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 […]

Mesmerized by clinical prediction models

I am not a surgical oncologist but I came across with this study:  A deep survival interpretable radiomics model of hepatocellular carcinoma patients. Authors conclude: In summary, novel deep radiomic analysis provides improved performance for risk assessment of HCC prognosis compared with Cox survival models and may facilitate stratification of HCC patients and personalization of […]

Problems in all-cause revision analyses in total joint replacement research?

I had a chance to collaborate with Nordic Arthroplasty Register Association in a study published in the Acta Orthopaedica last year. Study was titled “The effect of fixation type on the survivorship of contemporary total knee arthroplasty in patients younger than 65 years of age: a register-based study of 115,177 knees in the Nordic Arthroplasty […]

It´s all about explained variation in the periprosthetic joint infections

I showed this slide in my clinic meeting presentation which was about periprosthetic joint infections. Infection rates were very high in the early years of modern total joint replacement surgery in 1960s. Today, the risk of deep infection after a total hip or knee replacement surgery is something close to 1%. This major improvement is […]

Basics of artificial intelligence and machine learning for every trainee?

This was an interesting perspective: What Should Radiology Residency and Fellowship Training in Artificial Intelligence Include? A Trainee’s Perspective—Radiology In Training. Just some take from the commentary: Trainees should be introduced to the basic concepts of data collection, annotation, and algorithm validation. AI and ML are here to stay. Hence it is important that these […]

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 […]

Embracing the biopsychosocial and psychosocial characteristics of our patients

I write extensively about shared-decision making and patient´preferences as part of our decision making orthopaedics. Hence I considered this Invited Paper by Quaile, Mavrogenis and Scarlat in the International Orthopaedics as truly excellent piece: Managing patients’ expectations in orthopaedics. Authors write among other things: There is a problem with patient-reported outcome measurements, PROMs, as depressive symptoms and […]

No difference and type II error – a guideline?

Domb and Sebatian discuss about type II error in a “Level V guideline“. Among other things they conclude: Type II errors may be present in greater than 20% of studies that fail to find statistically significant differences. Incorrectly concluding that there is no difference in such studies poses a danger to the advancement of clinical practice, and indeed […]

Orthopaedic prediction models are getting there!

Purely predictive studies are becoming more common also in the orthopaedics. Unfortunately they have quite often very poor methodology and do not give much insight to actual prediction problems. Hence it was great to read the study by Schaefer et al. in Clinical Orthopaedics and Related Research. Their study was titled “What Factors Predict Adverse […]