scholarly journals Growth of the Journal of Arthroscopic Surgery and Sports Medicine (JASSM) continues

2021 ◽  
Vol 0 ◽  
pp. 1-2
Author(s):  
Raju Vaishya
Keyword(s):  
Sports Medicine ◽  
Arthroscopic Surgery

The Fragility of Statistically Significant Findings From Randomized Trials in Sports Surgery: A Systematic Survey

2016 ◽  
Vol 45 (9) ◽  
pp. 2164-2170 ◽  
Author(s):  
Moin Khan ◽  
Nathan Evaniew ◽  
Mark Gichuru ◽  
Anthony Habib ◽  
Olufemi R. Ayeni ◽  
...  
Keyword(s):  
Sports Medicine ◽  
Data Extraction ◽  
Statistical Significance ◽  
Arthroscopic Surgery ◽  
Fisher Exact Test ◽  
Fragility Index ◽  
Exact Test ◽  
Orthopaedic Care ◽  
Bivariate Correlation ◽  
Number Of Patients

Background: High-quality, evidence-based orthopaedic care relies on the generation and translation of robust research evidence. The Fragility Index is a novel method for evaluating the robustness of statistically significant findings from randomized controlled trials (RCTs). It is defined as the minimum number of patients in 1 arm of a trial that would have to change status from a nonevent to an event to alter the results of the trial from statistically significant to nonsignificant. Purpose: To calculate the Fragility Index of statistically significant results from clinical trials in sports medicine and arthroscopic surgery to characterize the robustness of the RCTs in these fields. Methods: A search was conducted in Medline, EMBASE, and PubMed for RCTs related to sports medicine and arthroscopic surgery from January 1, 2005, to October 30, 2015. Two reviewers independently assessed titles and abstracts for study eligibility, performed data extraction, and assessed risk of bias. The Fragility Index was calculated using the Fisher exact test for all statistically significant dichotomous outcomes from parallel-group RCTs. Bivariate correlation was performed to evaluate associations between the Fragility Index and trial characteristics. Results: A total of 48 RCTs were included. The median sample size was 64 (interquartile range [IQR], 48.5-89.5), and the median total number of outcome events was 19 (IQR, 10-27). The median Fragility Index was 2 (IQR, 1-2.8), meaning that changing 2 patients from a nonevent to an event in the treatment arm changed the result to a statistically nonsignificant result, or P ≥ .05. Conclusion: Most statistically significant RCTs in sports medicine and arthroscopic surgery are not robust because their statistical significance can be reversed by changing the outcome status on only a few patients in 1 treatment group. Future work is required to determine whether routine reporting of the Fragility Index enhances clinicians’ ability to detect trial results that should be viewed cautiously.

scholarly journals ACL Reconstruction: Problems, History and Future. Part 1

2020 ◽  
pp. 17-25
Author(s):  
I.M. Zazirnyi ◽  
O.O. Kostrub
Keyword(s):  
Acl Reconstruction ◽  
Sports Medicine ◽  
Cruciate Ligament ◽  
Rapid Development ◽  
Arthroscopic Surgery ◽  
Surgical Techniques ◽  
Clinical Results ◽  
The United States ◽  
Ligament Injury ◽  
Surgical Interventions

Summary. Damage to the anterior cruciate ligament (ACL) of the knee joint is a common injury in sports medicine. Before advances in arthroscopy and surgical techniques, an ACL damage was considered a career ending injury for many athletes. Since the 1990s, there has been a rapid development of arthroscopic surgery for ACL and continuous improvement of these techniques. Today’s athletes can expect a pre-injury level of stability and function after an ACL reconstruction. Modern surgical interventions have come a long way, having studied both the successes and failures of previous surgical techniques. In the United States, an ACL damage is diagnosed annually from 100,000 to 200,000 cases, making this the most common ligament injury [9, 10]. This number continues to increase in both the general population and in individuals who play sports. Football players sustain the greatest number of ACL injuries (53% of the total), with skiers and gymnasts also at high risk. The history of ACL reconstruction can be traced as far back as the Egyptians times. Research and innovation are constantly evolving, and this leads to improved clinical results. The knowledge of the evolution of ACL reconstruction is invaluable to those who continue to try to improve the outcomes of the procedure and reduce the risks of repeating mistakes of the past.

Elbow Arthroscopic Surgery Update for Sports Medicine Conditions

2013 ◽  
Vol 41 (9) ◽  
pp. 2191-2202 ◽  
Author(s):  
Ian R. Byram ◽  
H. Mike Kim ◽  
William N. Levine ◽  
Christopher S. Ahmad
Keyword(s):  
Sports Medicine ◽  
Arthroscopic Surgery

scholarly journals Fragility Index, power, strength and robustness of findings in sports medicine and arthroscopic surgery: a secondary analysis of data from a study on use of the Fragility Index in sports surgery

PeerJ ◽  
2019 ◽  
Vol 7 ◽  
pp. e6813 ◽  
Author(s):  
Aleksi Reito ◽  
Lauri Raittio ◽  
Olli Helminen
Keyword(s):  
Sports Medicine ◽  
Power Analysis ◽  
A Priori ◽  
Arthroscopic Surgery ◽  
Secondary Analysis ◽  
Medium Effect ◽  
Fragility Index ◽  
Medium Effect Size ◽  
Post Hoc ◽  
A Priori Power Analysis

Background A recent study concluded that most findings reported as significant in sports medicine and arthroscopic surgery are not “robust” when evaluated with the Fragility Index (FI). A secondary analysis of data from a previous study was performed to investigate (1) the correctness of the findings, (2) the association between FI, p-value and post hoc power, (3) median power to detect a medium effect size, and (4) the implementation of sample size analysis in these randomized controlled trials (RCTs). Methods In addition to the 48 studies listed in the appendix accompanying the original study by Khan et al. (2017) we did a follow-up literature search and 18 additional studies were found. In total 66 studies were included in the analysis. We calculated post hoc power, p-values and confidence intervals associated with the main outcome variable. Use of a priori power analysis was recorded. The median power to detect small (h > 0.2), medium (h > 0.5), or large effect (h > 0.8) with a baseline proportion of events of 10% and 30% in each study included was calculated. Three simulation data sets were used to validate our findings. Results Inconsistencies were found in eight studies. A priori power analysis was missing in one-fourth of studies (16/66). The median power to detect a medium effect size with a baseline proportion of events of 10% and 30% was 42% and 43%, respectively. The FI was inherently associated with the achieved p-value and post hoc power. Discussion A relatively high proportion of studies had inconsistencies. The FI is a surrogate measure for p-value and post hoc power. Based on these studies, the median power in this field of research is suboptimal. There is an urgent need to investigate how well research claims in orthopedics hold in a replicated setting and the validity of research findings.

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