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 […]

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 […]

Cup coverage and dislocation risk in THA

This is one of our recent work from Coxa Hospital for Joint Replacement. This relates to post-marketing surveillance which is always very important topic. In short, main primary THR system changed and anecdotal evidence started to accumulate that maybe dislocations had become more common with the new cup system. We decided to take a deeper […]