Arthroscopy 15 weeks before TKR surgery?

This post could be also titled “Why we dichotomize: Part XXIXCM”, but I´ll focus on the subject matter. Gu et al. investigated how prior knee arthroscopy affects the subsequent total knee replacement surgery. They concluded: This study suggests that an interval of at least 36 weeks should be maintained between the 2 procedures to minimize […]

Conceptual replication and elbow osteoarthritis

Van Berkel and Crandal define conceptual replication as follows: Conceptual replication means that researchers re-test the same theoretical idea or hypothesis repeatedly, but use different populations, different ways of manipulating variables, different ways of measuring variables, or using different study designs. Surgical treatment of joint degeneration is an excellent topic in orthopedics where conceptual replication applies […]

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 […]

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 […]

Global volume of knee arthroscopy surgeries

This blog post is an update to my earlier Twitter thread in which I presented trends of knee arthroscopy procedures in different countries. Full thread about arthroscopic partial meniscectomy (APM) can be found here. Finally, how has the orthopaedic community responded to this bulk of evidence? Not as would be expected. Further studies are urgently […]

Population health and orthopaedic surgeries

Both knee arthroscopy for partial meniscectomy and shoulder arthroscopy for acromioplasty were very common procedures few years back in orthopaedic surgery. During the first two decades of this millennium extensive amount of research has been published showing that the effect of these procedures to treat knee and shoulder pain and function is quite weak. Despite […]