Common elective orthopaedic procedures and their clinical effectiveness: umbrella review of level 1 evidence

Review written by Todd Hargrove info

Key Points

  1. Many of the most common elective orthopaedic interventions are not backed by high-quality evidence.
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BACKGROUND & OBJECTIVE

In the UK, musculoskeletal conditions account for over 25% of all surgical interventions (1). However, it is unclear whether the orthopaedic procedures for managing these musculoskeletal conditions are accompanied by high-quality evidence.

This umbrella review sought to determine the clinical effectiveness of the ten most common elective orthopaedic procedures: ACL reconstruction, meniscal repair, partial meniscectomy, rotator cuff repair, subacromial decompression, carpal tunnel decompression, lumbar spine decompression, lumbar spine fusion, total hip replacement, and total knee replacement.

In the UK, musculoskeletal conditions account for over 25% of all surgical interventions.
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Clinicians should help educate their patients about the evidence on the surgery they are considering, as well as the potential risks and benefits.

METHODS

The authors collected and evaluated systematic reviews, meta-analyses of randomized controlled trials, or other study designs, that compared the effectiveness of any of these 10 orthopaedic procedures with no treatment, placebo, or non-operative care. The evidence in support of each

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