I love the study from McDowell et al. where they tested different methods for keeping casts dry. It is simple but takes up a both common and important issue that we doctors frequently forget about. They compare six different methods and it seems that double plastic bags secured with duct tape provide the best protection for the money. Continue reading
Category Archives: Orthopaedic surgery
Does age matter for THR-outcomes?
Age is an important confounder in studying most health related outcomes [1, s 5], and perhaps the most commonly adjusted variable. In this and next post I will go into (1) what we know about the age effect in relation to total hip replacements (THR) re-operations and mortality, (2) what I found in my study on age and health-related quality of life (HRQoL) using splines, and (3) how I implemented and evaluated different splines using R for this study. Continue reading
Outcomes after total hip replacements
While total hip replacements (THR), also known as total hip arthroplasties, are hugely successful there still are, and will always be, poor outcomes. This post is an excerpt from my thesis where I tried to summarize the dark side of THR. Continue reading
My thesis: patient-related factors & hip arthroplasty outcomes
On May 29:th I successfully defended my thesis at the Karolinska Institute and I’m now a “Doctor of Philosophy“, i.e. PhD. It has been a fun and rewarding project that spurred me into starting this blog and diving into R. Below you can find the thesis abstract and my reflections on the subject. Continue reading
Drawing a directed acyclic graph (DAG) for blood transfusions after surgery
I recently wrote about blood transfusions and their inherent risk of postoperative infections. This post is a tutorial on some of the basics of drawing a directed acyclic graph (DAG). Blood transfusions and infections is a great topic as most are familiar with risk factors for infections. Continue reading
The final nail in the coffin for the degenerative meniscus?
I have my doubts when it comes to operating a degenerative meniscus (see my previous post) and in an amazing Finnish multicenter RCT it seems that my doubts have been confirmed. Sihvonen et al. managed to randomize 146 patients to arthroscopic meniscal or sham surgery where none of the outcomes differed between the groups. Continue reading
A bloody mess?
Blood transfusions lower the immune response – a known fact although not all doctors are aware of it. It is therefore nice to see that two new articles in JBJS that focus on the subject. Both focus on arthroplasties where the impact of an infection due to a lowered immune response can be catastrophic to the individual. Continue reading
The rotator cuff dilemma – revisited
Is Kukkonen et. al.’s RCT the end of our love for the rotator cuff tear? The industry surrounding rotator cuff tears costs in the US alone about $3 billion every year, earning a top position among common orthopaedic procedures. I have previously written about my doubts concerning this procedure and it is with some satisfaction that I dive in to this recent study by Kukkonen et. al.
It is better to have loved and lost, than never to have loved at all.
Alfred Lord Tennyson
Pills instead of surgery?
I recently stumbled upon one of the most interesting articles in a while. Albert et al. questioned the long-standing theory behind low back pain by doing a double-blind randomized clinical controlled trial. They randomized patients to antibiotics or placebo for 100 days and found an impressive effect on pain and other outcomes in the treatment group. Continue reading