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Annotation: L. Klenerman The evolution of the compartment syndrome since 1948 as recorded in the JBJS (B) J Bone Joint Surg Br 2007; 89-B: 1280-1282 [Abstract] [Full text] [PDF]

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Leslie Klenerman   (20 December 2007)

Evidence-based orthopaedics

Helen H Handoll   (21 November 2007)

Author's reply: 20 December 2007
Leslie Klenerman, Emeritus Professor of Orthopaedic and Accident Surgery University of Liverpool Send letter to journal: Re: Author's reply: d.gray{at}jbjs.org.uk Leslie Klenerman	Sir, Ms Handoll has drawn unfair conclusions from the last sentence of my annotation. It was not my intention to denigrate the role of evidence–based orthopaedics. I simply wanted to convey that there is still a role for interesting single case reports. All the examples printed in the JBJS are fully documented, with a clear and useful message, and can still contribute to our knowledge even in these days of prospective randomised controlled trials, which are not always easy to arrange in surgical specialities. L. Klenerman, ChM, FRCS, Emeritus Professor of Orthopaedic and Accident Surgery, University of Liverpool, Liverpool, UK.
Evidence-based orthopaedics 21 November 2007
Helen H Handoll, Senior Lecturer School of Health and Social Care, University of Teesside, Middlesbrough, UK Send letter to journal: Re: Evidence-based orthopaedics h.handoll{at}ed.ac.uk Helen H Handoll	Sir, I read this paper with interest. In its conclusion, Professor Klenerman dismisses evidence-based orthopaedics, which he seems to regard as a potential bar to progress. This is a misperception and misrepresentation of the evidence-based approach which promotes the use of rigorous scientific methods that by minimising bias increases the likelihood of getting reliable evidence to guide practice. The best methods for achieving this will vary with the question, with practicality and ethics also playing a crucial role in the selection of study design. In some instances, rigorously conducted and adequately reported case reports and case series can provide important evidence, but even then they have a high susceptibility to bias and confounding. It is through the active adoption and implementation of the principles of evidence-based orthopaedics that progress on important questions in orthopaedics will be made, and rather more quickly and less haphazardly than via “the publication of case reports and series”. H. Handoll, Senior Lecturer, School of Health and Social Care, University of Teesside, Middlesbrough, UK.