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We found 2168 reports published by T (Newest First)

6-month administration of teriparatide improves spinal BMD in women with anorexia nervosa

21 women with anorexia nervosa (according to DSM IV weight and psychiatric criteria), and a T-score of -2.5 or less, were randomized to self-administer a subcutaneous injection into the abdomen of either 20 ug teriparatide or placebo. The purpose of this study was to examine the effects of teriparatide (TPT) on bone mineral density and markers of b...

J Clin Endocrinol Metab. 2014 Apr;99(4):1322-9. doi: 10.1210/jc.2013-4105. Epub 2014 Jan 23

Early vs standard zoledronic acid treatments for prostate cancer metastatic to bone

645 patients with castration-resistant prostate cancer and bone metastases were randomized to either early administration of zoledronic acid or standard administration of zoledronic acid initiated following progression to castration-sensitive disease. The purpose was to determine whether early treatment would reduce time to developing a skeletal-re...

J Clin Oncol. 2014 Apr 10;32(11):1143-50. doi: 10.1200/JCO.2013.51.6500.

Orthopaedic evidence needs more diverse study populations

Data from 158 United States randomized controlled trials, investigating 37,625 patients, was analyzed in this systematic review to evaluate the inclusion of, and the reported rates of race and/or ethnicity in orthopaedic evidence. The findings presented in this analysis demonstrated a deficit in the number of United States-conducted orthopaedic ran...

J Bone Joint Surg Am. 2014 Apr 2;96(7):e56

Deep massage & neural mobilization to posterior calf muscles as treatment for heel pain

69 patients with plantar heel pain syndrome were randomized to receive either a deep massage therapy with neural mobilization and a self-stretch exercise program directed to the posterior calf muscles or therapeutic ultrasound therapy to the heel region with the same self-stretch exercise program to compare pain relief and function between these in...

Man Ther. 2014 Apr;19(2):102-8. doi: 10.1016/j.math.2013.08.001.

Radiostereometric analysis: no additional benefit of Unique femoral stem compared to AGB-I

100 patients with primary or secondary osteoarthritis were randomized to investigate any additional benefits associated with the use of the Unique customized stem compared with the conventional ABG-I stem. Patients were evaluated over 5 years using radiostereometric (RSA). The evidence presented in this study revealed no improvement in long-term me...

Acta Orthop. 2014 Apr;85(2):152-8

Frozen shoulder: Comparison of exercise class, individual physiotherapy, and home exercise

75 patients diagnosed with frozen shoulder were randomized to one of three common physiotherapy interventions - physiotherapist-supervised exercise class (EC) with home exercise, individual multimodal physiotherapy (IMP) and home exercise, or home exercise (HE) alone - to compare patient-reported outcomes. Results indicated more significant improve...

J Shoulder Elbow Surg. 2014 Apr;23(4):500-7. doi: 10.1016/j.jse.2013.12.026.

NCB-DF polyaxial vs LISS monoaxial plates in treatment of distal femur fractures

27 patients with a distal femur fracture were randomized to be treated with either the Non-Contact Bridging (NCB-DF) polyaxial plate or the Less Invasive Stabilizing System (LISS) monoaxial plate. The purpose of this study was to compare clinical/functional and radiographic outcome between to the two systems over the first postoperative year. Overa...

Int Orthop. 2014 Apr;38(4):857-63

A 12-month home-based exercise program reduces the risk of LBP in office workers

563 full-time office workers with limited trunk extension range of motion and trunk muscle endurance were randomized to either undergo a 12-month, home-based exercise program (focusing on trunk muscle stretching and endurance exercises), or not. The purpose of this study was to determine whether this exercise program had an effect on the incidence ...

Eur Spine J. 2014 Apr;23(4):786-93. doi: 10.1007/s00586-014-3212-3. Epub 2014 Feb 4

Intramedullary nailing versus plating for distal tibial metaphyseal fracture

14 studies (5 prospective and 9 retrospective) were included in this meta-analysis (842 patients) comparing the clinical outcomes and complication rates between intramedullary nailing (IMN) and plating. Results from meta-analysis revealed significant between-group differences in infection rate favouring IMN, and malunion rate favouring plating. Rat...

Injury. 2014 Apr;45(4):667-76. doi: 10.1016/j.injury.2013.10.024.

Enhanced therapeutic alliance plays an important role in pain relief in cLBP patients

117 patients with non-specific chronic low back pain were randomized to receive either active or sham interferential current therapy (IFC) with either limited or enhanced therapeutic alliance (TA). The purpose of this study was to determine the immediate role of TA in relieving pain in these patients. Results indicated that active IFC with enhanced...

Phys Ther. 2014 Apr;94(4):477-89. doi: 10.2522/ptj.20130118. Epub 2013 Dec 5

High-energy ESWT effective in treating chronic calcific shoulder tendinitis

28 RCTs (n=1745) were included in this systematic review to compare the benefits and harms of low- and high-energy extracorporeal shockwave therapy (ESWT), and to compare ESWT to placebo and other treatments, for the treatment of calcific and noncalcific tendinitis. Additionally, treatment effects between calcific and noncalcific conditions were co...

Ann Intern Med. 2014 Apr 15;160(8):542-9. doi: 10.7326/M13-1982.

Uncemented stems: Higher function but increased risk of late periprosthetic fracture

223 patients (with 230 fractures) were randomized to either an uncemented femoral stem or cemented femoral stem in hemiarthroplasty for a displaced femoral neck fracture. While outcomes at 3 months and 1 year were demonstrated to be similar, this study reported on functional outcome, health-related quality of life, and complications at a median of ...

Clin Orthop Relat Res. 2014 Apr;472(4):1291-9

Lorazepam vs. Diazepam in the treatment of Pediatric Status Epilepticus

Three hundred and ten patients, aged 3 months to 18 years, exhibiting tonic-clonic status epilepticus were randomized to determine a superior treatment between lorazepam and diazepam. Goals of treatment were cessation of status epilepticus by 10 minutes, without recurrence within 30 minutes. Patients were evaluated over 4 hours after treatment, an...

JAMA. 2014 Apr 23-30;311(16):1652-60

Outcomes similar between cruciate-retaining and posterior-stabilized TKA

Eight randomized controlled trials (RCTs) were included in this meta-analysis comparing the outcomes of posterior-stabilized (PS) and cruciate-retaining total knee arthroplasty. Outcomes of interest included range of motion, flexion angle, extension angle, clinical measures (knee society scores), survivorship, and complications. Pooling indicated s...

Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):556-64

Buddy strapping and aluminum orthoses in PIP joint hyperextension injuries

121 patients (83 children and 38 adults) with a proximal interphalangeal joint hyperextension injury without fracture were randomized to treatment through either buddy strapping with the neighbour finger or an aluminum orthosis which immobilized the joint at 15 degrees flexion, with each applied for one week. The purpose was to determine whether th...

J Hand Surg Am. 2014 Mar;39(3):449-54

Rotator cuff tendinopathy: Pilot methodology for self-managed exercise vs physiotherapy

24 patients with chronic rotator cuff disorders/tendinopathy were randomized to receive either a self-managed exercise programme, or usual physiotherapy. This pilot study was conducted to evaluate a new research methodology comparing the clinical efficacy between these treatments. The proportion of participants willing to be randomized was excellen...

Physiotherapy. 2014 Mar;100(1):54-60. doi: 10.1016/j.physio.2013.06.001.

Tourniquet use in TKA increases the risk for complications and early functional impairment

13 randomized controlled trials comparing tourniquet use to non-use in patients undergoing total knee arthroplasty (TKA) were included in this review. The purpose of this study was to determine the effect of tourniquet use on surgical, clinical and functional outcomes. Results indicated that although significant improvements were observed for intra...

J Orthop Surg Res. 2014 Mar 6;9(1):13. doi: 10.1186/1749-799X-9-13.

Clinical/functional outcome similar with vascularized or nonvascularized graft in nonunion

75 patients with scaphoid nonunion were randomized to receive either vascularized bone grafts (VBG) or distal radius nonvascularized bone grafts (NVBG) to compare union rates, time to union, and functional outcome. Results revealed faster bone union with VBG, but overall union rates were similar to NVBG. Ulnar deviation was statistically less sign...

J Orthop Trauma. 2014 Mar;28(3):e44-8. doi: 10.1097/BOT.0b013e3182a4a91a.

Using the transverse acetabular ligament as a guide in THA improves component alignment

80 patients undergoing total hip arthroplasty (THA) were randomized to have the acetabular component implanted either using the transverse acetabular ligament (TAL) as a guide or using a conventional freehand technique. The purpose of this study was to compare these two approaches with respect to the anteversion and inclination of the acetabular co...

Bone Joint J. 2014 Mar;96-B(3):312-8. doi: 10.1302/0301-620X.96B3.32989.

Myocardial injury after noncardiac surgery: Diagnostic criteria and 30-day outcomes

15,065 patients undergoing elective or urgent/emergency (i.e. non-cardiac) surgery under general or regional anesthesia were assessed for myocardial injury after noncardiac surgery (MINS) over the first 30 postoperative days. The purpose of this study was to establish the diagnostic criteria of MINS, as well as to determine the characteristics, pre...

Anesthesiology. 2014 Mar;120(3):564-78. doi: 10.1097/ALN.0000000000000113.

Patient-specific guides do not improve CT-assessed component alignment in TKA

63 male patients (64 knees) undergoing total knee arthroplasty (TKA) were randomized to receive treatment using either patient-specific cutting blocks - derived from 3D preoperative CT images - or standard instrumentation. The purpose of this study was to compare these two approaches with respect to component alignment and short-term clinical outco...

J Bone Joint Surg Am. 2014 Mar 5;96(5):366-72

Axillary nerve block & local anesthetic for elbow arthroscopy yield similar pain outcomes

36 patients undergoing arthroscopic elbow surgery under general anesthesia were randomized to receive an axillary nerve block or local anesthetic injection, with the purpose of comparing early functional outcomes between groups. During the first 48 hours post-operation, pain at rest and during physiotherapy, the number of required loxoprofen tablet...

J Shoulder Elbow Surg. 2014 Mar;23(3):291-6. doi: 10.1016/j.jse.2013.11.022. Epub 2014 Jan 15.

Patient-specific vs conventional instrumentation for component rotational alignment in TKA

45 patients scheduled to undergo total knee arthroplasty (TKA) were randomized to receive either patient-specific or conventional instrumentation. The purpose of this study was to compare these two techniques with respect to the rotational alignment of both the femoral and tibial components, as assessed by computed tomography (CT). Results at 1 wee...

Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):636-42. doi: 10.1007/s00167-013-2639-0. Epub 2013 Aug 29.

36mm metal-on-metal THA increases metal ion & erythrocyte cobalt levels vs 28mm bearing

105 patients with unilateral noninflammatory degenerative joint disease were randomized to undergo total hip arthroplasty using either a 28mm metal-on-metal bearing surface, a 36mm metal-on-metal bearing surface, or a 28mm metal-on-polyethylene bearing surface. The purpose of this study was to compare metal ion levels and clinical outcomes between ...

J Bone Joint Surg Am. 2014 Mar 19;96(6):448-55. doi: 10.2106/JBJS.M.00164.

Displaced Femoral Neck Fracture: Long-term complications fewer with THA

143 patients with a displaced femoral neck fracture were randomized to treatment with either total hip arthroplasty (THA) or internal fixation; of these, 54 were mentally impaired and 89 were lucid elderly patients. Participants were followed-up over an extended time period to evaluate the long-term complication rates of each intervention. Results ...

J Bone Joint Surg Am. 2014 Mar 19;96(6):e46. doi: 10.2106/JBJS.K.00244.

Clinical outcome similar between double-high and medial-pivot insert in TKA

40 patients undergoing ADVANCE total knee arthroplasty were randomized to receive either a double-high or a medial-pivot insert in order to compare clinical outcomes. Midterm follow-up results at 4-5 years post-surgery revealed improvements in clinical outcomes within each group. However, no significant differences between inserts were observed wit...

Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):576-80. doi: 10.1007/s00167-012-2314-x.

Effect of a preoperative home exercise programs on mobility and function following TKA

122 patients with non-inflammatory osteoarthritis scheduled to undergo primary unilateral TKA were randomized to complete a home exercise program 6 weeks before surgery, or not. This study aimed to determine whether this preoperative intervention would improve mobility and function following TKA. Patients experienced significant improvements in pas...

Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):703-9. doi: 10.1007/s00167-012-2349-z.

Oral non-steroidal anti-inflammatory drugs: viable for treating rotator cuff tendinopathy

12 randomized control trials comparing oral non-steroidal anti-inflammatory drugs (NSAIDs) to any another intervention for adult patients with rotator cuff tendinopathy were included in this systematic review/meta-analysis. Upon analysis, low to moderate grade evidence supports the use of oral non-steroidal anti-inflammatory drugs (NSAIDs) for shor...

J Rehabil Med. 2014 Mar 31;46(4):294-306. doi: 10.2340/16501977-1800.

Recovery from sensory and motor blockade quicker with levobupivacaine vs. bupivacaine

60 patients undergoing surgery for single-level lumbar disc herniation were randomized to spinal anaesthesia using either bupivacaine or levobupivacaine. The purpose was to compare the two local anaesthetic solutions with respect to efficacy in sensory and motor blockade. Results indicated that recovery time from anaesthesia was significantly short...

Eur Spine J. 2014 Mar;23(3):695-700

Deformity correction with serial casting and orthosis in children with metatarsus adductus

27 children below the age of 9 months and with metatarsal adductus were randomized to treatment with either serial casting or an orthosis. Intervention was discontinued once footprints and clinical examination indicated the deformity had resolved. Both groups demonstrated significant correction in calcaneal-fifth metatarsal angle, talo-first metata...

J Orthop Sci. 2014 Mar;19(2):250-6

TKA: Similar rates of anterior knee pain with fixed and mobile bearings after 7.9 years

69 patients undergoing primary TKA for unilateral knee osteoarthritis were randomized to undergo the procedure using either mobile or fixed bearings, with the purpose of comparing incidence of anterior knee pain between groups at a mean of 7.9 years post-surgery. At long-term follow-up, the incidence of anterior knee pain, overall pain, function, a...

Knee Surg Sports Traumatol Arthrosc. 2014 Mar;22(3):509-16. doi: 10.1007/s00167-012-2281-2. Epub 2012 Nov 3.

Higher complication rates and worse outcome following spinal surgery in obese individuals

32 studies (8 prospective, 24 retrospective; n=97,326) were included in this meta-analysis examining the effect of obesity on complication rates, mortality, revision rates, operative time and blood loss. Meta-analysis of level I/II studies revealed higher surgical site infection rate, higher risk of venous thromboembolism, higher revision rate, lon...

Clin Orthop Relat Res. 2014 Mar;472(3):968-75. doi: 10.1007/s11999-013-3346-3

Functional brace vs walking boot in management of severe lateral ankle sprains

186 patients with a severe lateral ankle sprain (type III) were randomized to treatment to 3 weeks of rigid immobilization with a walking boot followed by 3 weeks of immobilization with a functional brace, or to a functional brace for 6 weeks. The purpose was to compare these two conservative treatment methods for outcomes in pain, function, and an...

Foot Ankle Int. 2014 Mar;35(3):201-6

Insoles, external joint supports & training programs effectively prevent athletic injuries

68 randomized controlled trials examining the effect of various interventions - including insoles, external joint supports, training programs, stretching, protective head equipment, modified shoes, and injury prevention videos - for injury prevention were included in this review. Meta-analyses for these preventative interventions revealed that inso...

Sports Med. 2014 Apr;44(4):473-86. doi: 10.1007/s40279-013-0136-8.

Intraoperative infiltration of ropivacaine has no effect on morphine consumption after THA

60 patients undergoing primary total hip arthroplasty (THA) were randomized to receive single-shot intraoperative infiltration of ropivacaine alone or saline. The purpose of this study was to determine the efficacy of ropivacaine alone in the management of morphine consumption and postoperative pain in these patients. Results indicated that no sign...

Br J Anaesth. 2014 Apr;112(4):722-8. doi: 10.1093/bja/aet439. Epub 2014 Jan 14.

Fixation with a palmar plate similar to K-wires for distal radius fractures in the elderly

40 elderly patients (>65 years) with a distal radius fracture of AO type A2, A3, or C1 were randomized to undergo either palmar fixed-angle plate fixation or minimally-invasive K-wire fixation. The purpose was to compare these two treatment approaches with respect to functional, clinical and radiological outcomes. Results indicated that K-wire fixa...

J Hand Surg Eur Vol. 2014 Mar;39(3):249-57. doi: 10.1177/1753193413489057. Epub 2013 May 14.

Dry needling with and without PRP injection for patellar tendinopathy

23 patients diagnosed with patellar tendinopathy were randomized to treatment with eccentric exercise and either ultrasound-guided leukocyte-rich platelet-rich plasma (PRP) injection with dry needling (DN) or dry needling without PRP injection. The purpose of this trial was to compare patient-reported outcomes between to the interventions. Results ...

Am J Sports Med. 2014 Mar;42(3):610-8. doi: 10.1177/0363546513518416.

Open vs. arthroscopic repair after anterior shoulder instability with disease-specific QOL

196 patients with recurrent traumatic anterior shoulder instability were randomized to undergo open or arthroscopic repair to compare differences in disease-specific quality of life and recurrent instability over a period of two years. The results from this trial indicate that both procedures provided a significant improvement in disease-specific q...

J Bone Joint Surg Am. 2014 Mar 5;96(5):353-60

6-week oral administration of a mixture of beeswax alcohols (D-002) improves OA symptoms

60 patients with diagnosed osteoarthritis of the knee, hip, or fingers were randomized to receive an oral tablet once daily of either D-002 (50 mg) or placebo for a total of 6 weeks. At week 3, if no improvement was observed, the dose was increased to two tablets per day (daily dose of 100 mg). The purpose of this study was to determine the effect ...

Korean J Intern Med. 2014 Mar;29(2):191-202. doi: 10.3904/kjim.2014.29.2.191. Epub 2014 Feb 27.

Exercise based on McKenzie System of Mechanical Diagnosis & Therapy effective for knee OA

180 patients diagnosed with knee OA were randomized to receive either an exercise intervention based on the McKenzie Mechanical Diagnosis and Therapy (MDT) system or no intervention (wait-list control), to compare pain and function. Additionally, an exploratory subgroup analysis was performed among exercise patients between those with a MDT derange...

J Orthop Sports Phys Ther. 2014 Mar;44(3):173-81, A1-6. doi: 10.2519/jospt.2014.4791

Single- and two-incision carpal tunnel release techniques appear equally efficacious

30 patients with carpal tunnel syndrome were randomized to undergo single- or two-incision carpal tunnel release to compare clinical and functional outcomes between surgical techniques. Upon analysis, results revealed no significant difference between groups with respect to the Disabilities of the Arm, Shoulder, and Hand (DASH) Questionnaire, Brigh...

Hand (N Y). 2014 Mar;9(1):36-42. doi: 10.1007/s11552-013-9572-z.

Reporting of results appear inadequate and heterogeneous in network meta-analyses

121 network meta-analyses were included in this systematic review to examine the current reporting methodologies. Results revealed an overall inadequacy and heterogeneity in reporting essential components. 100 studies failed to describe the network and network geometry, and 52 and 96 studies failed to report number of RCTs and patients, respectivel...

BMJ. 2014 Mar 11;348:g1741. doi: 10.1136/bmj.g1741.

Extended immobilization following rotator cuff repair yields similar retear rate

100 patients undergoing rotator cuff repair were randomized to complete a rehabilitation program with 4 or 8 weeks of immobilization after surgery. The purpose of this study was to compare retear rates and short-term clinical outcomes between treatment groups. While significantly more patients in the 8 week immobilization group experienced stiffnes...

J Bone Joint Surg Am. 2014 Mar 19;96(6):e44. doi: 10.2106/JBJS.L.01741

Knee OA:Aceclofenac controlled release (200 mg) non-inferior to immediate release (100 mg)

125 patients with chronic knee OA were randomized to receive either aceclofenac controlled release (CR) 200 mg oral tablets taken once-daily or aceclofenac immediate release (IR) 100 mg oral tablets taken twice-daily to assess non-inferiority of a lower dosing frequency to a higher one. Results at 4 week post-treatment revealed aceclofenac CR was n...

Knee Surg Relat Res. 2014 Mar;26(1):33-42. doi: 10.5792/ksrr.2014.26.1.33

Zoledronic acid increases BMD at tibial epiphysis, but not tibial diaphysis

117 postmenopausal women who were enrolled in the HORIZON trial were recruited for this ancillary study which investigated the effect zoledronate (ZOL) on bone mineral density (BMD) of the tibia. This study measured tibial epiphsyis and tibial diaphysis BMD at 12, 24, and 36 months, and compared results to a group treated with placebo (PBL group). ...

Maturitas. 2014 Mar;77(3):287-93

Leg length inequality: Motion analysis of bilateral joint manipulation on gait parameters

21 asymptomatic student volunteers with Leg length inequality (LLI) were randomized to receive either bilateral sacroiliac (SI) joint chiropractic manipulative therapy (CMT) or no CMT. This study aimed to pilot an experimental design using advanced motion analysis technology to determine effect of treatment on gait parameters and determine sample s...

J Can Chiropr Assoc. 2014 Mar;58(1):85-95

Force threshold in joint mobilization appears necessary for effects on chronic neck pain

64 patients with chronic, nonspecific neck pain were randomized to determine if the force applied in joint mobilization influenced immediate and short-term treatment outcomes. Patients were treated with joint mobilization of either 30N, 90N, or a placebo intervention. Joint mobilization of either force did not significantly impact pressure pain thr...

J Orthop Sports Phys Ther. 2014 Mar;44(3):141-52

Darexaban vs placebo for prevention of VTE in Asian patients receiving TKA or THA

996 Asian patients undergoing TKA (1 study) and THA (second study) surgery were randomly assigned into 1 of 4 groups to determine if darexaban effectively and safely reduced the occurrence of venous thromboembolism (VTE) when compared to an oral placebo or subcutaneous enoxaparin. The four possible treatment methods were: a 15 or 30 mg oral dose of...

Clin Appl Thromb Hemost. 2014 Mar;20(2):199-211

AAOS: Increased BMD with uncemented versus cemented component in hip resurfacing

120 patients undergoing hip resurfacing were randomized to receive either a cemented or uncemented femoral component to compare these treatment approaches with respect to femoral bone mineral density (BMD). Results indicated that BMD was significantly increased in zones 1-4 when an uncemented femoral component was used compared to a cemented compon...

AAOS: Age and Tegner associated with risk of re-rupture and re-injury after ACLR

330 patients scheduled for anterior cruciate ligament reconstruction were randomized to undergo surgery using either a patellar tendon autograft, quadruple-stranded hamstring tendon autograft, or double-bundle reconstruction with hamstring tendons. The purpose was to evaluate each with respect to disease-specific ACL quality of life, and identify a...

AAOS: Weighted and uniform doses of tranexamic acid similar in reducing blood loss in TKA

50 patients undergoing primary total knee arthroplasty were randomized to receive either a uniform 1-gram dose or a weighted 20 mg/kg dose of intravenous tranexamic acid. The purpose of this study was to determine whether a uniform dose would be more effective than a weighted dose, with respect to postoperative blood loss and hemoglobin levels. Res...

AAOS: Flexor hallucis longus augmentation in the treatment of Achilles tendinopathy

44 patients at least 50 years old with chronic insertional Achilles tendinopathy for whom nonoperative treatments have failed, were randomized to Achilles debridement and ostectomy alone or with flexor hallucis longus (FHL) tendon augmentation. The purpose was to determine whether the augmentation would be more effective than the surgery alone. Res...

AAOS: Total elbow arthroplasty similar in function and ROM outcomes to ORIF

25 studies were included in this review investigating total elbow arthroplasty (TEA) and open reduction and internal fixation (ORIF) in the treatment of distal humeral fractures. Of the 25 studies included, 24 were deemed to be weak through quality assessment. The results indicated that functional outcome and range of motion appear to be similar fo...

AAOS: Computer-assisted surgery effective in distal radius malunion correction

15 patients with distal radius malunions were randomized to receive corrective osteotomy either with or without computer assistance and patient-specific guides. The purpose of the study was to determine whether the proposed accuracy of computer-assisted surgery provides patients with greater improvements in clinical outcomes. The results revealed t...

AAOS: Radialization versus centralization procedure for severe radial club hand

16 radial club hands of Heikel grade 3 and 4 were randomized to undergo either centralization or radialization. The purpose of the study was to compare the two techniques with respect to clinical, functional and radiological outcomes. Results after 1 year revealed lower clinical and radiological hand forearm angles with the radialization procedure....

AAOS: Fondaparinux appears to be associated with elevated blood coagulation factors

51 patients undergoing elective total knee and hip arthroplasty were randomized to receive thromboprophylaxis with either subcutaneous injection of fondaparinux (2.5 mg) or aspirin (325 mg) plus compression stockings. The purpose of this study was to determine whether changes in thrombogenicity can be measured with blood coagulation factors and pla...

AAOS: An automated gas-actuated sucker tip is superior to conventional suckers in TKA/THA

In 40 total knee arthroplasties (TKA) and 30 total hip arthroplasties (THA), surgeons were randomly instructed to use either the \'super sucker\', the Yankaur sucker, or a new gas-actuated sucker. The purpose of this study was to compare these three approaches with respect to both objective and subjective performance evaluations completed by surgeo...

AAOS: IV tranexamic acid & aminocaproic acid on reducing blood loss in orthopaedic surgery

54 studies (comprising 59 randomized controlled trials with 3402 patients) were included in this meta-analysis comparing the use of either intravenous tranexamic acid (TXA) or intravenous epsilon aminocaproic acid (EACA) to placebo in reducing blood loss in orthopaedic surgery. TXA was observed to significantly reduce intraoperative, postoperative,...

AAOS: Tranexamic acid equally effective when administered topically & intravenously in TKA

85 patients with end stage knee arthritis scheduled to undergo total knee arthroplasty (TKA) were randomized to receive tranexamic acid (TXA) administered either topically or intravenously. The purpose of this study was to compare the efficacy and safety of these two treatment approaches. Results indicated that TXA when topically-applied, resulted ...

AAOS: Hemostatic Agent does not appear to reduce transfusion events in THA

109 total hip arthroplasty patients were randomized to receive a collagen/thrombin/autologous platelet hemostatic agent in conjunction with standard hemostasis treatment, or standard hemostasis treatment alone, to determine the efficacy of the hemostatic agent on transfusion events. Other outcome measures included perioperative blood loss and narco...

AAOS: Thrombin-based hemostatic reduces blood loss, but not haemoglobin loss, in TKA

108 patients undergoing primary unilateral total knee arthroplasty (TKA) were randomized to receive either a thrombin-based topical hemostatic matrix sealant with electrocautery or electrocautery alone. The purpose of this study was to determine whether this hemostatic agent is effective for reducing blood loss and transfusion rates. Results indica...

AAOS: Plating versus nailing for distal femur fractures

126 patients with a distal femur fracture were randomized to fixation through either retrograde nailing or locked plating. The purpose was to compare radiographic, functional, and clinical outcomes up to 1 year postoperatively. The results indicated a similar rate of malalignments, although plating was associated with a greater frequency of >5 degr...

AAOS: Lower preoperative coagulation factors may correlate with transfusion risk in TJA

51 patients undergoing elective total knee and hip arthroplasty were randomized to receive thromboprophylaxis with either subcutaneous injection of fondaparinux (2.5 mg) or aspirin (325 mg) plus compression stockings. The purpose of this study was to determine whether a correlation exists between changes in thrombogenicity due to surgical trauma, a...

AAOS: Wear of oxinium/cobalt-chrome on standard/cross-linked polyethylene

80 patients (91 hips) undergoing total hip arthroplasty were randomly allocated to one of four bearing surfaces: cobalt-chrome (CoCr) & standard polyethylene, CoCr & cross-linked polyethylene (XLPE), oxinium & standard polyethylene, or oxinium & XLPE, to compare long-term polyethylene wear rate between groups. Results indicated that the wear rate w...

AAOS: Pre-admission chlorhexidine protocol appears to reduce infections following TJA

366 patients scheduled to undergo either total hip or knee arthroplasty were randomized to receive, in addition to standard in-hospital preparation procedures, cloths soaked with 2% chlorhexidine gluconate (to be used prior to hospital admission), or no pre-admission intervention at all.The purpose of this study was to determine if there was a diff...

AAOS: Pinless computer navigation system more accurate than conventional technique in TKA

100 patients scheduled to undergo primary total knee arthroplasty (TKA) were randomized to undergo the procedure using either a new pinless computer navigation system or a conventional technique. The purpose of this study was to examine the accuracy of this new system for implant alignment. Results indicated that there was a significant difference ...

AAOS: Superior outcome when elbow rotation is delayed following radial head fracture

300 patients with radial head fractures were randomized to receive a mobilization protocol with either early or delayed active elbow rotation. The purpose was to determine whether the difference in timing has an effect on clinical outcome after 2 years. Result indicated that patients with delayed elbow rotation enjoyed significantly better Broberg-...

AAOS: Triclosan-coated sutures do not reduce surgical site infection following THA & TKA

2547 patients undergoing total knee or hip arthroplasty were randomly allocated to receive triclosan-coated sutures or standard sutures for layered wound closure, with the purpose of determining if triclosan-coated sutures could reduce the incidence of surgical site infection. Results did not support the use of triclosan-coated sutures, as there wa...

AAOS: A combination of two prep solutions prevents infection regardless of order applied

95 patients undergoing foot and ankle surgery were randomized to receive either 4% chlorhexidine gluconate followed by 70% isopropyl alcohol while preparing the surgical site, or the same two solutions applied in a reverse order. The purpose of this study was to determine whether the order of application of these two solutions has an effect on bact...

AAOS: Pronator quadratus repair following volar plate fixation offers no clinical benefit

60 patients with distal radius fractures were randomly allocated to undergo volar plate fixation with or without pronator quadratus (PQ) muscle repair following the procedure, to determine whether PQ repair improves wrist function and other clinical outcomes. Results indicated that PQ repair did not improve wrist function or pain at 12 months post-...

AAOS: Blood loss and transfusion rates do not differ between tranexamic acid preperations

60 patients undergoing total hip arthroplasty were randomized to receive intravenous or topical tranexamic acid to compare the efficacy of preparations on postoperative blood loss and transfusion rates. Results indicated blood loss, change in hemoglobin levels, transfusion rates, and thromboembolic events did not differ significantly between groups...

AAOS: Quantitative ultrasound can detect the effects of risendronate on bone strength

138 women (100 at final follow-up) who underwent short proximal femoral nailing for a low-energy intertrochanteric fracture were randomized to receive either risendronate (75 mg twice monthly) or a placebo equivalent. The purpose of this study was to examine whether quantitative ultrasound was able to detect the effects of risendronate on bone stre...

AAOS: Time to ambulation without any assistive device is improved with direct anterior THA

54 patients were randomly allocated to receive a direct anterior or mini-incision posterior approach to total hip arthroplasty (THA), to determine if there were differences in time to ambulation between the two techniques. Results indicated that time to ambulation without any assistive device was significantly improved with direct anterior total h...

AAOS: Operative versus nonoperative management of Achilles tendon ruptures

Seven randomized controlled trials evaluating operative and nonoperative management of Achilles tendon ruptures were included in this meta-analysis. The purpose was to determine if the two treatment options differed in functional outcome over 2 years postintervention. The results indicated that while functional outcome was significantly better foll...

AAOS: Early rehabilitation acceptable following fixation of unstable ankle fracture

110 patients undergoing fixation of an unstable ankle fracture were randomized to either early weightbeaing (2 weeks postop) or delayed weightbearing (6 weeks non-weightbeaing and immobilization postop). The purpose was to compare the two protocols on rate of return to work and functional outcome. The results indicated that return to work was simil...

AAOS: Repeat skin antisepsis reduces incidence of surgical site infections after TJA

581 patients undergoing total joint arthroplasty (TJA) were randomized to receive standard or repeat preoperative skin antisepsis, to determine if repeat skin antisepsis is a beneficial addition to standard skin preparation. Results indicated that repeat skin antisepsis before incise draping significantly reduced surgical site infections compared t...

AAOS: Weightbearing-as-tolerated safe in rehabilitation following tibial shaft fractures

62 patients undergoing intramedullary nailing for tibial shaft fractures were randomized to postoperative protocols of either immediate weightbearing-as-tolerated (WBAT) or non-weightbearing (NWB) for 6 weeks postoperatively. Functional and radiographic outcomes were monitored up to fracture union, or until treatment failure or revision surgery was...

AAOS: Autologous chondrocyte implantation vs microfracture for articular cartilage lesions

50 patients with articular cartilage lesions were randomized to treatment with either mircrofracture surgery or all-arthroscopic matrix encapsulated autologous chondrocyte implantation (MECI). The purpose was to compare the clinical and morphological outcomes between techniques following repair. Results up to 2 years postoperative revealed better T...

AAOS: Hyaluronic acid and placebo produce similar pain and functional outcomes for knee OA

200 patients suffering from mild to moderate knee osteoarthritis were randomly allocated to receive 3 hyaluronic acid (HA) injections or 3 placebo injections to determine the ability of HA to improve knee pain and function. A Visual Analog Scale (VAS) for pain, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), knee range o...

AAOS: Complication rate lower with bone tunnels in repair of distal biceps tendon ruptures

23 studies (randomized controlled trials, prospective cohort studies, and retrospective case series) were included in this literature review comparing surgical approaches and fixation methods in operative management of distal biceps tendon ruptures. The results indicated that the overall complication rate among all studies was 24.7%, with no signif...

AAOS: Efficacy of BMP in expedited union continues to be debated

19 studies (12 RCTs, 6 prospective cohorts, 3 retrospective cohorts) were included in this investigation on the efficacy of BMP-2 and BMP-7 in bony healing following acute fracture or nonunion. The results indicated that there was no significant difference between BMP and non-BMP-treated groups regarding union rate of healing time following treatme...

AAOS: Medial parapatellar arthrotomy VS quadriceps-sparing subvastus approach for TKA

128 patients were randomly allocated to undergo a medial parapatellar arthrotomy or quadriceps-sparing approach to total knee arthroplasty (TKA), to determine if one technique provided superior early functional outcomes. To accurately compare results, both approaches used minimally invasive surgical principles. Short-term results revealed no statis...

AAOS: Lower graft failure with autograft vs. allograft ACL reconstruction at min. 10 years

100 knees from 99 patients were randomized to ACL reconstruction with the use of either autografts or allografts. The purpose of this study was to assess and compare the long-term results of the aforementioned interventions. Results at a minimum of 10 years revealed over 80% success rates and similar single assessment numeric evaluations. However, ...

AAOS: Superior functional outcome with arthroscopic versus open Bankart repair

38 patients with anterior glenohumeral joint dislocation schedule for Bankart repair were randomized to receive either open Bankart repair or arthroscopic Bankart repair. The purpose of this study was to determine whether one method was more effective with respect to functional outcome and incidence of recurrent dislocations. Results from follow-up...

AAOS: Highly-porous-metal tibial components appear durable & reliable 5 years after TKA

389 patients undergoing total knee arthroplasty (TKA) were randomized to one of three groups: an uncemented highly-porous-metal tibial component group, a cemented highly-porous tibial component group, or a cemented traditional tibial component group. The purpose of this study was to compare the reliability and durability between treatment groups. U...

AAOS: Barbed sutures may be a plausible option for wound closure in TKA

411 patients undergoing total knee arthroplasty were randomized to receive barbed or standard sutures for wound closure, with the purpose of comparing overall efficiency and safety of both treatment options. Upon analysis, barbed sutures appeared to reduce closure times and costs compared to standard sutures, while postoperative complications, clin...

RCT2: Blood loss with 6h postop flexion after TKA lower than with 3h flexion or extension

420 patients scheduled for total knee arthroplasty were randomized to either positioning of the knee in 120 deg passive flexion for 3 hours postoperatively, the same flexion for 6 hours postoperatively, or in full passive extension postoperatively. The objective was to determine the effect of each protocol on postoperative blood loss, transfusion r...

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

Teriparatide increases hip & spine BMD, particularly in type I osteogenesis imperfecta

79 patients with osteogenesis imperfecta (OI) were randomized to receive either teriparatide (recombinant human parathyroid hormone) or a placebo administered subcutaneously daily for 18 months. The purpose of this proof-of-concept study was to determine whether teriparatide increased bone formation and positively affected skeletal mass and strengt...

J Clin Invest. 2014 Feb 3;124(2):491-8. doi: 10.1172/JCI71101.

An intra-articular injection of LMW human serum albumin is safe and effective for knee OA

329 patients with symptomatic knee osteoarthritis (OA) were randomized to receive either Low Molecular Weight Fraction of 5% human serum albumin (LMWF-5A) or saline vehicle solution, each at a dose of either 4 or 10 mL. The purpose of this study was to determine the analgesic efficacy and safety of LMWF-5A in this study population. Results indicate...

PLoS One. 2014 Feb 3;9(2):e87910. doi: 10.1371/journal.pone.0087910. eCollection 2014.

Pulsed electromagnetic field therapy improves pain, swelling, and function following TKA

33 patients scheduled for total knee arthroplasty for severe knee osteoarthritis were randomized to receive 60 days of pulsed electromagnetic field (PEMF) therapy after surgery, or to no additional postoperative PEMF. The purpose was to examine the effect of PEMF on pain, function, and swelling up to 6 months postoperatively. The results indicated ...

Int Orthop. 2014 Feb;38(2):397-403

Anterior cervical fixation with dynamic or rigid plating not significantly different

In this systematic review, seven studies were included (4 RCTs and 3 nonrandomized/retrospective studies) comparing the clinical and radiological outcomes between anterior cervical fixation with dynamic plates or rigid plates. Additionally, 4 studies were included in a complications analysis for dynamic plates (2 [1 RCT, 1 prospective nonrandomized...

Eur Spine J. 2014 Feb;23(2):298-304. doi: 10.1007/s00586-013-3039-3.

Fragility Index to aid in the interpretation of significant findings from RCTs

While P-values in clinical studies are an easy method to denote statistical significance, the interpretation of significant findings can be somewhat skewed. The Fragility Index is a newly developed metric that complements p-values and confidence intervals. It is calculated by adding consecutive events to a significant dichotomous finding until the ...

J Clin Epidemiol. 2014 Feb 5. pii: S0895-4356(13)00466-6. doi: 10.1016/j.jclinepi.2013.10.019

Multimodal analgesia is safer and more effective than PCA after minimally-invasive TKA

Thirty-six patients undergoing minimally-invasive total knee arthroplasty (TKA) desiring rapid recovery were randomized to follow either a multimodal analgesic protocol or patient-controlled analgesia (PCA) regimen, to compare the efficacy and safety of the two approaches. Results indicated that the use of a multimodal analgesic regimen led to sign...

J Arthroplasty. 2014 Feb;29(2):329-34. doi: 10.1016/j.arth.2013.06.005. Epub 2013 Jul 11.

Effect of HVLA vs. sham on vertical jump in athletes with talocrural joint dysfunction

22 female elite-level handball athletes with talocrural joint dysfunction were randomized to undergo high-velocity, low-amplitude (HVLA) manipulation to either the talocrural joint (active treatment) or the distal tibia (sham treatment). The purpose of this pilot study was to determine the feasibility of trial comparing these two interventions with...

J Manipulative Physiol Ther. 2014 Feb;37(2):116-23. doi: 10.1016/j.jmpt.2013.11.004. Epub 2014 Jan 2

Vertebral end-plate signal changes may not be the cause of disabling back pain in sciatica

Two hundred and sixty-three patients with sciatica were randomized to undergo either rapid surgical intervention, or prolonged conservative treatment. The dual purpose of this publication was (1) to compare the extent of vertebral end-plate signal changes (VESC) between groups, and (2) to determine whether or not there is a correlation between VESC...

Spine J. 2014 Feb 1;14(2):225-33. doi: 10.1016/j.spinee.2013.08.058. Epub 2013 Nov 13.

Shoulder impingement syndrome: treatment similar with & without neck mobilisation

Seventy-four patients with non-traumatic shoulder impingement syndrome were randomized to receive shoulder treatment either with or without neck mobilisation therapy. The purpose of this study was to determine whether the combined neck and shoulder treatment was more effective in improving pain and disability outcomes, measured with a NPRS and the ...

Man Ther. 2014 Feb;19(1):18-24. doi: 10.1016/j.math.2013.05.007.

Denosumab is superior to alendronate for improving cortical bone porosity post-menopause

Two hundred and forty-seven post-menopausal women (146 with data at final follow-up) received a subcutaneous injection every 6 months and a pill weekly. These treatments were randomized as follows: Group one received denosumab injections and a placebo pill, Group two received alendronate and a placebo injection and Group three received a placebo i...

Bone. 2014 Feb;59:173-9. doi: 10.1016/j.bone.2013.11.016. Epub 2013 Nov 22.

Active cranio-cervical flexion exercise can improve muscle control for chronic neck pain

Eighteen adults with chronic idiopathic neck pain were randomized to receive either assisted plus active cranio-cervical flexion (exercise group) or passive mobilisation plus assisted cranio-cervical flexion (mobilisation group). The purpose of the study was to determine which treatment was more efficacious with respect to performance on the cranio...

Man Ther. 2014 Feb;19(1):25-31. doi: 10.1016/j.math.2013.05.011.

TKA: Non-continuous drainage is equally safe, yet more effective than continuous drainage

9 randomized controlled trials (761 patients; 811 knees) comparing continuous with non-continuous drainage in total knee arthroplasty (TKA) were included in this review. The purpose of this review was to compare the efficacy and safety of these two techniques. Results indicated that non-continuous drainage significantly reduced haemoglobin loss and...

Int Orthop. 2014 Feb;38(2):361-71. doi: 10.1007/s00264-013-2105-0. Epub 2013 Sep 19.

Subluxation versus eversion of the patella in total knee arthroplasty

68 patients undergoing total knee arthroplasty were randomized to either patellar subluxation (retraction) or patellar eversion during surgery. The purpose was to determine if subluxation of the patella led to any benefit over eversion in outcome in the short- and medium-term. Follow-up was conducted for 1 year postoperatively. The results demonstr...

J Bone Joint Surg Am. 2014 Feb 5;96(3):207-13

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