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 […]

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 […]

More research on nonoperative treatment in soft tissue injuries

This study really caught my attention: Long-term Outcome After Nonoperative Treatment for Rockwood I and II Acromioclavicular Joint Injuries published in the American Journal of Sports Medicine. You don´t see this kind of studies every day in sports surgery journals. Actually I managed to find only 20 studies ever published in the AJSM which mentioned […]

All those novel surgical techniques and classification systems

In my last post I asked for more research investigating the value our research has produced to our patients. This is something I tweeted a year ago. One might ask if all these new techniques really translate to actual beneft for our patients? Or just benefit for the authors? Here is similar analysis for new […]

We need more research on impact of our research

Number of scientific publications increases massively every year. All sorts of “novel techniques” and “novel approaches” are published continuously. Arthroscopic surgery is a good example. I would guess that ACL reconstrution surgery has the highest number of publications in the field of arthroscopic and sports surgery. Kay et al. published “historical analysis” in ACL surgery […]