More well developed orthopaedic prediction models

It seems that appropriate methodology in the development of prediction models is becoming more common in our field. These two recent studies caught my attention: Development of a model to predict the probability of incurring a complication during spine surgery and Prediction of 90-day mortality after total hip arthroplasty. Both studies report calibration performance and […]

Orthopaedic journals really stand out and not in a good way

Preprint policy of majority of academic journals can be found in the Wikipedia: https://en.wikipedia.org/wiki/List_of_academic_journals_by_preprint_policy. Some 130 journals can be found in the list. Large majority of journals allow preprints prior to submission. Few journals have restrictions. Four journals glow in red since journal policy does not allow preprints. Which journals would they be? These journals […]

The fallacy of “meniscal of symptoms”: part 2

I don´t have anything else to add to my post from yesterday, besides what MacFarlane conclude: “Meniscal symptoms” were not associated with improved pain relief. Although symptoms of clicking and intermittent locking had a greater reduction in the APM group, the presence of “meniscal symptoms” in isolation should not inform clinical decisions surrounding APM vs. […]

The fallacy of “meniscal symptoms”

A long story short. Farina et al. conclude: Contrary to current dogma, this study demonstrates that traditionally defined “meniscal” and “mechanical” knee symptoms are strongly associated with the burden and severity of underlying cartilage damage rather than with specific meniscal pathology. It is only relevant to ask how could an arthroscopic partial meniscectomy be an […]

When we stop “treating” degeneration?

This is a second post about an excellent Invited Paper in the International Orthopaedics. Authors begin their paper as follows: The specialism of orthopaedic surgery covers many subdisciplines. Most of these deal with degenerative changes occurring as a result of the normal aging process. Some will follow trauma or are as a result of congenital […]

How to investigate “novel techniques”?

I liked the study by Lapner et al. very much. Their study was titled “Preoperative bone marrow stimulation does not improve functional outcomes in arthroscopic cuff repair: a prospective randomized controlled trial”. They proposed a new concept to improve healing of rotator cuff repair. Authors hypothesized that preoperative ultrasound-guided bone channeling in the footprint 5-7 […]

Mesenchymal stem cells outperforming total knee replacement

Tan et al. published a meta-analysis about mesencymal stem cells in the tretment of osteoarhritis. They reported pooled estimates as follows: The standardized mean differences (SMDs) for the visual analog scale (VAS) for pain at rest and upon exertion were –1.48 (95% CI, –1.85 to –1.11) and –2.25 (95% CI, –2.64 to –1.85), respectively. This […]

Nth conclusion about hip resurfacings

It can´t be argued that the theoretical premises of hip resurfacing arthroplasty would not have been truly great. What could sound any better than “restoring native anatomy and hip biomechanics”? As we know, everything went a different road. Clough & Clough outlined quite accurate statement about hip resurfacings: Whilst MoM HRA can, in very limited […]

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 […]