Author Archives: Aleksi R

Global volume of knee arthroscopy surgeries

By | June 30, 2020

This blog post is an update to my earlier Twitter thread in which I presented trends of knee arthroscopy procedures in different countries. Full thread about arthroscopic partial meniscectomy (APM) can be found here. Finally, how has the orthopaedic community responded to this bulk of evidence? Not as would be expected. Further studies are urgently… Read More »

Cup coverage and dislocation risk in THA

By | May 11, 2020

This is one of our recent work from Coxa Hospital for Joint Replacement. This relates to post-marketing surveillance which is always very important topic. In short, main primary THR system changed and anecdotal evidence started to accumulate that maybe dislocations had become more common with the new cup system. We decided to take a deeper… Read More »

Views of orthopaedics – part 2

By | May 8, 2020

I continue discussing an excellent editorial published in the BJJ. Alex Trompeter writes: We are now seeing the pendulum swing in terms of treatments we select, as our understanding of the science of fracture fixation improves. Moreimportant, however, is the recognition that the patient’s own experience is the most vital outcome when measuring the success… Read More »

Views on orthopaedics motivated by recent editorial – Part 1

By | May 5, 2020

A recent editorial in the Bone & Joint Journal was about weight-bearing in orthopaedic traumatology. Written by Alex Trompeter, the title was intriguing: A call to arms: it’s time to bear weight! This editorial was best I have read in a while. Besides weight-bearing, Trompeter addressed many other general topics. In following posts I will… Read More »

Why do we need randomized trials?

By | April 28, 2020

Discussion about randomized controlled trials (RCT) has been extensive in social media during this spring due to corona virus epidemic. This discussion was especially heated when “not so good” clinical trial was published stating that hydroxychloroquine is efficient in the treatment of corona virus disease (CoViD-19). I drew this picture and posted it on Twitter.… Read More »

Exploratory or confirming study?

By | February 21, 2020

Methodology is hard. And making valid inferences is very hard. With regard to these topics, orthopaedic research is not very different to other field in medicine. It means that misconceptions, misunderstandings and flawed approaches are prevalent also in our field. American Journal of Sports Medicine published recently two papers which both made a quite common,… Read More »

Treatment outcomes and shared decision making

By | February 10, 2020

Key points Clinical equipoise will become more common in orthopaedics When treatment outcomes are subjective and have large heterogeneity, shared decision making should be used Clinical equipoise means a situation when there is no objective superiority between two choices. The lack of superiority may be due to complete lack of data or evidence about certain… Read More »

Population health and orthopaedic surgeries

By | January 15, 2020

Both knee arthroscopy for partial meniscectomy and shoulder arthroscopy for acromioplasty were very common procedures few years back in orthopaedic surgery. During the first two decades of this millennium extensive amount of research has been published showing that the effect of these procedures to treat knee and shoulder pain and function is quite weak. Despite… Read More »

Propensity scores, orthopaedics and shared decision making

By | January 7, 2020

This is something I posted on Twitter last October. Extended discussion can be found below the tweets Propensity score matching is often used when two cohorts of patient are compared. Aim is to have somewhat comparable groups so effect of treatment or intervention could be estimated reliably. In short, two groups of patient tread by… Read More »