Risk communication is crucial part of doctor-patient interaction. This is also true for field of orthopaedics and traumatology. As we move towards shared decision making in our field, research about different methods for risk communication is very relevant. Waters et al. investigated different methods for risk communication in the study “Risk Ladder, Table, or Bulleted […]
About: Aleksi R
Posts by Aleksi R:
No APM study should go without citing sham or physiotherapy controlled RCTs
Beletsky et al. conclude in their study: The majority of patients undergoing APM achieve benefit within 6 months of surgery, with diminishing proportions at later timepoints. This should not come as a surprise considering that arthroscopic partial meniscectomy (APM) has no proven efficacy as shown by numerous high quality RCTs which have included even sham-surgery […]
Do we have bigger problems than possible lowering the threshold of statistical significance
Evans et al. published following study in the Arthroscopy Journal “The Potential Effect of Lowering the Threshold of Statistical Significance From P < .05 to P < .005 in Orthopaedic Sports Medicine”. This caught my attention since these authors published similar article in another journal in 2019 titled “Effects of a proposal to alter the statistical significance threshold on […]
Larger sample sizes in orthopaedics?
My recent research efforts have concerned metaresearch on orthopaedic RCTs. We have argued many aspects in those studies and in their quality. One major aspect is the sample size which still remains very small. In our recent paper we investigated orthopaedic RCTs published in 2016 and 2017 and we reported: The median numbers of patients […]
Yet another clavicle fracture review
Systematic reviews and meta-analyses on clavicle fractures are never ending sources of publications. We did our share by investigating the potential of sources of heterogeneity among RCTs investigating operative and nonoperative treatment in midshaft claviclar fractures. Our study titled Factors explaining heterogeneity in studies comparing surgical and nonsurgical treatment of midshaft clavicle fractures: a meta-regression […]
Role of sisu, a special form of courage, grit, and determination in orthopaedics
Sochacki et al. write as follows in recent study criticizing sham-controlled studies in orthopaedics: Additionally, two studies in this systematic review were performed in Finland. Unfortunately, any study investigating an intervention (e.g. surgery) on individuals born and raised in Finland cannot be extrapolated to the rest of the world. Finns embrace sisu, a special form […]
When you thought you had seen it all… Part 2
Sham-surgery or surgical placebo is increasingly used in orthopaedic randomized controlled trials. Most notable studies include comparison between sham-surgery and arthroscopic partial meniscectomy in knee and arthoscopic subacromial decompression in shoulder. These studies have truly challenged the traditional treatment guidelines in degenerative knee and shoulder conditions. I have previously posted about population level changes in […]
When you thought you had seen it all…
I follow regularly the field of sports surgery and new studies published in that subspecialty. It seems the true research gems are only seen in sports surgery… I introduce the recent top 2 studies in this and subsequent post. I have research interest in ACL reconstruction studies and this study published in the American Journal […]
Global volume of knee arthroscopy surgeries
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 […]
When to engage in shared decision making?
Very good article about shared decision making was just recently published in the Canadian Family Physician. Authors discuss when shared decision making is the best option. Table 1 in their article is the most important. It gives a clear and concise description when SDM should be considered. First option states: There are at least 2 […]