Why double placebo studies are so common in orthopaedics?

The title is slightly provocative, but I will explain it. On of the leading orthopaedic journals, Journal of Bone and Joint Surgery Am, referenced a study published in another leading orthopaedic journal under a Evidence-based orthopaedics section. This is somewhat controversial. The study, JBJS referenced, was published in September in the American Journal of Sports […]

Machine learning algorithm for correlation analysis – Yes!

I have a PubMed alert for studies involving search with “machine learning”. This study was included in the search list recently: “One-year Follow-Up Results with Hydrogel Implant in Therapy of Hallux Rigidus: Case Series with 44 Patients“. That really stood out. But yes, they indeed used machine learning algorithm to investigate risk factors for treatment […]

Orthopaedic journals really stand out and not in a good way

Preprint policy of majority of academic journals can be found in the Wikipedia: https://en.wikipedia.org/wiki/List_of_academic_journals_by_preprint_policy. Some 130 journals can be found in the list. Large majority of journals allow preprints prior to submission. Few journals have restrictions. Four journals glow in red since journal policy does not allow preprints. Which journals would they be? These journals […]

The fallacy of “meniscal of symptoms”: part 2

I don´t have anything else to add to my post from yesterday, besides what MacFarlane conclude: “Meniscal symptoms” were not associated with improved pain relief. Although symptoms of clicking and intermittent locking had a greater reduction in the APM group, the presence of “meniscal symptoms” in isolation should not inform clinical decisions surrounding APM vs. […]

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 […]

Nth conclusion about hip resurfacings

It can´t be argued that the theoretical premises of hip resurfacing arthroplasty would not have been truly great. What could sound any better than “restoring native anatomy and hip biomechanics”? As we know, everything went a different road. Clough & Clough outlined quite accurate statement about hip resurfacings: Whilst MoM HRA can, in very limited […]

Improvement after APM?

Clinical improvement after certain surgical procedure is a fundamental aspect when evaluating success of a surgical treatment. The most important aspect is outlined in a question: “How would have this patient fared without the procedure?”. This is also major paradigm in the surgical and orthopaedic research. Our clinical experience is usually based on observations how […]

Our response to Sochacki et al. regarding sham-controlled RCTs

Sochacki et al. wrote in their study: Randomized sham-controlled studies in orthopaedic sports medicine have significant methodologic deficiencies that may invalidate their conclusions. High quality sham-controlled RCTs in the field of sports and arthroscopic surgery have met severe objection from people who are advocates of these common procedures. A study after another study show that […]

What to do in infected tibial nonunion when distraction osteogenesis, Mascale or vascularized bone graft is not possible?

Not all science is randomized trials. Some conditions are really rare and in those you can mostly rely on clinical experience. This was exactly the case my colleague had. He had a patient who had undergone a bicondylar plating of severely comminuted proximal tibia fracture. Deep infection resulted to a massive bone loss which lead […]

More research on nonoperative treatment in soft tissue injuries

This study really caught my attention: Long-term Outcome After Nonoperative Treatment for Rockwood I and II Acromioclavicular Joint Injuries published in the American Journal of Sports Medicine. You don´t see this kind of studies every day in sports surgery journals. Actually I managed to find only 20 studies ever published in the AJSM which mentioned […]

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