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RANDOMIZED CONTROLLED TRIAL
Verinder S Sidhu, Thu-Lan Kelly, Nicole Pratt, Stephen E Graves, Rachelle Buchbinder, Sam Adie, Kara Cashman, Ilana Ackerman, Durga Bastiras, Roger Brighton, Alexander W R Burns, Beng Hock Chong, Ornella Clavisi, Maggie Cripps, Mark Dekkers, Richard de Steiger, Michael Dixon, Andrew Ellis, Elizabeth C Griffith, David Hale, Amber Hansen, Anthony Harris, Raphael Hau, Mark Horsley, Dugal James, Omar Khorshid, Leonard Kuo, Peter Lewis, David Lieu, Michelle Lorimer, Samuel MacDessi, Peter McCombe, Catherine McDougall, Jonathan Mulford, Justine Maree Naylor, Richard S Page, John Radovanovic, Michael Solomon, Rami Sorial, Peter Summersell, Phong Tran, William L Walter, Steve Webb, Chris Wilson, David Wysocki, Ian A Harris
IMPORTANCE: There remains a lack of randomized trials investigating aspirin monotherapy for symptomatic venous thromboembolism (VTE) prophylaxis following total hip arthroplasty (THA) or total knee arthroplasty (TKA). OBJECTIVE: To determine whether aspirin was noninferior to enoxaparin in preventing symptomatic VTE after THA or TKA. DESIGN, SETTING, AND PARTICIPANTS: Cluster-randomized, crossover, registry-nested trial across 31 hospitals in Australia...
August 23, 2022: JAMA
#2
JOURNAL ARTICLE
John M Pinski, Scott P Ryan, Jason L Pittman, Paul Tornetta
INTRODUCTION: It is unclear whether the medial malleolus in unstable bi- and tri- malleolar ankle fractures without medial talar displacement should be addressed surgically. This study reviews a fixation protocol for the medial malleolar component of unstable bi- or tri- malleolar ankle fractures. MATERIALS AND METHODS: Two hundred fifty-seven patients who sustained bi- (AO/OTA 44-B2) or tri- (AO/OTA 44-B3) malleolar ankle fractures between January 2005 and August 2019 at two Level 1 trauma centers were retrospectively identified...
June 2023: Archives of Orthopaedic and Trauma Surgery
#3
JOURNAL ARTICLE
Frede Frihagen, Marianne Comeau-Gauthier, Daniel Axelrod, Sofia Bzovsky, Rudolf Poolman, Diane Heels-Ansdell, Mohit Bhandari, Sheila Sprague, Emil Schemitsch
AIMS: The aim of this study was to explore the functional results in a fitter subgroup of participants in the Hip Fracture Evaluation with Alternatives of Total Hip Arthroplasty versus Hemiarthroplasty (HEALTH) trial to determine whether there was an advantage of total hip arthroplasty (THA) versus hemiarthroplasty (HA) in this population. METHODS: We performed a post hoc exploratory analysis of a fitter cohort of patients from the HEALTH trial. Participants were aged over 50 years and had sustained a low-energy displaced femoral neck fracture (FNF)...
August 2022: Bone & joint open
#4
JOURNAL ARTICLE
Paula J Watts, Michael Kopstein, Weston Harkness, Brendon Cornett, Oliwier Dziadkowiec, M Elizabeth Hicks, Shakib Hassan, Dmitriy Scherbak
STUDY OBJECTIVE: Rivaroxaban, enoxaparin, and aspirin are commonly used medications for thromboprophylaxis following lower extremity joint arthroplasty or revision. Previous research has demonstrated efficacy in preventing venous thromboembolism with each medication, however, the comparative risk of bleeding between them remains poorly understood. The aim of this study was to compare the odds of bleeding between rivaroxaban, enoxaparin, and aspirin following lower extremity joint arthroplasty or revision...
July 2021: Pharmacotherapy
#5
RANDOMIZED CONTROLLED TRIAL
David J Beard, Loretta Davies, Jonathan A Cook, Jamie Stokes, Jose Leal, Heidi Fletcher, Simon Abram, Katie Chegwin, Akiko Greshon, William Jackson, Nicholas Bottomley, Matt Dodd, Henry Bourke, Beverly A Shirkey, Arsenio Paez, Sarah E Lamb, Karen Barker, Michael Phillips, Mark Brown, Vanessa Lythe, Burhan Mirza, Andrew Carr, Paul Monk, Carlos Morgado Areia, Sean O'Leary, Fares Haddad, Chris Wilson, Andrew Price
BACKGROUND: Anterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability. METHODS: We did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK...
August 20, 2022: Lancet
#6
RANDOMIZED CONTROLLED TRIAL
Truls Martin Straume-Næsheim, Per-Henrik Randsborg, Jan Rune Mikaelsen, Einar Andreas Sivertsen, Brian Devitt, Lars-Petter Granan, Asbjørn Årøen
BACKGROUND: Surgical treatment of young patients with recurrent lateral patella dislocation (RLDP) is often recommended because of loss of knee function that compromises their level of activity or even their daily life functioning. This situation is comparable to young patients with an anterior cruciate ligament (ACL) rupture. The purpose of this study was therefore to explore the time from injury to surgery and the pre-operative symptoms and knee function of young RLPD patients scheduled for stabilizing surgery and compare this group to age and sex-matched ACL-deficient patients...
July 8, 2019: BMC Musculoskeletal Disorders
#7
RANDOMIZED CONTROLLED TRIAL
T O Ugland, G Haugeberg, S Svenningsen, S H Ugland, Ø H Berg, A H Pripp, L Nordsletten
AIMS: The aim of this randomized trial was to compare the functional outcome of two different surgical approaches to the hip in patients with a femoral neck fracture treated with a hemiarthroplasty. PATIENTS AND METHODS: A total of 150 patients who were treated between February 2014 and July 2017 were included. Patients were allocated to undergo hemiarthroplasty using either an anterolateral or a direct lateral approach, and were followed for 12 months. The mean age of the patients was 81 years (69 to 90), and 109 were women (73%)...
July 2019: Bone & Joint Journal
#8
JOURNAL ARTICLE
Katarina Greve, Karin Modig, Mats Talbäck, Erzsébet Bartha, Margareta Hedström
Background and purpose - Waiting time to surgery for patients with hip fractures and its potential association with mortality has been frequently studied with the hypothesis that longer waiting time is associated with adverse outcomes. However, despite numerous studies, there is no consensus regarding which time frames are appropriate, and whether some patients are more vulnerable to waiting than others. We explored the association between waiting time to surgery and short-term mortality and whether sex, age, surgical method, and comorbidity (ASA) modified this association...
April 24, 2020: Acta Orthopaedica
#9
RANDOMIZED CONTROLLED TRIAL
David Sanders, Dianne Bryant, Christina Tieszer, Abdel-Rahman Lawendy, Mark MacLeod, Steven Papp, Allan Liew, Darius Viskontas, Chad Coles, Kevin Gurr, Tim Carey, Wade Gofton, Chris Bailey, Debra Bartley, Andrew Trenholm, Trevor Stone, Ross Leighton, Julia Foxall, Mauri Zomar, Kelly Trask
OBJECTIVES: To compare outcomes in elderly patients with intertrochanteric hip fractures treated with either the sliding hip screw (SHS) or InterTAN intramedullary device (IT). DESIGN: Prospective, randomized, multicenter clinical trial. SETTING: Five level 1 trauma centers. PATIENTS: Two hundred forty-nine patients 55 years of age or older with AO/OTA 31A1 (43) and OA/OTA 31A2 (206) fractures were prospectively enrolled and followed for 12 months...
January 2017: Journal of Orthopaedic Trauma
#10
RANDOMIZED CONTROLLED TRIAL
Andreas Eisenschenk, Romy Spitzmüller, Claas Güthoff, Adrian Obladen, Simon Kim, Esther Henning, Jenny E Dornberger, Dirk Stengel
AIMS: The aim of this study was to investigate whether clinical and radiological outcomes after intramedullary nailing of displaced fractures of the fifth metacarpal neck using a single thick Kirschner wire (K-wire) are noninferior to those of technically more demanding fixation with two thinner dual wires. PATIENTS AND METHODS: This was a multicentre, parallel group, randomized controlled noninferiority trial conducted at 12 tertiary trauma centres in Germany. A total of 290 patients with acute displaced fractures of the fifth metacarpal neck were randomized to either intramedullary single-wire (n = 146) or dual-wire fixation (n = 144)...
October 2019: Bone & Joint Journal
#11
RANDOMIZED CONTROLLED TRIAL
Steven F Shannon, Brandon J Yuan, William W Cross, Jonathan D Barlow, Michael E Torchia, Pamela K Holte, Stephen A Sems
OBJECTIVE: To compare functional and clinical outcomes in patients with pertrochanteric hip fractures treated with either a short (SN) or long (LN) cephalomedullary nail. DESIGN: Prospective, randomized. SETTING: Clinical investigation was performed at the Mayo Clinic's Level 1 Trauma Center in Rochester, MN. PATIENTS/PARTICIPANTS: Two hundred twenty patients with intertrochanteric fractures were prospectively randomized to an SN or LN cohort...
October 2019: Journal of Orthopaedic Trauma
#12
JOURNAL ARTICLE
Taylor R Dunphy, Justin Hudson, Michael Batech, Daniel C Acevedo, Raffy Mirzayan
BACKGROUND: Distal biceps brachii tendon ruptures lead to substantial deficits in elbow flexion and supination; surgical repair restores muscle strength and endurance. PURPOSE: To examine clinical and surgical outcomes for distal biceps tendon repairs in a large, multispecialty, integrated health care system. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Retrospective cohort study of distal biceps tendon repairs performed between January 1, 2008, and December 31, 2015...
November 2017: American Journal of Sports Medicine
#13
JOURNAL ARTICLE
Wender Figved, Marius Myrstad, Ingvild Saltvedt, Merete Finjarn, Liv Marie Flaten Odland, Frede Frihagen
No abstract text is available yet for this article.
June 2019: JBJS Reviews
#14
JOURNAL ARTICLE
Jeremy S Somerson, Ian J Isby, Mia S Hagen, Christopher Y Kweon, Albert O Gee
BACKGROUND: Women have a higher risk of anterior cruciate ligament (ACL) tears than men, the causes of which are multifactorial. The menstrual cycle and its hormonal effect on the knee may contribute to knee laxity and ACL injury. This work reviewed published studies examining the effects of the phases of the menstrual cycle on anterior knee laxity and the rate of ACL tears. METHODS: A systematic review with meta-analysis and meta-regression was performed. Studies with data comparing the menstrual cycle phase with ACL injury or anterior knee laxity were included for analysis...
September 2019: JBJS Reviews
#15
JOURNAL ARTICLE
D Metcalfe, C K Zogg, A Judge, D C Perry, B Gabbe, K Willett, M L Costa
AIMS: Hip fractures are associated with high morbidity, mortality, and costs. One strategy for improving outcomes is to incentivize hospitals to provide better quality of care. We aimed to determine whether a pay-for-performance initiative affected hip fracture outcomes in England by using Scotland, which did not participate in the scheme, as a control. MATERIALS AND METHODS: We undertook an interrupted time series study with data from all patients aged more than 60 years with a hip fracture in England (2000 to 2018) using the Hospital Episode Statistics Admitted Patient Care (HES APC) data set linked to national death registrations...
August 2019: Bone & Joint Journal
#16
JOURNAL ARTICLE
Sunniva Leer-Salvesen, Lars B Engesæter, Eva Dybvik, Ove Furnes, Torbjørn B Kristensen, Jan-Erik Gjertsen
AIMS: The aim of this study was to investigate mortality and risk of intraoperative medical complications depending on delay to hip fracture surgery by using data from the Norwegian Hip Fracture Register (NHFR) and the Norwegian Patient Registry (NPR). PATIENTS AND METHODS: A total of 83 727 hip fractures were reported to the NHFR between 2008 and 2017. Pathological fractures, unspecified type of fractures or treatment, patients less than 50 years of age, unknown delay to surgery, and delays to surgery of greater than four days were excluded...
September 2019: Bone & Joint Journal
#17
JOURNAL ARTICLE
Mette R Andersen, Lien M Diep, Frede Frihagen, Johan Castberg Hellund, Jan E Madsen, Wender Figved
OBJECTIVES: To evaluate the relationship between syndesmosis reduction and outcome. DESIGN: Retrospective cohort study. SETTING: One Level 1 and 1 Level 3 Trauma Center. PATIENTS: Ninety-seven patients with syndesmosis injury. INTERVENTION: Stabilization of syndesmosis injury. Open reduction and internal fixation of malleolar fracture, if present. MAIN OUTCOME MEASUREMENTS: Anterior, central, and posterior measures of syndesmosis width on computed tomography scans, Olerud-Molander Ankle score, American Orthopaedic Foot and American Orthopaedic Foot and Ankle Society Ankle-Hindfoot score, and range of motion measurements...
August 2019: Journal of Orthopaedic Trauma
#18
RANDOMIZED CONTROLLED TRIAL
Marjolein A M Mulders, Monique M J Walenkamp, Susan van Dieren, J Carel Goslings, Niels W L Schep
BACKGROUND: There is no consensus as to whether displaced extra-articular distal radial fractures should be treated operatively or nonoperatively. We compared the outcomes of open reduction and volar plate fixation with closed reduction and plaster immobilization in adults with an acceptably reduced extra-articular distal radial fracture. METHODS: In this multicenter randomized controlled trial, patients 18 to 75 years old with an acceptably reduced extra-articular distal radial fracture were randomly assigned to open reduction and volar plate fixation or plaster immobilization...
May 1, 2019: Journal of Bone and Joint Surgery. American Volume
#19
RANDOMIZED CONTROLLED TRIAL
Victor A van de Graaf, Julia C A Noorduyn, Nienke W Willigenburg, Ise K Butter, Arthur de Gast, Ben W Mol, Daniel B F Saris, Jos W R Twisk, Rudolf W Poolman
IMPORTANCE: Despite recent studies suggesting arthroscopic partial meniscectomy (APM) is not more effective than physical therapy (PT), the procedure is still frequently performed in patients with meniscal tears. OBJECTIVE: To assess whether PT is noninferior to APM for improving patient-reported knee function in patients with meniscal tears. DESIGN, SETTING, AND PARTICIPANTS: Noninferiority, multicenter, randomized clinical trial conducted in 9 hospitals in the Netherlands...
October 2, 2018: JAMA
#20
JOURNAL ARTICLE
Guri Ranum Ekås, Marit Mjelde Laane, Arne Larmo, Håvard Moksnes, Hege Grindem, May Arna Risberg, Lars Engebretsen
BACKGROUND: The rate of secondary knee injuries after pediatric anterior cruciate ligament (ACL) injury is uncertain, and previous studies are limited because of poor methodology. PURPOSE: To evaluate the incidence of new meniscal injuries since the initial diagnostic magnetic resonance imaging (MRI) of young adults who sustained a pediatric ACL injury. In addition, to evaluate meniscal and cartilage injuries in the index knee and contralateral knee injuries on MRI at final follow-up (9...
June 2019: American Journal of Sports Medicine
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