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 […]

Continues discourse about “level V evidence”

In my recent post I discussed about “Level V Guideline” for subacromial decompression. I naturally participated to the discussion Drs Poolman and van den Bekerom had started. We wrote in our letter: ‘Optimal patient selection’ can be considered a myth until evidence of effect modifiers arises. We argue that if there were subpopulations that benefit […]

Crusade against low value care continues

Hohmann et al. published a truly exceptional “Level V Guideline” in the Arthroscopy Journal. They conclude: However, when indicated, SAD has stood the test of time and long-term studies have clearly demonstrated good and excellent outcomes. So, two recent high-quality sham-controlled studies clearly demonstrate that arthroscopic subacromial decompression offers no relevant benefit over sham-surgery. Apparently […]