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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Chronic low back pain is one of the most common musculoskeletal complaints, and this trial shows how a supervised, exercise-heavy rehabilitation package can outperform minimal home breathing exercises, although this does not prove that the diaphragm-training component itself is the key ingredient.
Frozen shoulder is extremely common and often slow to resolve with steroid injection alone, so a same-day, ultrasound-guided manipulation protocol that avoids general anaesthesia could change how orthopaedic surgeons manage refractory stiffness in the clinic.
Early mobilisation after knee replacement is standard, and this trial suggests that a cheap bedside cycle may add short-term gains in pain, motion and function, which is relevant when counselling patients on inpatient rehab after TKR.
Many patients still have pain and poor knee function years after ACL reconstruction, and this trial tests whether a structured late-stage exercise programme can help them.
CRPS-I of the foot/ankle is a difficult, disabling condition with limited proven adjuncts, so evidence about a home-use, non-invasive PEMF device is relevant to orthopaedic and rehabilitation practice even though this trial is small and unblinded.
As AI tools and telehealth enter musculoskeletal care, this suggests patients may trust clinicians less when AI use is visible, which matters for how clinicians communicate about technology.
Flexor tendon repairs in zones 1 and 2 are common hand injuries, and this is the first large randomised comparison of the splints therapists choose between after surgery.
Elastic bands are a cheap, portable way to add resistance training for female athletes, and hamstring strength is relevant to hamstring and ACL injury prevention, though this study did not measure injuries.
Once the physis has closed, guided growth is no longer an option for adolescent genu valgum, so knowing that both osteotomy types correct alignment well but change leg length in opposite directions helps with technique choice and family counselling.
Patients on biologics or JAK inhibitors commonly ask whether to pause treatment around vaccination, and this trial suggests pausing adds flare risk without a measurable antibody gain.
Graft choice in MPFL reconstruction is a common patellofemoral instability question, and this trial suggests synthetic augmentation may speed early recovery without changing 1-year function, while long-term safety of synthetic material remains unknown.
Biceps tenodesis is common and lacks a standardised tensioning technique, so evidence on whether a more meticulous patient-specific method actually improves outcomes helps surgeons decide if the extra technical effort is worthwhile.
Many spine surgeons already use intrawound vancomycin powder for SSI prophylaxis, and this trial addresses a lingering safety worry from retrospective data that it might shift infections toward resistant or gram-negative organisms.
Core motor-control exercise programmes are a mainstay for chronic non-specific low back pain, and this trial tests whether a consumer VR headset adds measurable value on top of them.
Anemic MI patients are common in both cardiology and perioperative orthopaedic settings, and this reanalysis illustrates how a 'negative' P=.07 trial can be reframed as supportive evidence using Bayesian statistics, a distinction trainees should recognise when reading transfusion literature.
First MTP fusion is the standard operation for end-stage hallux rigidus, and whether patients must stay off the foot for 6 weeks has a large effect on driving, work, falls risk and who can safely be offered surgery.
