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 […]

Example of change of attitude

As I wrote yesterday, in some injuries and conditions, it is very hard for us surgeons to say is it better to operate or treat nonoperatively. Echalier et al. conclude in their study: This study supports open reduction and internal fixation with an anatomical plate of displaced fractures of the middle third of the clavicle […]

Change of attitude

Objective superiority between treatment options is becoming rarer in orthopaedics. This means that in numerous conditions, such as in Achilles tendon ruptures, distal radius fractures in the elderly patients and midshaft clavicle fractures, superiority of treatment options, namely operative and nonoperative, is based on patient values and preferences. Patient may not value slightly reduced risk […]

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 […]

How to communicate risk?

Risk communication is crucial part of doctor-patient interaction. This is also true for field of orthopaedics and traumatology. As we move towards shared decision making in our field, research about different methods for risk communication is very relevant. Waters et al. investigated different methods for risk communication in the study “Risk Ladder, Table, or Bulleted […]

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 […]

Do we have bigger problems than possible lowering the threshold of statistical significance

Evans et al. published following study in the Arthroscopy Journal “The Potential Effect of Lowering the Threshold of Statistical Significance From P < .05 to P < .005 in Orthopaedic Sports Medicine”. This caught my attention since these authors published similar article in another journal in 2019 titled “Effects of a proposal to alter the statistical significance threshold on […]