What is it? I have example! Take a look at this study: Arthroscopic Subacromial Balloon Spacer for Massive Rotator Cuff Tears Demonstrates Improved Shoulder Functionality and High Revision-Free Survival Rates at Minimum 5-Year Follow-up. Authors concluded: “… subacromial balloon spacer placement in conjunction with biceps tenotomy and subacromial bursectomy for massive rotator cuff tears yielded […]
How to recognize low-value treatments in orthopaedic research?
Low-value care is defined “as the use of a health service for which the harms or costs outweigh the benefits“. In other words, if a certain surgical procedure cannot be shown to result in superior results compared to nonoperative treatment or simple watchful waiting, this procedure can be labelled as low-value care. Randomized clinical trials […]
Inefficiency is a major problem in the orthopaedic surgery and treatment of MSK diseases
The following text was written by my esteemed research colleague and a collaborator Teemu Karjalainen. It was published as a scientific editorial in the Finnish Medical Journal. This editorial is very solid description of the current state in the treatment of MSK diseases and I advise all orthopaedic surgeons to read it carefully and assimilate […]
Orthopaedic science is amiss
I have been conducting clinical research in orthopaedics and traumatology for 15 years. I have also had the opportunity to work with excellent collaborators in the field of clinical research, providing me with a comprehensive overview of clinical research as a whole. My overall conclusion from several years of my own research and collaboration is […]
Apparently not all PRP is made equal
Orthobiologics have become increasingly popular in recent years. OrthoInfo defines orthobiologics as “therapies developed from biologic (natural) substances that can be used by orthopaedic specialists to relieve pain […], enhance the body’s ability to heal from a repetitive use injury […] and in some cases, improve healing after orthopaedic surgery.” One of the most popular […]
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 […]
We need to get better in contrafactual thinking
This probably also applies to other medical subspecialties, but we orthopaedic surgeons are very bad at contrafactual thinking. For the sake of our patients, we need to understand better a hypothetical situation in which we could have done otherwise. Once again, something like this was written: Extremely medialized repair of large and massive tears not […]
What was left out from our critical APM paper?
Early this year, we published a paper that I am incredibly proud of. For a long time, I have thought that arthroscopic partial meniscectomy in the treatment of degenerative meniscus tears “does not make sense.” I mean that there is no credible biological mechanism for removing the torn meniscus to make the knee any better […]
Low-intensity pulsed ultrasound or LIPUS to improve injury healing?
LIPUS has been proposed to improve fracture healing but no evidence supports this proposal. Omer Ilahi writes in a recent editorial in the Arthroscopy: Still, the positive findings of animal investigations with LIPUS in the acute setting are intriguing. I therefore find myself in agreement with Lai et al. in that large, randomized, placebo-controlled human […]
Checklist for robust methodology and statistical analyses?
Recent editorial in the CORR was about EQUATOR guidelines and the editors write: Since reporting guidelines rely on consensual scientific principles and evidence-based research, consulting them before beginning a project will tend to cause clinician scientists to consider why an element of a checklist is included; doing so inevitably results in discussion and consideration of […]