Every edition. An expanding view of orthopaedic evidence.
Compression bandaging and soft braces are commonly recommended or self-applied for knee osteoarthritis pain, and this trial suggests short courses of simple elastic compression have no clinically meaningful benefit over a sham wrap or no treatment, which should temper enthusiasm for this low-cost adjunct.
This helps surgeons decide when the extra time and cost of double-row fixation is justified: reserving it for larger tears while using the faster single-row technique for small-to-medium tears.
Orthopaedic surgeons increasingly manage fragility fractures in an aging population on GLP-1 receptor agonists, and this large observational signal raises the question of whether these drugs affect bone health differently than assumed.
This challenges the assumption, embedded in current PROSPECT guidelines, that specific regional blocks meaningfully reduce pain after hip arthroplasty, and instead points clinicians toward opioid-sparing and discharge-related benefits rather than pain control itself.
DOMS is a near-universal complaint after unaccustomed eccentric exercise with no proven treatment, so a sham-controlled test of a passive modality like PEMF is relevant for sports medicine and rehabilitation counselling.
Ankle fracture fixation is one of the most common orthopaedic trauma operations, and this trial supports letting selected patients bear weight at 2 weeks rather than restricting them until 6 weeks.
High volume injections are increasingly offered for stubborn Achilles tendinopathy, and this sham-controlled trial suggests they add no lasting benefit to exercise, with steroid offering only brief relief and possible later harm.
Paediatric distal radius fractures are the most common childhood fracture, and knowing when remodelling makes reduction unnecessary can spare young children anaesthesia, pins, and their complications.
Distal tibia fractures are a common trauma problem, and knowing the trade-off between infection risk with plating and knee pain with nailing is core knowledge for counselling and for exams.
Denosumab biosimilars may lower cost and widen access to a key antiresorptive for osteoporosis, which matters for secondary fracture prevention after fragility fractures seen on orthopaedic services.
Cell-based injections for knee arthritis are widely marketed, so a sham-controlled trial showing a 12-month responder benefit (with a wide confidence interval and an unusual composite endpoint) is directly relevant to how you counsel patients asking about biologics.
Patients with RA on biologics or JAK inhibitors often come to orthopaedic surgery, and knowing that carefully supervised dose reduction usually preserves disease control helps in perioperative medication discussions and co-management with rheumatology.
Weight gain from modern HIV regimens is a major cardiometabolic concern worldwide, and this is the first head-to-head RCT designed specifically to test whether an alternative first-line regimen can reduce that risk without sacrificing viral control.
Interscalene blocks routinely paralyze the ipsilateral hemidiaphragm, so a surgeon-performed lung-sparing alternative matters for patients with poor respiratory reserve and for centres without ultrasound-guided regional anaesthesia.
Topical vancomycin powder is increasingly used off-label in fracture surgery, so clerkship students should know the current evidence is a modest, fragile pooled signal rather than a settled practice.
This is one of the largest comparative cohorts on posterior cervical decompression strategy and adds long-term reoperation data to an ongoing debate about laminoplasty versus laminectomy/fusion for multilevel cervical myelopathy.
How PRP is delivered (preparation, image guidance, rehab) may matter as much as whether it is given at all, which helps explain the conflicting PRP literature in knee osteoarthritis.
Psoriatic arthritis can cause erosive hand and foot joint destruction that orthopaedic surgeons may later reconstruct, so knowing which biologics slow radiographic damage helps with referral and with counselling before surgery.
Tibial plateau fractures are common trauma cases, and this pooled RCT evidence suggests arthroscopic-assisted fixation for lower-grade fractures may offer better function and fewer complications than the traditional open approach.
Frozen shoulder is a common clinic and exam topic, and this review shows that the evidence behind most of its many treatments is weak, short-term, and unable to rank options definitively.
It is the only randomised comparison of the two main stabilisation operations in the highest-risk group of shoulder dislocators, and it directly informs the Bankart versus Latarjet decision often tested on boards and debated in clinic.
Tetraplegia after posterior cervical decompression is a rare but catastrophic complication, and these real-world incidence estimates and procedure comparisons can inform how surgeons counsel patients when choosing between laminectomy and laminoplasty.
Double- versus single-bundle ACL reconstruction is a classic sports medicine debate, and this review suggests any rotational stability advantage is modest, early, and does not clearly translate into function, return to sport, or graft survival.
Prehabilitation and nutritional optimisation before joint replacement are common enhanced-recovery topics, and this trial suggests a cheap, simple protein-plus-exercise bundle may speed early recovery after THA.
This raises a real concern for how surgeons counsel elderly patients about adding fusion to decompression when there is no clear structural indication like instability or deformity.
Distal radius fracture is one of the most common orthopaedic procedures, so identifying patients with opioid-related disorder as a high-utilisation, high-risk subgroup could help hand surgeons target perioperative counselling and opioid stewardship.
Psychological distress and baseline disability may not prevent patients with chronic whiplash from benefiting from exercise, which matters when deciding who to refer for neck-specific rehabilitation.
Liposomal bupivacaine costs about $330 more per dose, and this review suggests its added analgesic benefit in interscalene blocks is too small to matter clinically for most shoulder surgery patients.
Swimming is commonly recommended for chronic low back pain despite almost no prior trial evidence, so this is the first dedicated RCT testing whether it actually helps.
Fear of movement and catastrophizing predict poor recovery after TKA and ACL reconstruction, so knowing whether psychologically informed rehab actually helps is relevant to perioperative counselling and rehab referral.
Preoperative anxiety is common in spine surgery patients and is linked to worse pain and recovery, so a drug-free, content-matched way to reduce it is relevant to perioperative counselling.
Spine surgeons increasingly operate on elderly patients, and this suggests cognitive screening could help identify who needs tighter glycemic, frailty, and blood management optimisation before lumbar fusion.
Chronic lateral ankle instability is a common indication for ankle ligament surgery, and knowing that arthroscopic repair mainly changes early recovery and wound problems, not long-term function, helps frame surgical choice and patient counselling.
Choosing a hip arthroplasty approach is a common exam and clinic question, and this trial suggests a muscle-sparing posterior approach may bleed less and take less time than DAA in the early perioperative period. Because each approach was done by one surgeon with a different implant system, part of the difference may reflect the surgeon or implant rather than the approach itself.
Displaced midshaft clavicle fractures are a common trauma and exam topic, and this review suggests surgery is chosen to prevent nonunion and malunion rather than to improve final shoulder function.
Early rehabilitation after TKA is a high-volume, routine part of care, and low-cost motion-sensing VR is increasingly marketed as an add-on, so knowing whether it adds real benefit beyond extra therapy time is practical for counselling and resource planning.
For surgeons performing meniscal allograft transplantation, this study suggests that fixation technique choice may meaningfully affect long-term graft durability and reoperation risk, a key consideration in patient counselling and surgical planning.
Students counselling families of children with mild to moderate scoliosis should know that scoliosis-specific exercise, especially Schroth, has the strongest pooled signal for curve and rotation change, although the trials are small and often at risk of bias.
It challenges the standard teaching that arthroplasty beats fixation for displaced femoral neck fractures, but mostly shows how registry outcomes can mislead in patients with dementia.
It suggests that getting L4-S1 lordosis into a specific numeric target at the index TLIF may be one of the biggest levers surgeons have to prevent costly, disabling revision surgery down the road.
This helps spine surgeons decide how far to extend cervical fusion constructs and whether to use pedicle versus lateral mass screws at C7 to reduce revision risk at the cervicothoracic junction.
This adds single-surgeon RCT data to the ongoing debate about whether robotic functional alignment TKA meaningfully improves patient-reported outcomes over conventional mechanically-aligned TKA, a question directly relevant to whether surgeons should adopt costly robotic platforms.
Trapeziectomy-based procedures are the classic operation for thumb CMC arthritis, and dual-mobility prostheses are a newer option that may speed early recovery, but any long-term trade-off in revision risk remains unknown.
Distal radius fractures in older adults are among the most common fractures you will see, and whether to cast or plate them is a frequent exam and clinic question.
It highlights that gout patients, who are frequently exposed to glucocorticoids and have comorbid CKD, are being under-screened and undertreated for osteoporosis despite bearing a higher fracture burden, a gap relevant to any clinician managing bone health in this population.
Duloxetine is a guideline-listed option for osteoarthritis pain, and students should know that its benefit is small, best shown against placebo, and comes with more side effects.
TXA is used routinely to limit bleeding in spine fusion, and this review suggests IV TXA, alone or with topical TXA, is the most reliable way to give it, while showing that safety data on thromboembolic events remain thin.
Spine surgeons using the GAP score to counsel older Asian patients about mechanical complication risk should know it performs poorly, essentially no better than a coin flip, in this population.
Paediatric forearm fractures are very common, and vitamin D deficiency is a plausible modifiable factor in slower bone healing, but these results are associations from a non-randomised comparison with internal numerical inconsistencies.
This adds observational support for using robotic assistance in a high dislocation-risk THA population, a decision point residents will face increasingly often as spinopelvic considerations become standard in preoperative planning.
