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The Journal of Bone and Joint Surgery (American) 83:1274-1275 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.

Letters to The Editor

The Usefulness of Meta-Analyses in Treatment Decisions

Ian Shrier, MD, PhD, A. C. M. Pijnenburg, MD, C. N. van Dijk, MD, PhD, P. M. M. Bossuyt, PhD and R. K. Marti, MD, PhD

Centre for Clinical Epidemiology and Community Studies SMBD-Jewish General Hospital 3755 Cote Sainte-Catherine Rd. Montreal, QC H3T 1E2, Canada E-mail address: ishrier@med.mcgill.ca
Corresponding author: A.C.M. Pijnenburg, MD, Orthopaedic Research Center Amsterdam, Academisch Medisch Centrum, Meibergdreef 9, Postbus 22660, 1100 DD Amsterdam, The Netherlands E-mail address: a.c.pijnenburg@amc.uva.nl

To The Editor:

I recently read the article "Treatment of Ruptures of the Lateral Ankle Ligaments: A Meta-Analysis" (82-A: 761-773, June 2000), by Pijnenburg et al., with interest. The authors concluded that functional treatment was better than casting or no treatment, in agreement with previous reviews. However, the authors also stated that the summary measures of effectiveness for operative treatment were better than those for functional treatment, and they stated that this result differs from those of previous reviews, including one that I authored1. There are two points that I would like to make.

First, I had, in fact, come to the same conclusion that the current authors had. When my article was written, the studies comparing the results of surgery with those of early functional treatment were, overall, in favor of surgery. However, given the higher risks of surgical treatment and the fact that late reconstruction gave excellent . . . [Full Text of this Article]


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