How to investigate “novel techniques”?

I liked the study by Lapner et al. very much. Their study was titled “Preoperative bone marrow stimulation does not improve functional outcomes in arthroscopic cuff repair: a prospective randomized controlled trial”. They proposed a new concept to improve healing of rotator cuff repair. Authors hypothesized that preoperative ultrasound-guided bone channeling in the footprint 5-7 […]

Three-to-one response to our letter

In my previous blog post I told about our letter to editor concerning a study criticizing sham-controlled studies in orthopaedics. Another letter was also submitted and accepted at the same time by Harris, Poolman and Buchbinder. They had also very important aspects regarding the criticism towards sham-controlled RCTs: We agree that there are other methods […]

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 […]

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 […]

Larger sample sizes in orthopaedics?

My recent research efforts have concerned metaresearch on orthopaedic RCTs. We have argued many aspects in those studies and in their quality. One major aspect is the sample size which still remains very small. In our recent paper we investigated orthopaedic RCTs published in 2016 and 2017 and we reported: The median numbers of patients […]

Role of sisu, a special form of courage, grit, and determination in orthopaedics

Sochacki et al. write as follows in recent study criticizing sham-controlled studies in orthopaedics: Additionally, two studies in this systematic review were performed in Finland. Unfortunately, any study investigating an intervention (e.g. surgery) on individuals born and raised in Finland cannot be extrapolated to the rest of the world. Finns embrace sisu, a special form […]

Why do we need randomized trials?

Discussion about randomized controlled trials (RCT) has been extensive in social media during this spring due to corona virus epidemic. This discussion was especially heated when “not so good” clinical trial was published stating that hydroxychloroquine is efficient in the treatment of corona virus disease (CoViD-19). I drew this picture and posted it on Twitter. […]