The Journal of Bone and Joint Surgery (American). 2005;87:214-217.
doi:10.2106/JBJS.D.02555
© 2005 The Journal of Bone and Joint Surgery, Inc.
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Multicenter Clinical Trials in Orthopaedics: Time for Musculoskeletal Specialty Societies to Take Action

James G. Wright, MD, MPH, FRCSC1 and Mark C. Gebhardt, MD2

1 Division of Orthopaedic Surgery, The Hospital for Sick Children, 555 University Avenue, Toronto, ON M5G 1X8, Canada. E-mail address: jim.wright@sickkids.ca
2 Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center, Shapiro CC2, 330 Brookline Avenue, Boston, MA 02215

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Orthopaedic surgeons want what is best for their patients. Determining best practice, however, is not always straightforward. Clinicians use many sources of information to determine treatment options for their patients. Surgeons rely in large part on their training. As surgeons progress through their careers, practice learned through training is influenced by their own experience, the advice of colleagues, and their personal learning, including continuing medical education and the use of texts or the surgical literature. One of the more powerful forces in shaping best practice is, and should be, the surgical literature. The literature, however, is often contradictory. Contradictory literature leads to conflicting treatment recommendations for many conditions, and, in some situations, to a complacency among surgeons that anything goes (as surgeons can find some support for just about anything in the literature). Varying treatment recommendations in the literature and subsequent variation in practice may be acceptable if different treatments . . . [Full Text of this Article]


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