Posts by Aleksi R:

Crusade against low value care continues

Hohmann et al. published a truly exceptional “Level V Guideline” in the Arthroscopy Journal. They conclude: However, when indicated, SAD has stood the test of time and long-term studies have clearly demonstrated good and excellent outcomes. So, two recent high-quality sham-controlled studies clearly demonstrate that arthroscopic subacromial decompression offers no relevant benefit over sham-surgery. Apparently […]

What sort of improvement we need in our research?

This is not a new study but I came across to this study by Brophy et al. titled “Update on the Methodological Quality of Research Published in The American Journal of Sports Medicine“. They concluded: Despite a dramatic increase in the number of published articles, the research published in AJSM shifted toward more prospective, randomized, […]

Improvement after APM?

Clinical improvement after certain surgical procedure is a fundamental aspect when evaluating success of a surgical treatment. The most important aspect is outlined in a question: “How would have this patient fared without the procedure?”. This is also major paradigm in the surgical and orthopaedic research. Our clinical experience is usually based on observations how […]

Three-to-one response to our letter

In my previous blog post I told about our letter to editor concerning a study criticizing sham-controlled studies in orthopaedics. Another letter was also submitted and accepted at the same time by Harris, Poolman and Buchbinder. They had also very important aspects regarding the criticism towards sham-controlled RCTs: We agree that there are other methods […]

Our response to Sochacki et al. regarding sham-controlled RCTs

Sochacki et al. wrote in their study: Randomized sham-controlled studies in orthopaedic sports medicine have significant methodologic deficiencies that may invalidate their conclusions. High quality sham-controlled RCTs in the field of sports and arthroscopic surgery have met severe objection from people who are advocates of these common procedures. A study after another study show that […]

Conceptual replication and elbow osteoarthritis

Van Berkel and Crandal define conceptual replication as follows: Conceptual replication means that researchers re-test the same theoretical idea or hypothesis repeatedly, but use different populations, different ways of manipulating variables, different ways of measuring variables, or using different study designs. Surgical treatment of joint degeneration is an excellent topic in orthopedics where conceptual replication applies […]

What to do in infected tibial nonunion when distraction osteogenesis, Mascale or vascularized bone graft is not possible?

Not all science is randomized trials. Some conditions are really rare and in those you can mostly rely on clinical experience. This was exactly the case my colleague had. He had a patient who had undergone a bicondylar plating of severely comminuted proximal tibia fracture. Deep infection resulted to a massive bone loss which lead […]

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