Your go-to source for evidence-based orthopaedics. Join our community of over 50,000 health practitioners worldwide – start today with a free 30-day trial!
Reading the scientific literature is essential for evidence-based practice.
Enter, The Pulse — a free newsletter bringing you the latest high-quality orthopedic research, twice a week.
Join 28,000+ orthopedic professionals from around the world:
💉PRP vs. Corticosteroid for Knee Osteoarthritis: A Systematic Review of RCTs
An OE Original
Knee osteoarthritis is a pervasive condition, affecting as many as 1 in 6 adults. It is the most common cause of chronic pain and can lead to significant loss of function.
Surgical vs. Non-Surgical Treatment for ACL Tears
An OE Original
Pain. Lost training time. Risk of Osteoarthritis.
ACL tears are one of the most common and troublesome injuries in sports.
Surgical treatment -- the ACL Reconstruction -- is a popular intervention for many
💉PRP vs. Corticosteroid for Shoulder Pain: A Meta-Analysis
An OE Original
Shoulder pain affects more than 1 in 4 people and can significantly impact one's quality of life.
Treatment options include injection therapy. Corticosteroids have been used for decades, however,
🦵 Arthroscopic Partial Meniscectomy vs Physical Therapy for Degenerative Meniscal Tears: A Systematic Review of RCTs
An OE Original
Degenerative meniscal tears typically occur in middle-to-older adults and are a strong predictor of knee osteoarthritis.
Arthroscopic partial
💉Hyaluronic Acid Injection for Shoulder Conditions: A Systematic Review and Meta-Analysis of RCTs
An OE Original
Disability. Reduced quality of life. Increased societal burden.
Shoulder pain can affect as much as 80% of people over 50.
Hyaluronic acid injection has been used
💊Duloxetine for Hip & Knee Osteoarthritis: A Systematic Review & Meta-Analysis
An OE Original
Depression...anxiety...osteoarthritis?
Duloxetine is commonly used as an antidepressant but has also been utilized to manage pain.
Can it effectively manage pain from hip & knee
🦶Immobilization vs. Early Motion of the Ankle After Achilles Tendon Rupture: A Randomized Trial
Published in
@BJSM_BMJ
Tom Brady. David Beckham. Kobe Bryant.
Achilles tendon ruptures have affected some of our most beloved athletes.
For patients who receive non-operative
Corticosteroid for Pain Relief After Total Knee Arthroplasty
Published in the
@jbjs
Total knee arthroplasty (TKA) works...but it's really painful.
As high as 26% of patients have substantial post-operative pain.
Corticosteroids, in both periarticular and intravenous
🎾Tennis Elbow Treatment: A Systematic Review and Meta-Analysis
An OE Original
Pain. Tenderness. Weakness. Lateral epicondylitis, better known as tennis elbow, can be a real problem.
Extracorporeal shockwave therapy & ultrasound therapy are popular treatments -- but which one
💊Aspirin for Thromboprophylaxis After Fracture: The PREVENT CLOT Trial
Published in the
@NEJM
Venous thromboembolism is one of the most dangerous complications in trauma cases.
Low molecular weight heparin is regularly used for prophylaxis. But could aspirin be just as good?
🦵To Operate or Not To Operate: Degenerative Meniscal Tears
An OE Original
Degenerative meniscal tears strongly predict knee osteoarthritis and can lead to disability, time off work, and reduced quality of life.
The arthroscopic partial meniscectomy is one of the most common
Optimal Immobilization for Displaced Distal Radius Fracture
Hot Off The Press In The
@jbjs
Cast immobilization after closed reduction can be highly effective. However, many suffer from pain and stiffness, which may be caused by prolonged immobilization.
The typical length of
Robotic Total Knee Arthroplasty -- A Randomized Trial
Hot off the Press in the
@jbjs
Robotic-assisted TKA could change how knee replacements are performed worldwide. However, more robust evidence is needed to confirm their effectiveness in relation to conventional methods.
Non-Operative vs. Operative Treatment for Humeral Shaft Fractures: Which is Better?
Published in the
@jbjs
The optimal method of treatment for humeral shaft fractures remains a topic of contention.
What is better, bracing or surgical fixation? And which fixation technique is
🏛️Best of OTA 2023
This year's
@otatrauma
meeting featured some of the latest high-quality research in the trauma space.
If you didn't get a chance to attend, we've got you covered! Here are some of the key highlights from the meeting:
1⃣ Posterolateral vs. Direct Lateral
💉PRP vs. Micro-fragmented Adipose Tissue for Knee Osteoarthritis: A Randomized Trial
Published in Orthopaedic Journal of Sports Medicine
PRP injections have become widely popular.
But another autologous treatment for knee osteoarthritis is micro-fragmented adipose tissue.
💉Spinal vs. General Anesthesia for Hip Fracture Surgery: A Systematic Review and Meta-Analysis
An OE Original
Anesthesia is a necessity in hip fracture surgery.
Spinal and general anesthesia are most commonly used, but there's debate on which is safer and more effective.
We
🪛 Routine vs. On-Demand Removal of Syndesmotic Screws in Ankle Fractures: A Randomized Trial
Published in
@BoneJointJ
Most syndesmotic injuries are treated with screw fixation. But is syndesmotic screw removal necessary to optimize outcomes?
The RODEO Trial compared routine
PRP for Achilles Tendon Rupture: A Randomized Trial
Published in
@BoneJointJ
Platelet-rich plasma (PRP) injections are gaining momentum as an orthopedic treatment.
But can it effectively treat Achilles tendon ruptures?
Researchers from
@UniofOxford
aimed to find out!
4 Factors Influencing ACL Injury Rehabilitation
An OE Insight
We asked Dr. Darren de SA, an orthopaedic surgeon and professor at
@McMasterSurgery
, to break down the most important factors affecting ACL recovery. He identified 4 key factors:
1⃣ Pre-habilitation
Most
Can Denervation of the Patella Improve Pain After TKA?
🔥 Hot Off The Press in
@JArthroplasty
Anterior knee pain after TKA is a problem. Some surgeons are choosing to denervate the patella using electrocautery, but does this really reduce pain and improve function?
This study
The FixDT Trial: IM Nail vs. Locking Plate for Distal Tibia Fractures
Published in
@JAMA_current
Distal tibia fractures can be tricky to operate on.
With intramedullary (IM) nail fixation, there are concerns about malalignment and penetration of the ankle joint. And with
Direct Anterior vs. Antero-Lateral Approaches in Hip Hemiarthroplasty
Published in Archives of Orthopaedic & Trauma Surgery
Femoral neck fractures are one of the most common fractures in the elderly.
Hip hemiarthroplasty is an effective treatment option, but which approach
Total vs. Partial Knee Replacement for Medial Compartment Osteoarthritis: The TOPKAT Trial
Published in
@TheLancet
(2019)
Millions of knee replacements are performed every year.
Surgeons have two main options: partial knee replacement (PKR; or unicompartmental knee replacement)
🦠Preventing Surgical Site Infection in Arthroplasty
Hot off the Press in the
@NEJM
1 in-patient case of infection in knee arthroplasty can cost more than $28,000. Prevention is critical.
Most guidelines recommend 1st and 2nd generation cephalosporin antimicrobials like
Intramedullary Nailing vs. Sliding Hip Screws: Is There A Difference?
🚨 Just released in
@JAMANetworkOpen
Intramedullary nails are the implant of choice for surgeons treating trochanteric hip fractures, despite costing more than sliding hip screws. But do they really provide
Arthroscopic vs. Open Shoulder Stabilization: 15-Year Follow-up
Published in The American Journal of Sports Medicine
Recurrent shoulder instability is commonly seen in athletes and military personnel, resulting in worse performance and function.
Surgical stabilization of the
🦶Chronic Ankle Instability: A Meta-Analysis of Randomized Controlled Trials
An OE Original
Roughly 20% of ankle sprains become chronic. When surgery is needed, lateral ligament augmentation is the go-to.
The modified Brostrom-Gould procedure (MBG) is the most common approach
💊 Does Vitamin D3 Supplementation Improve Fracture Healing?
It's not uncommon for surgeons to prescribe Vitamin D3 in fracture patients. But does this really improve healing?
This phase II RCT studied various doses of Vitamin D3 in acute fracture patients to find out...
🚨 In the New England Journal of Medicine 🚨
Aspirin or Low Molecular-Weight Heparin for Thromboprophylaxis after a Fracture?
The results found that Aspirin was non-inferior to LMW heparin with respect to death at 90 days, albeit with a higher rate of deep vein thrombosis!
Did you know that 1 in 2 healthcare professionals are at risk for burnout? We discuss it all with
@carrie_kollias
&
@colmjmccarthy
- OrthoPod coming soon!
Skin Antisepsis in Open Fractures: The Aqueous PREP Trial
Published in
@TheLancet
Many guidelines recommend alcohol-based solutions like chlorhexidine gluconate for skin antisepsis.
However, many of the trials informing these guidelines were not based on open fracture surgery
To Operate or Not to Operate: Proximal Humerus Fractures
There is no clear agreement on how to manage displaced proximal humerus fractures.
A range of surgical approaches are available, including locking plate fixation, intramedullary nailing, and hemiarthroplasty. At the same
The Most Influential Articles in Orthopaedics
We read a lot of articles at OE.
Some papers are so influential that we see them cited again, and again, and again.
By the end of this tweet, you'll know some of the most influential papers in orthopaedics:
Harris 1969: Traumatic
🐯The ChEETAh Trial: Preventing Surgical Site Infection in Low-Middle Income Countries
Published in
@TheLancet
Surgical site infection is the most common surgical complication. Especially in low-to-middle-income countries.
Routine change of gloves and instruments before wound
🦵Patient Journey in Knee Osteoarthritis: What Defines Success?
OE's Dr. Mohit Bhandari sat down with Dr. Aaron Johnson, a surgeon at the University of Maryland, to discuss treatment options for knee arthritis, and how surgeons and patients should define success when it comes to
ANNOUNCING! OrthoJOE, a podcast featuring JBJS Editor-in-Chief, Dr. Marc Swiontkowski and OrthoEvidence's Editor-in-Chief, Dr. Mohit Bhandari. Listen to our first episode.
#orthoevidence
#jbjs
#podcast
#orthojoe
💉Adding Dexmedetomidine to Femoral Nerve Blocks in Total Knee Arthroplasty: A Systematic Review of RCTs
An OE Original
Total knee arthroplasty (TKA) is an effective treatment for knee osteoarthritis.
But the procedure is painful to recover from.
Femoral nerve blocks have
More Pain, More Gain? Exercise for Osteoarthritis
Based on Insights from
@Dinosaur_MD
The relationship between OA and physical activity is hotly debated. Does running cause or prevent OA? Should patients with OA engage in exercise, even if waiting for a total joint replacement?
All-Polyethylene vs. Metal-Backed Tibial Components in Total Knee Arthroplasty: A Meta-Analysis of RCTs
Just released in
@JArthroplasty
What is the best type of tibial component in total knee arthroplasty (TKA)?
Three different meta-analyses have compared metal-backed and
Ceramic-On-Ceramic vs. Metal-on-Conventional Polyethylene Bearings in Total Hip Arthroplasty
🚨 A 20-YEAR Follow-Up Study
A clinical trial started in 1996 aimed to find out how Ceramic-on-Ceramic (CoC) and Metal-on-Conventional Polyethylene (MoPc) compared with respect to
Tourniquet use during total knee arthroplasty is HIGHLY controversial.
Whether it’s blood loss, complications or pain, surgeons can’t seem to agree on its benefits and risks.
This meta-analysis aimed to clear up the confusion around tourniquet use in TKA:
💊The NoPain Trial: Reducing Opioid Consumption in Knee & Shoulder Arthroscopy
Published in
@JAMA_current
Orthopedic surgeons are among the top prescribers of opioids.
Can an opioid-sparing pain protocol - consisting of education, NSAIDs, and acetaminophen - reduce
Improving Pain with Digital Interventions After Knee Replacement
Just published in
@JAMANetworkOpen
Total knee arthroplasty is an effective treatment for end-stage knee osteoarthritis. However, post-operative rehabilitation is critical -- many patients suffer from pain and have
We are pleased to celebrate Canadian Orthopaedic Care Day — dedicated to all those in Orthopaedics; surgeons, nurses, physical therapists, researchers and administrative professionals.
🍁
#CdnOrthoDay
#OrthoCareCanada
DID YOU KNOW?
In 1971, Dr Frank Gunston published his designs for a new polycentric knee implant, the 1st to consider the natural biomechanics of the knee! 🦿
Oral vs. Intravenous Antibiotics for Bone & Joint Infection
Published in the NEJM (2019; 380: 425-436)
The management of bone or joint infection typically involves intravenous antibiotics. But can oral antibiotics provide comparable results?
This trial aimed to find out 👇
🎙New OPEN ACCESS OrthoPod: New Lancet Trial Bursts the Balloon: Subacromial Balloon Spacer for Irreparable Rotator Cuff Tears with
@AndyMetOrtho
#orthotwitter
Have you become dated🤔? View Marc and Mo's discussion on the OrthoJoe E. 23: Evidence-Based Orthopedics (Second Edition) and the Future of Books in Orthopaedic Learning
@jbjs
Citation: OrthoEvidence. Platelet-rich Plasma (PRP) Versus Corticosteroid Injection for Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials. OE Original. 2022;5(11):2. Available from:
Mo and Marc
@jbjs
are joined by
@DrAntoniaChen
and Andrew Schoenfeld in a discussion of their vision for the newest JBJS podcast, “Your Case Is On Hold,” which covers each upcoming issue of JBJS, with an added dose of entertainment and pop culture.
🎙️NEW ORTHOPOD: Surgery Wins in Trial of Operative VS Non-Op Treatment of Non-Acute ACL Injury with
@david_j_beard
, University of Oxford.
#orthotwitter
Watch the full episode⬇️