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- Talk
- 21/09/2021
- UK
Common Elective Orthopaedic Procedures and Their Clinical Effectiveness: An Umbrella Review of Level 1 Evidence
Description
This presentation by Richard Donovan, a registrar based in Bristol, outlines a systematic review of evidence regarding common elective orthopedic procedures and their clinical effectiveness. Donovan discusses the objective of the study, which aimed to evaluate the level of evidence supporting ten prevalent procedures, including ACL reconstruction, rotator cuff repair, carpal tunnel decompression, and hip and knee replacements. A systematic umbrella review was conducted, adhering to PRISMA and MOOSE guidelines, utilizing major databases like Medline, Embase, and Cochrane.
The findings indicate that carpal tunnel decompression and total knee replacement were superior to non-operative care. Conversely, six procedures exhibited similar effectiveness between surgical and non-operative treatments while meniscal repairs and total hip replacements lacked level 1 evidence altogether. Donovan notes that this review connects with existing clinical guidelines, an encouraging sign for healthcare practices. While the comprehensive approach of the review was praised, it also pointed out limitations, such as the absence of level 1 evidence for some procedures.
Donovan emphasizes the necessity for improved research funding and collaboration among surgeons to fill gaps in evidence, particularly with a growing surgical backlog. He invites continued investigation into non-operative interventions and urges the healthcare community to prioritize generating quality research to enhance patient outcomes.