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 […]

What do we need in open fracture research?

Randomized clinical trials are quite rare in open fracture research. Hence, Albright et al. should be commended about their work published in the Clinical Orthopaedics and Related Research. They compared external fixator and intramedullary nail in the treatment of open tibia fractures in Tanzania. This study was further discussed in a CORR Insight which are […]

Benefits of hip resurfacing

I outlined some recent perspectives about hip resurfacing in a post almost two years ago. These perspectives are still well supported as the findings by McLawhorn et al. show. They performed a propensity-score matched analysis between THA and hip resurfacing in “appropriate” patients. They conclude: HRA may provide a functional benefit in sports and recreation […]

Answers are only needed when there are questions to be answered

St Mart et al. conclude in their review: Given the already high satisfaction rate of manual THA, further high-quality comparative studies are required utilizing outcome scores that are not limited by high ceiling effects to assess whether robotic systems justify their additional expense The first part is very often ignored when robotics and other new […]

Silver bullet for fracture healing?

Platelet-rich plasma (PRP) is one of those innovations in orthopaedics which has always had huge potential. It is widely used for variety of different acute and chronic conditions, but unfortunately the evidence of efficacy is still very weak. Fracture healing has been suggested as potential target for PRP. Recent review in the Injury journal quite […]

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 […]

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 […]

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