesis for humeral shaft fractures

Forty one patients, who suffered a displaced humeral shaft fracture no more than 30 days before study initiation, were randomly assigned into 1 of 2 groups to compare the efficacy of intramedullary nailing, and minimally invasive plate osteosynthesis. Results from the study indicated that both treatments resulted in similar shoulder function 1 year...

J Shoulder Elbow Surg. 2014 Jun;23(6):767-74

Dislocated shoulder reduction: Suprascapular nerve block reduces hospital stay

Twenty one patients presenting with a dislocated shoulder in the emergency department were randomized to receive either procedural sedation analgesia (SA) or an ultrasound-guided suprascapular nerve block (SNB) prior to reduction. This study aimed to compare hospital stay and reduction success between these techniques. Results indicated comparable ...

Am J Emerg Med. 2014 Jun;32(6):549-52. doi: 10.1016/j.ajem.2014.02.014. Epub 2014 Feb 17.

Low-magnitude high-frequency vibration limits fracture risk in elders

710 elderly females were randomized to either receive low magnitude high-frequency vibration (LMHFV) or a control to investigate the efficacy of LMHFV in fracture prevention. Patients were monitored over 18 months based on fall and fracture rates, muscle performance, and bone quality. The evidence presented in this study demonstrated that LMHFV res...

Osteoporos Int. 2014 Jun;25(6):1785-95

Intramedullary fibular nail versus plate fixation for ankle fractures

71 patients with an ankle fracture were randomized to internal fixation using either an intramedullary nail or a plate. Patients were evaluated for radiographic union at 1 year postoperatively, and also assessed for functional outcome using the Kitaoka score and Olerud-Molander score. Results demonstrated similar union rates between intramedullary ...

Orthop Traumatol Surg Res. 2014 Jun;100(4Suppl):S255-9. doi: 10.1016/j.otsr.2014.03.005. Epub 2014 Apr 4

The effect of weight loss and exercise training on BMD in obese adults with OA

284 older (>55 years of age), overweight/obese adults with grade II-III radiographic tibiofemoral osteoarthritis (OA) or tibiofemoral plus patellofemoral OA, were randomly assigned to 1 of 3 groups to determine the effect dietary-induced weight loss and weight loss plus exercise had on bone mineral density (BMD). Patients took part in a dietary int...

Osteoarthritis Cartilage. 2014 Jun;22(6):726-33

Web-Based vs. Routine Follow-up after joint arthroplasty

256 patients 12 months or more postoperatively from total hip or knee arthroplasty were randomized to evaluate patient satisfaction with a web-based follow-up programme as opposed to routine follow-up. Patients were evaluated over 1 year based on a 7 point patient satisfaction questionnaire. The evidence presented in this study indicated that signi...

Clin Orthop Relat Res. 2014 Jun;472(6):1972-81

Autologous wound drains have no effect on transfusion rates following THA/TKA

575 patients scheduled to receive primary THA or TKA were randomly assigned to 1 of 3 groups to determine the effect an autologous blood transfusion applied at two postoperative intervals had on blood transfusion rate. Patients had their drain removed after 6 or 24 hours, (following autologous blood reinfusion) or received no wound drainage at all....

Bone Joint J. 2014 Jun;96-B(6):765-71

Pedicle screw position affects adjacent segment degeneration rate after instrumented PLF

210 patients undergoing instrumented posterolateral fusion were randomized to pedicle insertion through either the method by Du and Zhao or through Magerl's method. The purpose of the study was to determine whether the position of pedicle screws affects the rate of adjacent segment degeneration of the superior level over minimum follow-up of 9 year...

Spine (Phila Pa 1976). 2014 Jun 15;39(14):1093-8

Microfracture technique similar to osteochondral autologous transplantation mosaicplasty

25 patients with full-thickness chondral or osteochondral lesions of the knee were randomized to treatment with either osteochondral autologous transplantation (OAT) mosaicplasty or microfracture technique. The purpose of the study was to compare the long-term functional and radiological outcome between techniques. Results indicated comparable chan...

Knee Surg Sports Traumatol Arthrosc. 2014 Jun;22(6):1207-15. doi: 10.1007/s00167-014-2843-6. Epub 2014 Jan 21.

Effect of a fibromyalgia rehabilitation programme in warm and cold climates

132 Patients, between the ages of 18 and 60 years, diagnosed with fibromyalgia (FM) were randomly assigned into 1 of 3 groups to determine the effect of climate on the efficacy of a rehabilitation programme designed to help stem the effects of FM. Patients received treatment in either a warm or cold climate or received no intervention at all (contr...

J Rehabil Med. 2014 Jun 25;46(7):676-83

Comparison of plating, nailing, and external fixation of distal tibial shaft fracture

137 patients with a closed or open (grade I or II) distal tibial shaft fracture, were randomized to treatment with either external fixation, minimally invasive plate osteosynthesis, and intramedullary nailing. Patients were followed for 1 year postoperatively. There was no significant difference between groups in healing or time to radiographic uni...

Int Orthop. 2014 Jun;38(6):1261-7

The effect of a collar and surface finish on cemented femoral stems in THA patients

163 Patients, between the ages of 60 and 80 years, who had been diagnosed with primary osteoarthritis, and who were scheduled to undergo THA, were randomly assigned into 1 of 4 groups to determine the effect of collared/collarless stems with various surface area alterations on implant survivorship rates and subsidence. Patients received cemented fe...

Int Orthop. 2014 Jun;38(6):1131-7

Ilizarov external fixation vs. intramedullary nailing as treatment for tibial fractures

58 patients, between the ages of 18 and 75, with isolated displaced tibial shaft fractures, were randomly assigned into 1 of 2 groups to compare the efficacy of circular Ilizarov external fixator to intramedullary nailing for the fixation of tibial diaphyseal fractures. Upon study completion, healing analysis indicated that fractures in both groups...

Arch Orthop Trauma Surg. 2014 Jun;134(6):793-802

Strength training and proprioception exercises effective for sport injury prevention

25 randomized controlled trials were included in this review and meta-analysis investigating the effect of physical exercise interventions on sports injury prevention. Along with the risk ratio of overall effect for intervention, subgroup analyses were performed based on type of intervention (strength, proprioception, or stretching exercises). Outc...

Br J Sports Med. 2014 Jun;48(11):871-7

Safety and efficacy of edoxaban similar to enoxaparin for hip fracture surgery

92 patients undergoing hip fracture surgery were randomized to receive postoperative thromboprophylaxis with either oral once-daily edoxaban or once- or twice-daily subcutaneous injections of enoxaparin. This study aimed to compare the safety and efficacy between these two anticoagulant therapies. Results indicated a comparable percentages of patie...

Thromb Res. 2014 Jun;133(6):1016-22. doi: 10.1016/j.thromres.2014.03.009. Epub 2014 Mar 6.

The use of intra-articular hyaluronic acid in the treatment of Kashin-Beck disease

Data from 7 RCTs, investigating 955 intra-articular hyaluronic acid (IAHA) injection patients and 495 control patients, was pooled to evaluate the safety and efficacy of IAHA in the treatment of Kashin-Beck disease (KBD). The evidence presented in this meta-analysis indicated that the overall effectiveness of IAHA and control was 93.7% and 62.9% re...

Osteoarthritis Cartilage. 2014 Jun;22(6):718-25

Care initiated by nurses inferior to physician for radial-head subluxation reduction in ED

245 children with presumed diagnosis of radial-head subluxation were treated by either triage nurses or physicians in the emergency department in this cluster-randomized controlled trail, based on day of presentation. The purpose of this study was to determine whether nurse-initiated treatment was inferior to physician-initiated treatment with resp...

CMAJ. 2014 Jun 10;186(9):E317-23. doi: 10.1503/cmaj.131101. Epub 2014 Mar 24.

Efficacy of polynucleotide solution vs hyaluronic acid for knee osteoarthritis

72 patients with knee osteoarthritis were randomized to intra-articular injections of either Condrotide or hyaluronic acid. Condrotide is a gel containing a solution of polynucleotides. The purpose of this study was to compare the efficacy of Condrotide to that of hyaluronic acid (HA), a standard injection therapy for knee osteoarthritis. Assessmen...

Knee. 2014 Jun;21(3):661-8

Vertebroplasty for osteoporotic fractures yield no benefit over placebo at 2-years

78 patients with painful osteoporotic vertebral fractures were randomized to receive a vertebroplasty spinal procedure or placebo approach, with the purpose of comparing clinical outcomes between treatments up to two years. Results indicated no significant between group differences in overall pain (primary outcome) and all other secondary outcomes ...

J Bone Miner Res. 2014 Jun;29(6):1346-55.

Comparative efficacy of minimally invasive surgery for posterior lumbar fusion

26 studies were included in this systematic review (1 RCT, 11 prospective comparative cohort studies, 14 retrospective comparative cohort studies) comparing the surgical outcomes, clinical outcomes, and complication rates between minimally invasive surgery (MIS), and open transforanimal or posterior lumbar interbody fusion (Open) (856 patients in t...

Clin Orthop Relat Res. 2014 Jun;472(6):1727-37. doi: 10.1007/s11999-014-3465-5.

ECTES: Interscalene block vs. general anaesthesia for proximal humerus fracture fixation

50 patients suffering from a proximal humerus fracture of the shoulder were randomized to evaluate the efficacy of interscalene block anaesthesia (ISBA) against general anaesthesia (GA). Treatments were evaluated based on VAS pain, time needed to prepare anaesthesia, duration of operation, hemodynamic and respiratory stability, loss of blood during...

ECTES: Influence of learning style and gender in teaching anatomy

242 medical students attending a compulsory dissection cadaver course were randomized to receive training from either 5th year medical students, board-certified Orthopaedic Trauma surgeons, or no training. This study aimed to evaluate the influence of learning styles and gender characteristics. Results indicated higher scores in male versus female ...

ECTES: Intramedullary vs. plate fixation for dislocated midshaft clavicle factures

120 patients, between the ages of 18 and 65, with dislocated midshaft clavicle fractures, were randomly assigned into 1 of 2 groups to compare the effect intramedually nail fixation or plate fixation had on disability and complications. The short term results of the study indicated that patients in the plate fixation group experienced significantly...

ECTES: Intensive physiotherapy is more beneficial than usual PT for trauma patients

An unspecified number of trauma patients were randomized to undergo either an intensive or usual physical therapy regimen. The purpose of this study was to compare these two rehabilitation approaches with respect to short-term physical function, patient satisfaction and length of stay. Upon completion of the study, the more intensive physical thera...

TKA: Gap Balancing versus Measured Resection Techniques

103 patients undergoing primary total knee arthroplasty (TKA) were randomized to evaluate the efficacy of the gap balancing approach (GB) against the measured resection technique (MR) for TKA. Patients were monitored for 24 months, and were primarily evaluated on femoral component rotation (Hollywood Perth-Protocol CT-scan) and joint-line (defined ...

J Arthroplasty. 2014 May;29(5):950-4

Kineflex-L and CHARITE artificial discs yield similar rates of clinical success at 2 years

394 patients undergoing total disc replacement (TDR) were randomized to receive either the Kineflex-L or CHARITE artificial disc. A total of 63 non-randomized patients were also included in this study. The purpose of this trial was to compare these two discs with respect to rates of clinical success. Results over 24 months indicated that both the K...

Spine (Phila Pa 1976). 2014 May 20;39(12):925-31. doi: 10.1097/BRS.0000000000000319.

Role of high flexion implant design for cruciate-retaining TKA

132 patients undergoing cruciate-retaining total knee arthroplasty (TKA) were randomized to evaluate the efficacy of high flexion implants against a standard prosthetic. 122 patients were included in the analysis with 51 patients receiving standard prosthetic and 71 receiving the High Flex implant. Patients' preoperative, intraoperative, and 1 year...

J Arthroplasty. 2014 May;29(5):961-5

The effect of topical tranexamic acid on blood loss following TKA or THA

100 patients (50 TKA and 50 THA) who were over the age of 18 and scheduled to receive either TKA or THA, were randomly assigned into 1 of 2 groups (an intervention and a placebo) to determine the effect that topical tranexamic acid, applied at the joint space immediately prior to joint closure for TKA and THA, had on blood loss in patients followin...

J Arthroplasty. 2014 May;29(5):889-94

Shoelace technique for leg fasciotomy is both time and cost effective

50 patients with acute compartment syndrome stemming from leg fracture and/or blunt injury undergoing leg fasciotomy were randomized to wound closure through either vacuum-assisted closure (VAC) or the shoelace technique. This study aimed to compare wound outcome, time to closure, and complications between these treatments. Results indicated signif...

Injury. 2014 May;45(5):890-3. doi: 10.1016/j.injury.2012.02.002.

US guidance is beneficial in arthroscopic debridement for calcific rotator cuff tendinitis

20 patients undergoing arthroscopic debridement for calcific rotator cuff tendinitis were randomized to have the deposit located either with ultrasound guidance or using conventional methods. The purpose of this study was to compare these two techniques with respect to the number of needle punctures and time required to locate the calcific deposit,...

Arch Orthop Trauma Surg. 2014 May;134(5):651-6. doi: 10.1007/s00402-014-1927-6. Epub 2014 Feb 1.

Knee OA: Dietary support, knee exercise, or no treatment do not limit disease progression

192 obese patients with knee osteoarthritis (OA) who underwent a rigorous 16 week exercise program were randomized to receive dietary support, knee exercise, or no further treatment in order to investigate the effect of therapy on OA disease progression. Patients were monitored over 52 additional weeks using magnetic resonance imaging (MRI). The ev...

Osteoarthritis Cartilage. 2014 May;22(5):639-46

The effect of patella denervation on patient satisfaction and function following TKA

126 patients who were scheduled to undergo primary TKA due to osteoarthrosis were randomly assigned into 1 of 2 groups: a patella denervation group and a standard TKA group. The purpose was to determine the effect of patella denervation during the TKA procedure over 2 years postoperatively. The results of the study indicated that pain scores for an...

J Arthroplasty. 2014 May;29(5):977-81

Intravenous metamizole has a greater analgesic efficacy than paracetamol following THA

94 patients scheduled to undergo total hip arthroplasty were randomized to receive patient-controlled morphine paired with either intravenous metamizole or paracetamol as the postoperative analgesic regimen. The purpose of this study was to compare these two pharmacological interventions with respect to analgesic efficacy over the first 24 postoper...

Arch Orthop Trauma Surg. 2014 May;134(5):631-6. doi: 10.1007/s00402-014-1979-7. Epub 2014 Mar 28.

Povidone-iodine soaks: no additional benefit following drainage of hand abscesses

100 patients who were scheduled to receive treatment for their hand abscesses were randomly assigned into 1 of 2 groups to determine the effect povidone-iodine soaks had on the outcomes of hand infections that occurred following operative drainage. Patients were either treated with a daily povidone soak (3 times a day) or simply received a daily dr...

J Hand Surg Am. 2014 May;39(5):962-5

CDR and ACDF similarly cost-effective in the treatment of DDD

209 patients with cervical radiculopathy due to single level cervical degenerative disc disease (DDD) were randomized to undergo cervical arthroplasty (CDR) or anterior cervical discectomy and fusion (ACDF) in a previous investigational device exemption (IDE) trial. A cost-effectiveness analysis (CEA) was performed on data from the previous trial t...

J Neurosurg Spine. 2014 May;20(5):475-9

Resistance training and PEMF in hemophilia patients with osteoporosis

48 patients with severe haemophilia A and osteoporosis were randomized to one of four groups: (1) resistance training [RT] + sham pulsed electromagnetic fields (PEMF); (2) RT+ PEMF; (3) PEMF only; and (4) control group [i.e. no intervention]. These interventions occurred over a period of 6 weeks to determine the effect of resistance training and PE...

Clin Rehabil. 2014 May;28(5):440-50. doi: 10.1177/0269215513505299. Epub 2013 Nov 18.

Continuous and pulsed similar to sham ultrasound for knee osteoarthritis

60 patients, between the ages of 40 and 80 years, who had experienced knee pain for at least 6 months, and who were diagnosed with knee OA, were randomly assigned into 1 of 3 groups to determine the effect continuous and pulsed ultrasound had on pain and function in patients. Participants either received continuous ultrasound treatment, pulsed trea...

Am J Phys Med Rehabil. 2014 May;93(5):405-12

Mat-based and equipment-based Pilates both efficacious for chronic low back pain

86 patients with chronic low back pain were randomized to receive either mat-based or equipment-based Pilates. The purpose of this study was to compare efficacy between interventions in reducing pain and disability. Results indicated significant within-group improvements from baseline in pain intensity and disability for both groups. Patient-specif...

Phys Ther. 2014 May;94(5):623-31. doi: 10.2522/ptj.20130277.

Effect of teriparatide on vertebral fracture risk factors in osteoporosis patients

237 elderly men and postmenopausal women, between the ages of 65 and 91 years old, with primary osteoporosis with up to 5 prevalent vertebral fractures caused by low BMD of the lumbar spine, were randomly assigned into 1 of 2 groups, a treatment and a placebo, to determine the effect a once a week administration of 56.6 microgram teriparatide had o...

Curr Med Res Opin. 2014 May;30(5):931-6

Intracapsular hip fracture: Targon Femoral Neck hip screw similar to cannulated screws

174 patients (65 years and older) with an intracapsular hip fracture (displaced or undisplaced) were randomized to fixation with either the Targon Femoral Neck hip screw or standard of care using cannulated screws. The purpose was to compare interventions with respect to risk of revision surgery at 1 year. Results indicated no significant differenc...

Bone Joint J. 2014 May;96-B(5):652-7. doi: 10.1302/0301-620X.96B5.33391.

Resistance exercise and lumbar extensor exercise in the treatment of obese-patient cLBP

49 obese patients suffering from chronic low back pain (cLBP) were randomized to receive resistance exercise (TOTRX), lumbar extensor exercise (LEXT), or to a control group (CON), in order to investigate the role of lumbar muscle strength on walking endurance. Patients were monitored over 4 months. The evidence presented in this study demonstrated ...

PM R. 2014 May;6(5):418-26

ACLR: Quadriceps tendon autograft offers less donor-site morbidity than patellar tendon

51 patients with anterior cruciate ligament and scheduled for reconstruction surgery were randomized to receive either a quadriceps tendon-bone autograft or a bone-patellar tendon-bone autograft. The purpose of this study was to compare stability and donor-site morbidity associated with the two graft choices. Results after 2 years indicated similar...

Arthroscopy. 2014 May;30(5):593-8. doi: 10.1016/j.arthro.2014.01.012. Epub 2014 Mar 14

Single bupivacaine administration for pain reduction after iliac crest bone graft harvest

40 patients undergoing posterior spinal fusion with posterior iliac crest bone graft were randomized to receive either a single administration of bupivacaine or placebo at the donor site. The purpose of this study was to evaluate long-term pain management between the two groups. Results at 20 weeks indicated significantly lower pain (visual analogu...

Orthopedics. 2014 May 1;37(5):e428-34. doi: 10.3928/01477447-20140430-52.

Limb preconditioning significantly reduces pain following total knee arthroplasty

60 patients scheduled to receive unilateral TKA under tourniquet, were randomly assigned into 1 of 2 groups to determine the effect ischemic preconditioning had on postoperative pain, pain medication consumption, local inflammatory markers, and length of stay. Patients either partook in a preconditioning process before surgical intervention or rece...

Clin Orthop Relat Res. 2014 May;472(5):1467-74

Lower pain during activity with braceless rehab after ACLR vs with stabilizing brace

64 patients undergoing anterior cruciate ligament (ACL) reconstruction surgery with a patellar tendon autograft were randomized to receive rehabilitation with or without a stabilizing knee brace in order to investigate the effect of a knee brace. Patients were monitored over 4 years based on IKDC 2000, and KT1000 measurements, along with VAS and ra...

Knee Surg Sports Traumatol Arthrosc. 2014 May;22(5):1156-62

Local antibiotics added to routine regimen limits infection after IM for tibia fracture

Evidence from 21 studies (14 Retrospective or Case Studies; 6 RCTs; 1 Review) was identified using two distinct searches to evaluate the addition of locally-delivered antibiotics to prophylactic administration of systemic antibiotics in order to further limit incidence of infection of tibial fractures fixed intramedullary nailing. The evidence pres...

Int Orthop. 2014 May;38(5):1025-30

Deltoid split vs. deltopectoral approach for the treatment of humeral fractures

120 patients, >18 years of age, with displaced proximal humeral fractures were randomly assigned into 1 of 2 groups to compare the surgical efficacy of a deltoid split approach to a deltopectoral approach. The results of the study indicated that complications and reoperation rates were statistically similar between the two intervention methods. Con...

Clin Orthop Relat Res. 2014 May;472(5):1576-85

More accurate anteversion of acetubular components placed with patient-specific guides

36 patients undergoing total hip arthroplasty were randomized to undergo acetabular component placement using either patient-specific instrumentation (PSI) or standard mechanical guides. The purpose was to evaluate whether the use of PSIs resulted in more accurate positioning of the acetabular cup with respect to preoperative planned angles of ante...

J Arthroplasty. 2014 May;29(5):1030-7. doi: 10.1016/j.arth.2013.10.006. Epub 2013 Oct 16

TKA: Mini-midvastus approach yields better short-term outcomes vs. parapatellar approach

18 randomized controlled trials (937 patients; 1093 TKAs) comparing the mini-midvastus and parapatellar approaches in patients undergoing total knee arthroplasty (TKA) were included in this meta-analysis. The purpose of this review was to compare these two treatment approaches with respect to postoperative pain, function and complications. Pooled d...

PLoS One. 2014 May 20;9(5):e95311. doi: 10.1371/journal.pone.0095311. eCollection 2014.

The effect of an adductor canal block on pain following total knee arthroplasty

50 patients, between the ages of 30 and 85 years, who had just undergone unilateral TKA (post-op day 1 or 2) were randomly allocated to 1 of 2 groups to determine the effect an adductor canal block (ACB) had on postoperative pain. Patients in group 1 were administered an active ACB immediately after inclusion into the study, while those in group 2 ...

Br J Anaesth. 2014 May;112(5):912-9

Continuous low or high-concentration FNB vs. single injection following TKA

99 patients undergoing primary unilateral total knee arthroplasty were randomized to evaluate the efficacy of varied volumes and concentrations of a fixed dose of femoral nerve block (FNB). Patients were administered either a high-concentration, low-concentration, or single injection FNB, and were evaluated based on time to discharge readiness and ...

Clin Orthop Relat Res. 2014 May;472(5):1384-93

Denosumab and teriparatide significantly improves BMD in patients with osteoporosis

94 postmenopausal women, >45 years of age, who had been diagnosed with osteoporosis and who were at high risk for fracture, were randomly assigned into 1 of 3 treatment groups to determine the long term effect (24 months) a combination of denosumab and teriparatide had on hip and spine BMD. Patients either received a combined drug treatment of deno...

J Clin Endocrinol Metab. 2014 May;99(5):1694-700

Imageless computer-assisted TKA superior in mechanical alignment & short-term function

21 randomized controlled trials analyzing a total of 1713 knees were included in this meta-analysis comparing radiographic alignment and functional outcome between imageless computer-assisted (CAS) TKA to conventional TKA. Results indicated significantly better mechanical alignment and significantly higher Knee Society Scores in favour of CAS over ...

J Arthroplasty. 2014 May;29(5):938-44. doi: 10.1016/j.arth.2013.09.018.

Delayed LMWH lowers bleeding while maintaining DVT prophylaxis in TKA

210 patients undergoing primary total knee arthroplasty were randomized to administration of low-molecular-weight heparin (enoxaparin) started at either 12 hours or 24 hours after wound closure. The purpose of this study was to determine the effect of delayed LMWH administration (24h) on bleeding and the incidence of deep vein thrombosis after TKA ...

Arch Orthop Trauma Surg. 2014 May;134(5):679-83. doi: 10.1007/s00402-014-1939-2. Epub 2014 Feb 18

FIFA11+ programme reduced incidence of overall injury in male youth soccer players

416 male youth football (soccer) players in Africa were randomized to evaluate the injury-prevention efficacy of the FIFA11+ programme, when compared against routine training over 6 months. Players were evaluated primarily based on time-loss injury to players, injuries by type of exposure (match or training) and all injuries to lower extremities (L...

J Sports Sci Med. 2014 May 1;13(2):321-8. eCollection 2014

Operative vs. nonoperative treatment of complex proximal humeral fractures

Six randomized control trials were included in the meta-analysis investigating the efficacy between operative and nonoperative treatment for complex 3- and 4-part humeral fractures. Overall, outcomes were similar between operative and nonoperative treatment, with few differences noted in functional outcome up to 24 months. Operative management requ...

Orthopedics. 2014 May 1;37(5):e410-9

Interlaminar or transforaminal MI versus open MD for lumbar disc herniation sciatica

Evidence from 29 studies (n=4472), including 16 RCTs and 13 non-RCTs, was reviewed and, where possible, pooled to evaluate outcomes associated with 2 minimally invasive techniques (MI) and a conventional open microdiscectomy (MD) in the treatment of sciatica due to lumbar disc herniation. 21 studies compared interlaminar minimally invasive discecto...

Eur Spine J. 2014 May;23(5):1021-43

TLIF suggested to be not cost-effective compared to intrumented PLF in cLBP

100 patients with chronic low back pain were randomized to undergo either transforaminal lumbar interbody fusion (TLIF) or posterolateral fusion (PLF). The purpose of the current study was to evaluate the cost-utility and cost-efficacy of TLIF relative to PLF. Data on primary health care costs, secondary health care costs, and production loss costs...

Eur Spine J. 2014 May;23(5):1137-43. doi: 10.1007/s00586-014-3238-6. Epub 2014 Feb 21

Unilateral vs. bilateral screw fixation in degenerative lumbar diseases

12 studies (n=865; 9 RCTs, 1 prospective, 2 retrospective) were included in this meta-analysis comparing the clinical outcomes between unilateral pedicle screw fixation to bilateral pedicle screw fixation in the treatment of degenerative lumbar diseases. Pooled results demonstrated bilateral fixation led to a significantly higher rate of successful...

Eur Spine J. 2014 May;23(5):974-84. doi: 10.1007/s00586-014-3221-2.

Multimodal physical therapy versus sham for patients with hip osteoarthritis

102 patients with hip osteoarthritis were randomized to either an active or sham physical therapy program. The purpose of this study was to investigate the efficacy of a multimodal physical therapy program. Patients performed 10 supervised sessions over 13 weeks under a physical therapist, and were to continue with home regimens for 6 months afterw...

JAMA. 2014 May 21;311(19):1987-97. doi: 10.1001/jama.2014.4591

Anatomic double-bundle ACL reconstruction offers less knee laxity than single-bundle

Fifteen randomized controlled trials and prospective comparative studies were included in this meta-analysis which compared knee kinematics and graft failure rates between anatomic single-bundle anterior cruciate ligament (ACL) reconstruction and anatomic double-bundle ACL reconstruction. Pooled estimates of knee laxity (side-to-side difference in ...

Knee Surg Sports Traumatol Arthrosc. 2014 May;22(5):1009-23. doi: 10.1007/s00167-013-2811-6. Epub 2013 Dec 17

POISE 2 (Part 1): The safety and efficacy of aspirin following non-cardiac surgery

10,010 patients with, or at risk for, major vascular disease, and undergoing non-cardiac surgery were randomized to receive either aspirin or placebo (both with and without clonidine) as part of the Perioperative Ischemic Evaluation 2 (POISE-2) trial. This report, Part 1, summarizes the data pertaining to the safety and efficacy of aspirin, while c...

N Engl J Med. 2014 Apr 17;370(16):1494-503. doi: 10.1056/NEJMoa1401105. Epub 2014 Mar 31

POISE 2 (Part 2): The safety and efficacy of clonidine following non-cardiac surgery

10,010 patients with, or at risk for, major vascular disease, and undergoing non-cardiac surgery were randomized to receive either clonidine or placebo (both with and without aspirin) as part of the Perioperative Ischemic Evaluation 2 (POISE-2) trial. This report, Part 2, summarizes the data pertaining to the safety and efficacy of clonidine, while...

N Engl J Med. 2014 Apr 17;370(16):1504-13. doi: 10.1056/NEJMoa1401106. Epub 2014 Mar 31.

WCO-IOF: Prevention Nail System safety and efficacy in patients with osteoporosis

80 patients with severe osteoporosis and undergoing surgery for a femoral neck fracture were randomized to have the contralateral hip treated with or without the Prevention Nail System (PNS). The purpose was to determine if the PNS reduced the incidence of contralateral hip fractures in this patient population. Seven contralateral hip fractures wer...

WCO-IOF: Efficacy of an early, complex rehabilitation program following TKA

27 patients who had undergone total knee arthroplasty (TKA) were randomized to undergo either an early, complex rehabilitation program (treatment group) - including both supervised and home-based exercises - or standard care (control group). The purpose of this study was to compare these two rehabilitation protocols with respect to postoperative pa...

WCO-IOF: Changes with QCT, DXA, and TBS between denosumab, alendronate, & placebo

215 postmenopausal women with low spine or total hip bone mineral density (BMD) were randomized to treatment with either denosumab, alendronate, or placebo for a period of 12 months. Quantitative computed tomography (QCT) and densitometry (DXA), in addition to a novel trabecular bone score (TBS) were evaluated to determine if a differences exists b...

WCO-IOF: Vitamin D supplementation appears to improve muscle function

A meta-analysis was performed including 21 randomized controlled trials (RCTs) to examine the effect of vitamin D supplementation on muscle function. Results indicated a small effect of vitamin D supplementation on global muscle strength, a moderate effect on muscle mass, but no effect on muscle power. Patients who were either < 65 years old or had...

WCO-IOF: The addition of kinetotherapy to usual care for hip OA improves pain and function

25 patients with primitive bilateral hip osteoarthritis were randomized to undergo usual care either on its own or with the addition of kinetotherapy. The purpose of this study was to determine whether this combined treatment yielded significant improvements in pain and functional outcomes. Results indicated that although patients in both groups de...

WCO-IOF: Rituximab positively impacts QOL in patients with rheumatoid arthritis

98 patients diagnosed with rheumatoid arthritis (RA) were randomized to receive methotrexate with or without rituximab therapy to determine effect of rituximab on quality of life in this patient population. The Euro-QOL 5 dimension (EQ-5D) and Health Assessment Questionnaire for Rheumatoid Arthritis (HAQ) were assessed over 24 months. Upon analysis...

WCO-IOF: Teriparatide injected once weekly reduces fracture risk regardless of subgroup

In a previous randomized controlled trial, 542 patients (65-95 years) with osteoporosis were randomized to receive an injection of 56.5 mg teriparatide or a placebo injection, once weekly, to determine the effect of this treatment approach on vertebral fracture risk. The purpose of the current analysis was to determine whether the effects remain in...

WCO-IOF: A comparison of physical therapy modalities for glenohumeral OA

30 patients with moderate glenohumeral osteoarthritis (OA) were randomized to undergo one of two combinations of physical therapy modalities. In group A, patients underwent breaststroke swimming with galvanic current therapy and paraffin therapy, while in group B, patients underwent breaststroke swimming with low-level laser therapy (LLLT) and tran...

WCO-IOF: Kinetotherapy with usual care improves pain and function in patients with knee OA

62 patients with primitive bilateral knee osteoarthritis (stage I, II, or III) were randomized to undergo usual care with or without the addition of kinetotherapy. The purpose of this study was to determine whether this combined treatment yielded significant improvements in pain and functional outcomes. Results indicated that patients in both group...

WCO-IOF: Rituximab for rheumatoid arthritis positively impacts BMD of femoral neck

92 patients diagnosed with rheumatoid arthritis (RA) were randomized to receive methotrexate with or without rituximab therapy to assess the impact of rituximab treatment on bone mineral density (BMD) at the femoral neck. BMD and T-scores significantly increased after 3 years in patients who received methotrexate and rituximab therapy, and maintain...

WCO-IOF: Better outcome with hydrotherapy vs. conventional exercise after hip arthroplasty

58 patients who underwent recent hip arthroplasty were randomized to postoperative rehabilitation involving either hydrotherapy or conventional exercise for 12 days. This study aimed to compare functional outcome between the two rehabilitation modalities following discharge from the program and at 6-month follow-up. Results indicated improvements i...

WCO-IOF: Dynamic electroneurostimulation vs placebo for osteoporotic spine fractures

60 postmenopausal women at least one osteoporotic vertebral fracture were randomized to receive dynamic electroneurostimulation (DENS) or placebo treatment to determine the effect of DENS on back pain and quality of life. Upon analysis, 10 treatment sessions of dynamic electroneurostimulation once daily (or every other day) was associated with sign...

WCO-IOF: Similar functional outcome between hydrotherapy and physiotherapy in hip OA

30 patients with hip osteoarthritis were randomized to intervention through either hydrotherapy or conventional physiotherapy. The purpose was to determine how the treatments compared with respect to pain, function, and health-related quality of life. The results indicated that both groups significantly improved in pain within 2 weeks. Hydrotherapy...

Exercise is beneficial in frail older adults, however the optimal regimen remains unknown

19 randomized controlled trials examining the effects of physical exercise in frail older adults were included in this review. The purpose was to determine whether exercise influenced performance-based measures of physical function, using a definition of frailty which takes into account the individual level of physical function and ability to perfo...

Arch Phys Med Rehabil. 2014 Apr;95(4):753-769.e3. doi: 10.1016/j.apmr.2013.11.007. Epub 2013 Nov 27

Dexamethasone and triamcinolone injections comparable for radicular pain

78 patients suffering from unilateral radicular pain were randomized to receive a transforaminal epidural steroid injection using either particulate (dexamethasone) and nonparticulate (triamcinolone) corticosteroid. The purpose was to evaluate if there were any differences between corticosteroid preparations over 6 months of follow-up. The evidence...

Pain Med. 2014 Apr;15(4):548-55

Myofascial release as an adjunct to specific back exercise for treatment of CLBP

80 nursing professionals (aged 20 to 40 years) who were diagnosed with chronic low back pain (pain for 3 or more months) were randomly assigned into 1 of 2 groups to determine if myofascial release effectively reduces chronic low back pain. Patients received either a direct myofascial release (MFR) treatment or a sham treatment. The results of the ...

J Bodyw Mov Ther. 2014 Apr;18(2):273-81

Short-term benefits of tamoxifen in Dupuytren patients with a predisposition to fibrosis

30 Patients suffering from Dupuytren disease, with a predisposition toward fibrosis, were randomized to evaluate the efficacy of tamoxifen against a placebo, following subtotal fasciectomy. Patients were regularly assessed over 2 years to evaluate improvements of total passive extension deficit, and satisfaction as determined by the visual analogue...

J Bone Joint Surg Am. 2014 Apr 16;96(8):655-62

The effect of lumbopelvic belts on trunk muscles in patients suffering from low back pain

60 healthy male volunteers, between the ages of 18 and 55 years, with no history of low back pain, were randomly assigned into 1 of 2 groups to determine the effect lumbopelvic belts had on the thickness of lateral abdominal and lumbar multifidus (LM) muscles- two muscle groups that are closely related to spine stability. Patients received 8 weeks ...

PM R. 2014 Apr;6(4):302-8

The effect of adjuvant aromatase inhibitors on BMD in women with breast cancer

497 postmenopausal women with hormone-receptor-positive breast cancer were randomized to receive adjuvant exemestane 25 mg or anastrozole 1 mg daily for 5 years. Two subgroups were identified: those with baseline T-scores of -2.0 or greater at the spine and hip (subgroup 1), and those with baseline T-scores less than -2.0 at the spine and hip and t...

Lancet Oncol. 2014 Apr;15(4):474-82. doi: 10.1016/S1470-2045(14)70035-X. Epub 2014 Mar 11

Nondisplaced scaphoid fracture union with and without thumb immobilization

62 patients with a fracture of the scaphoid waist were randomized to below-elbow casting with or without immobilization of the thumb. Cast were worn for 10 weeks. The purpose was to assess the extent of union after 10 weeks with both treatment options. Computed tomography (CT) scans at 10 weeks revealed a significantly greater extent of union acros...

J Hand Surg Am. 2014 Apr;39(4):621-7

Analgesics have no effect on functional outcome in CLBP patients

50 patients suffering from chronic low back pain were randomized to investigate the effect of acetaminophen and tramadol in achieving favorable outcomes of function, self-reported disability, and pain relief in patients, when compared to a placebo administered over 2 weeks. The evidence presented in this study suggested that the use of acetaminophe...

Eur Spine J. 2014 Apr;23(4):800-6

Open-door vs. French-door laminoplasty for cervical compressive myelopathy

92 patients with cervical compressive myelopathy who were scheduled to undergo cervical posterior compressive surgery were randomly assigned into 1 of 2 groups to determine the efficacy of French- and open-door laminoplasty. The results of the study indicated that French-door laminoplasty and open-door laminoplasty led to similar neurological recov...

Spine (Phila Pa 1976). 2014 Apr 15;39(8):642-7

Imageless computer-assisted navigation yields superior cup placement vs freehand in THA

130 patients scheduled for total hip arthroplasty (THA) were randomized to undergo the procedure using either a computer-assisted imageless navigation system or a freehand technique. The purpose of this study was to compare the angles of inclination and anteversion of the acetabular cup, along with functional outcomes. Results at a mean follow-up o...

J Arthroplasty. 2014 Apr;29(4):786-91. doi: 10.1016/j.arth.2013.08.020. Epub 2013 Nov 26

Platelet rich plasma superior to corticosteroid injections for plantar fasciitis treatment

40 patients with chronic unilateral plantar fasciitis, who had failed extensive, traditional, nonoperative management, were randomly assigned into 1 of 2 treatment groups to determine if platelet rich plasma injections effectively treated chronic unilateral plantar fasciitis. Patients either received a single ultrasound guided injection of autologo...

Foot Ankle Int. 2014 Apr;35(4):313-8

The effect of trigger point dry needling on acute mechanical neck pain

17 patients with acute mechanical, idiopathic, unilateral neck pain were randomly assigned into 1 of 2 groups to determine if trigger point dry needling had any effect on neck pain, pressure pain sensitivity, and cervical range of motion 1 week after intervention. Patients received either trigger point dry needling intervention or no intervention a...

J Orthop Sports Phys Ther. 2014 Apr;44(4):252-60

Addition of ketamine to morphine significantly reduced pain after orthopaedic surgery

60 patients undergoing orthopaedic surgery were randomized to investigate the synergistic effects of ketamine and opioids in terms of patient-controlled analgesia (PCA). Patients were monitored over 48 hours postoperatively, and were evaluated based of VAS pain and narcotic use. The evidence presented in this study indicated that the addition of ke...

Perspect Clin Res. 2014 Apr;5(2):85-7

More re-tears in single- as compared to double-row rotator cuff repair

7 level I randomized controlled trials comparing single- and double-row rotator cuff repair were included in this meta-analysis. The purpose of this review was to compare the clinical and structural outcomes associated with each treatment approache. Pooled data revealed that single- and double-row anchoring techniques yielded similar American Shoul...

J Shoulder Elbow Surg. 2014 Apr;23(4):586-97. doi: 10.1016/j.jse.2013.10.006. Epub 2014 Jan 8

The role of acetaminophen and ibuprofen for pain relief in children undergoing pin removal

240 children who had undergone closed reduction and percutaneous pinning for either a suprocondylar humeral fracture or a lateral humeral condyle fracture were randomized to receive acetaminophen, ibuprofen or a placebo tablet, one hour prior to pin removal. The purpose of this study was to compare the effects of these treatment approaches with res...

J Bone Joint Surg Am. 2014 Apr 2;96(7):597-602. doi: 10.2106/JBJS.M.00806.

Benefits of a knee extension constraint device in ACL injury prevention program

28 athletes with knee flexion angles of less than 30 degrees were randomized to investigate the efficacy of a knee extension constraint device in improving knee flexion angles during peak impact posterior ground-reaction force, and in decreasing peak impact ground-reaction forces during landing of a stop-jump, and side-cutting task. The evidence pr...

Am J Sports Med. 2014 Apr;42(4):979-86

Direct decompression with radiotherapy for metastatic epidural spinal cord compression

5 studies (1 RCT) involving adults who were diagnosed with metastatic epidural spinal cord compression (MESCC) that compared direct decompression with tumor removal followed by RTx to RTx alone were analyzed to determine the efficacy of the two treatments. The results of the meta-analysis indicated that patients who received direct decompressive su...

Spine (Phila Pa 1976). 2014 Apr 20;39(9):E587-92

Femoral tunnel enlargement reduced with autologous ruptured tissue vs conventional DB ACLR

10 patients with ACL deficiencies were randomized to undergo double-bundle ACLR with either autologous ruptured ACL tissue sutured to grafts or conventional grafts, to compare magnitude of tunnel enlargement and clinical outcomes. Results indicated a significant decrease in femoral tunnel enlargement between groups, favouring the ruptured tissue gr...

Arthroscopy. 2014 Apr;30(4):468-74. doi: 10.1016/j.arthro.2013.12.014.

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