I understand that the results of sham-controlled trials can be difficult to accept, especially when they challenge prior beliefs about a procedure’s efficacy. However, these trials are essential for answering the fundamental question: Does it really work? Even if you disagree with their conclusions, I urge you not to rely on the Fragility Index in […]
Tag: orthopaedics
What do we need in orthopaedic research? – Case gluteal tendon tear
Orthobullets is an excellent educational platform. However, their case examples consistently seem to favor surgical treatment. This may, of course, stem from the generally surgery-oriented culture in the US. When compensation is tied to the number of operations performed, treatment preferences naturally reflect this. A recent Orthobullets case in X featured a 78-year-old female patient […]
Shamanism and orthopaedics
Yes, we orthopedic surgeons are shamans or spiritual healers. And I don’t mean the magic of surgery. There is nothing magical about the majority of our operations. We are shamans because we trick ourselves and our patients with the same principles as shamans and spiritual leaders of the past. Firstly, Stuart Green wrote an excellent […]
Quote from Mark Twain doesn’t mean good patient treatment
If you decide to quote a famous writer in your article, make sure the context is preferably fundamental. Sherman and Albersheim quote Mark Twain in their opinion piece. Age is an issue of mind over matter. If you don’t mind, it doesn’t matter. Their punchline is a criticism towards a dogma, saying, “‘older’ patients with […]
To my fellow orthopods 1 – Why do we oppose orthopaedic sham-controlled trials so aggressively?
Sometimes, I wonder if orthopaedics is a branch of modern medicine at all. While large, multicenter RCTs are common practice in other fields, in orthopaedics, we seem to rely on mechanical reasoning, biological plausibility, and uncontrolled before-after studies. This duality has become very visible with regard to orthopaedic sham-controlled trials. A recent research in the […]
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 […]
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 […]