Background. As the number of studies in the literature is increasing, orthopaedic surgeons rely heavily on meta-analyses as their primary source of scientific evidence. The objectives of this review were to assess the scientific quality and number of published meta-analyses on orthopaedic-related topics over time. Methods. We conducted, in duplicate and independently, a systematic review of published meta-analyses in orthopaedics in the years 2005 and 2008 and compared them with a previous systematic review of meta-analyses from 1969-1999. A search of electronic databases (Medline, EMBASE, and the Cochrane Database of Systematic Reviews (CDSR)) was performed to identify meta-analyses published in 2005 and 2008. We searched bibliographies and contacted content experts to identify additional relevant studies. Two investigators used the Oxman and Guyatt Index to assess the quality of the studies and abstracted relevant data. Results. We included 45 and 44 meta-analyses from 2005 and 2008, respectively. While the number of meta-analyses increased five-fold from 1999 to 2008, the mean quality score did not change significantly over time (p=0.067). A significantly lower proportion of meta-analyses had methodological flaws (56% in 2005 and 68% in 2008) compared to meta-analyses published prior to 2000 (88%) (p=0.006). In 2005 and 2008, respectively 18% and 30% of meta-analyses had major to extensive flaws in their methodology. Studies from 2008 with positive conclusions did not use and report appropriate criteria for the validity assessment as often as those reporting negative results. The use of random-effects and fixed-effects models as pooling methods became more popular toward 2008. Conclusion. Although methodological quality of orthopaedic meta-analyses has increased in the past 20 years, a substantial proportion displays major to extensive methodological flaws. As the number of published meta-analyses is increasing, a routine checklist for scientific quality should be used in the peer-review process to ensure methodological standards for publication

Aim: To measure the quality of five major scientific meetings by assessing the publication rate of papers presented and recording their citation index. Material and Methods: Abstracts of podium presentations at the meetings of the Scoliosis Research Society, International Society for the Study of the Lumbar Spine, British Scoliosis Society, BritSpine and Eurospine were included. We performed a Medline search to identify publications from the abstract. We calculated the time from meeting to publication and recorded the citation rate of the articles. Results: Of 396 abstracts, 182 were published in peer-review journals – a publication rate of 46%. The publication rates of the five meetings (SRS, BSS, ISSLS, Eurospine, Britspine) were 69%, 53%, 51%, 38%, 24% respectively. Most publications were in “Spine” (55%), then European Spine Journal (11%). The median citation rate of the papers from the SRS, ISSLS, BSS, Eurospine, Britspine meetings was 3, 3, 3, 2, and 1 respectively. The average time to publication was 16 months. Discussion & Conclusions: Podium presentation is a valuable means for the dissemination of research findings. However, a paper in a peer-reviewed journal is subjected to greater scrutiny, and is perhaps a better indicator of the work’s merit. The average rate of publication in medicine following presentation is 45%. 1. Spinal meetings are within this range. Although the quality of the scientific work is not the only factor to determine publication, and nor is the quality of the presentations the only factor to assess in evaluating a meeting, the rate of publication and citation rate provide an indicator of the quality and scientific level of meetings

Aim: To measure the quality of five major scientific meetings by assessing the publication rate of papers presented and recording their citation index. Material and Methods: Abstracts of podium presentations at the meetings of the Scoliosis Research Society, International Society for the Study of the Lumbar Spine, British Scoliosis Society, BritSpine and Eurospine were included. We performed a Medline search to identify publications from the abstract. We calculated the time from meeting to publication and recorded the citation rate of the articles. Results: Of 396 abstracts, 182 were published in peer-review journals – a publication rate of 46%. The publication rates of the five meetings (SRS, BSS, ISSLS, Eurospine, Britspine) were 69%, 53%, 51%, 38%, 24% respectively. Most publications were in “Spine” (55%), then European Spine Journal (11%). The median citation rate of the papers from the SRS, ISSLS, BSS, Eurospine, Britspine meetings was 3, 3, 3, 2, and 1 respectively. The average time to publication was 16 months. Discussion & Conclusions: Podium presentation is a valuable means for the dissemination of research findings. However, a paper in a peer-reviewed journal is subjected to greater scrutiny, and is perhaps a better indicator of the work’s merit. The average rate of publication in medicine following presentation is 45%. 1. Spinal meetings are within this range. Although the quality of the scientific work is not the only factor to determine publication, and nor is the quality of the presentations the only factor to assess in evaluating a meeting, the rate of publication and citation rate provide an indicator of the quality and scientific level of meetings

Purpose: Our aim of this study was to find out the abstract to publication ratio (APR) in peer-reviewed indexed journals of abstracts presented at BASK annual meetings. We also wanted to identify the publishing journals and to look at the amount of time taken for publication. Methods: We obtained permission from BASK executive committee and retrieved all presentations (podium & poster) over six year period (2000–2005). An extensive PubMed database search was performed to determine whether or not the abstract had been published as a full paper up to the beginning of Nov 2008. Results: A total of 294 abstracts identified, 114 of them were published as 101 full-text articles in 21 different journals. ‘The Knee’ Journal was the most popular destination with 47 publications (41.2%) followed by JBJS (British) with 28 publications (24.5%). The overall abstract to publication ratio (APR) at BASK annual meetings was 38.77%. The mean duration between presentations to publication was 3.96 yrs (range 0 to 7.2 yrs, median 3.4 yrs). Conclusion: On bench marking the APR ratio at BASK presentations, it is comparable with those of BOA (33.1%), other BOA affiliated societies (26–50%) and medical specialties (32–66%). Abstract to publication ratio (APR) is considered as a measure of the quality of scientific meetings and our results indicates the higher credentials of BASK meetings. It is very difficult to exactly determine the reason for abstracts failing to indexed publications; it is arguable that some of these projects did not meet the scientific scrutiny of the peer-review process required for full publication. We recommend authors to submit the full manuscript of paper after acceptance of their abstracts for the BASK meeting as done in AAOS meeting in order to encourage them to complete their manuscript before presentation

Study design: A systematic review of the literature to inform the development of occupational health guidelines for the management of low back pain at work. Objectives: To evaluate the evidence from occupational health settings or concerning occupational outcomes. Summary of background: Clinical guidelines for the management of low back pain (LBP) provide only limited guidance on the occupational aspects. Thus the Faculty of Occupational Medicine requested this review in order that a multi-disciplinary working group could develop the first evidence-based UK guidelines for management of LBP at work. Methods: A systematic literature search was followed by rating of the strength of the evidence plus a narrative review, by agreement between two experienced and independently-minded reviewers. There was no attempt at blinded double review or quality scoring. The final version followed peer-review by four international experts. Results: More than 2000 titles were considered. 34 systematic reviews, 28 narrative reviews, 52 additional scientific studies, 22 less rigorous scientific studies and 17 previous guidelines were identified and included. The evidence statements (rated for strength) were presented under headings that reflect a logical sequence of occupational health situations (Background, Pre-placement assessment, Prevention, Assessment of the worker presenting with back pain, Management principles for the worker presenting with back pain, Management of the worker having difficulty returning to normal occupational duties at 4–12 weeks). Some important areas were given additional narrative evidence-linked discussion (High risk patients/physically demanding jobs, Return to work with back pain, Rehabilitation programmes). Thirty six evidence-linked statements were developed to inform the guidelines group. The strongest evidence suggests that: generally the physical demands at work have only a modest influence on the incidence of LBP or permanent spinal damage; a history of LBP is not a reason to deny employment; preventive strategies based on the injury model do not reduce LBP or work loss; individual and work-related psychosocial factors play an important role in persisting symptoms and work loss; the management approach should be ‘active’ (including early work return); the combination of clinical, rehabilitation and organisational interventions designed to assist work return is more effective than single elements. However, further research is needed to identify the optimal roles of all stakeholders (clinicians, employers and workers) in case management. Conclusions: This review consolidates the emerging focus on active management of LBP at work, and indicates that approaches addressing obstacles to recovery will provide greater benefits than attempts at primary prevention. The outcome of the review has resulted in what we believe are the first truly evidence-linked occupational health guidelines for back pain in the world (. www.facoccmed.ac.uk. )

Aims

The aims of this study were to describe the demographic, socioeconomic, and educational factors associated with core surgical trainees (CSTs) who apply to and receive offers for higher surgical training (ST3) posts in Trauma & Orthopaedics (T&O).

Aims

Olecranon fractures are usually caused by falling directly on to the olecranon or following a fall on to an outstretched arm. Displaced fractures of the olecranon with a stable ulnohumeral joint are commonly managed by open reduction and internal fixation. The current predominant method of management of simple displaced fractures with ulnohumeral stability (Mayo grade IIA) in the UK and internationally is a low-cost technique using tension band wiring. Suture or suture anchor techniques have been described with the aim of reducing the hardware related complications and reoperation. An all-suture technique has been developed to fix the fracture using strong synthetic sutures alone. The aim of this trial is to investigate the clinical and cost-effectiveness of tension suture repair versus traditional tension band wiring for the surgical fixation of Mayo grade IIA fractures of the olecranon.

Aims

Preprint servers allow authors to publish full-text manuscripts or interim findings prior to undergoing peer review. Several preprint servers have extended their services to biological sciences, clinical research, and medicine. The purpose of this study was to systematically identify and analyze all articles related to Trauma & Orthopaedic (T&O) surgery published in five medical preprint servers, and to investigate the factors that influence the subsequent rate of publication in a peer-reviewed journal.

Cite this article: Bone Joint Open 2020;1-11:706–708.

Aims

The aim of the British Association for Surgery of the Knee (BASK) Meniscal Consensus Project was to develop an evidence-based treatment guideline for patients with meniscal lesions of the knee.

In 2006, approximately 1.3 million peer-reviewed scientific articles were published, aided by a large rise in the number of available scientific journals from 16 000 in 2001 to 23 750 by 2006. Is this evidence of an explosion in scientific knowledge or just the accumulation of wasteful publications and junk science? Data show that only 45% of the articles published in the 4500 top scientific journals are cited within the first five years of publication, a figure that is dropping steadily. Only 42% receive more than one citation. For better or for worse, “Publish or Perish” appears here to stay as the number of published papers becomes the basis for selection to academic positions, for tenure and promotions, a criterion for the awarding of grants and also the source of funding for salaries. The high pressure to publish has, however, ushered in an era where scientists are increasingly conducting and publishing data from research performed with ‘questionable research practices’ or even committing outright fraud. The few cases which are reported will in fact be the tip of an iceberg and the scientific community needs to be vigilant against this corruption of science.

Objectives

Bisphosphonates are widely used as first-line treatment for primary and secondary prevention of fragility fractures. Whilst they have proved effective in this role, there is growing concern over their long-term use, with much evidence linking bisphosphonate-related suppression of bone remodelling to an increased risk of atypical subtrochanteric fractures of the femur (AFFs). The objective of this article is to review this evidence, while presenting the current available strategies for the management of AFFs.

The August 2014 Wrist & Hand Roundup360 looks at: Trapeziectomy superior to arthrodesis;Tamoxifen beneficial in the short term; Semi-occlusive dressing “the bee’s knees” even with exposed bone; “Open” a relative concept in the hand and wrist; Editorial decisions pushing up standards of reporting; Ulnar variance revisited; Traditionalists are traditional; Diabetes not so bad with carpal tunnel

The peer review process for the evaluation of manuscripts for publication needs to be better understood by the orthopaedic community. Improving the degree of transparency surrounding the review process and educating orthopaedic surgeons on how to improve their manuscripts for submission will help improve both the review procedure and resultant feedback, with an increase in the quality of the subsequent publications. This article seeks to clarify the peer review process and suggest simple ways in which the quality of submissions can be improved to maximise publication success.

Cite this article: Bone Joint Res 2013;2:245–7.

Cartilage repair in terms of replacement, or regeneration of damaged or diseased articular cartilage with functional tissue, is the ‘holy grail’ of joint surgery. A wide spectrum of strategies for cartilage repair currently exists and several of these techniques have been reported to be associated with successful clinical outcomes for appropriately selected indications. However, based on respective advantages, disadvantages, and limitations, no single strategy, or even combination of strategies, provides surgeons with viable options for attaining successful long-term outcomes in the majority of patients. As such, development of novel techniques and optimisation of current techniques need to be, and are, the focus of a great deal of research from the basic science level to clinical trials. Translational research that bridges scientific discoveries to clinical application involves the use of animal models in order to assess safety and efficacy for regulatory approval for human use. This review article provides an overview of animal models for cartilage repair.

Cite this article: Bone Joint Res 2014;4:89–94.

The surgical community is plagued with a reputation for both failing to engage and to deliver on clinical research. This is in part due to the absence of a strong research culture, however it is also due to a multitude of barriers encountered in clinical research; particularly those involving surgical interventions. ‘Trauma’ amplifies these barriers, owing to the unplanned nature of care, unpredictable work patterns, the emergent nature of treatment and complexities in the consent process. This review discusses the barriers to clinical research in surgery, with a particular emphasis on trauma. It considers how barriers may be overcome, with the aim to facilitate future successful clinical research.

Cite this article: Bone Joint Res 2014;3:123–9.