Views of orthopaedics – part 2

I continue discussing an excellent editorial published in the BJJ. Alex Trompeter writes: We are now seeing the pendulum swing in terms of treatments we select, as our understanding of the science of fracture fixation improves. Moreimportant, however, is the recognition that the patient’s own experience is the most vital outcome when measuring the success […]

Views on orthopaedics motivated by recent editorial – Part 1

A recent editorial in the Bone & Joint Journal was about weight-bearing in orthopaedic traumatology. Written by Alex Trompeter, the title was intriguing: A call to arms: it’s time to bear weight! This editorial was best I have read in a while. Besides weight-bearing, Trompeter addressed many other general topics. In following posts I will […]

Exploratory or confirming study?

Methodology is hard. And making valid inferences is very hard. With regard to these topics, orthopaedic research is not very different to other field in medicine. It means that misconceptions, misunderstandings and flawed approaches are prevalent also in our field. American Journal of Sports Medicine published recently two papers which both made a quite common, […]

Treatment outcomes and shared decision making

Key points Clinical equipoise will become more common in orthopaedics When treatment outcomes are subjective and have large heterogeneity, shared decision making should be used Clinical equipoise means a situation when there is no objective superiority between two choices. The lack of superiority may be due to complete lack of data or evidence about certain […]

Propensity scores, orthopaedics and shared decision making

This is something I posted on Twitter last October. Extended discussion can be found below the tweets Propensity score matching is often used when two cohorts of patient are compared. Aim is to have somewhat comparable groups so effect of treatment or intervention could be estimated reliably. In short, two groups of patient tread by […]

Industry based evidence synthesis

In 2017, me and colleagues published both a literature and registry based analysis of use of metal-on-metal hip replacements. This study, titled Lack of evidence—the anti-stepwise introduction of metal-on-metal hip replacements, was a hypothesis-driven study since at that time it seemed that the use of ASR hip replacements was not that evidence based but mainly […]

Declining incidence of MoM revision surgeries

Our recent study investigating annual trends of revision surgeries in patients with MoM hip replacements was recently published in the Journal of Arthroplasty (www). Here is the GrAbstract of the study: This study is of great importance because it is the largest non-registry based study investigating what sort of trends the number of revision surgeries […]

Increasing incidence of quadriceps tendon rupture

Our study about increasing incidence of surgically treated quadriceps tendon ruptures was just published in the Knee Surgery, Sports Traumatology, Arthroscopy. At this moment it is in Open Access format so full-text is freely available. Below is the grabstract, ie. graphical abstract, of our study. In our study we write “There is no evidence of […]