Orthopedic Surgery

PRO reporting in spinal RCTs is inconsistent; only a minority meet ISOQOL standards.

In 42 RCTs (8,669 patients) of spinal disorders, PROs were primary in 95.2% but reporting quality was poor overall. Investigators used 25 different PRO tools spanning pain, function, QoL, experience, and psychology; psychological measures were underused. Only 27.2% of trials met high-quality PRO reporting criteria, with frequent failures to justify instrument choice and handle missing data. The authors recommend standardized PRO selection, prespecified collection modalities, and robust missing-data plans to improve validity and comparability. 1

Protocol: randomized trial of nitrous oxide versus placebo for pain during post-THA rehabilitation in patients ≥65.

This double-blind RCT will randomize 160 patients aged ≥65 with acute rehabilitation pain (VAS ≥4) to nitrous oxide or placebo during therapy. Primary endpoint is between-group VAS pain difference during rehabilitation (T1), with secondary endpoints including anxiety, balance, ambulation, side effects, and satisfaction. Safety monitoring includes continuous pulse oximetry, vital signs, and predefined stopping rules for adverse events. Results will inform whether nitrous oxide provides rapid, reversible analgesia during THA rehabilitation in elderly patients. 2

Non‑opioid multimodal regimen yields similar pain, opioid use, and satisfaction after arthroscopic labral repair in youths.

In 34 opioid‑naive patients aged 15–25 undergoing arthroscopic glenoid labrum repair, mean total MME was very low in both groups (experimental 4.0 vs control 2.4). There were no significant differences in daily VAS pain scores, total MME, or satisfaction between non‑opioid and opioid‑containing regimens. By day 14, 88.24% of patients reported being very satisfied with pain control, and 85% of the cohort consumed no postoperative opioids. These randomized data support using nerve block plus multimodal non‑opioid strategies to minimize opioid exposure in this population. 3