Stephen Bridgman

Has endometrial ablation replaced hysterectomy for the treatment of dysfunctional uterine bleeding? National figures

Objectives To describe trends in the use of endometrial ablation and hysterectomy for the treatment of dysfunctional uterine bleeding.

Sub-vastus approach is more effective than a medial parapatellar approach in primary total knee arthroplasty: a randomized controlled trial

In a prospective single-centre longitudinal randomized controlled trial 116 patients were allocated to the sub-vastus approach, and 115 to the medial parapatellar approach. At one week follow-up, compared to baseline, range of motion, Knee Society (KS) global, KS knee, and KS pain scores were significantly better in the sub-vastus group. At the one year follow-up, WOMAC global and pain scores, SF36 physical function and role-physical scores, and EuroQol utility and pain score were significantly better in the sub-vastus group. The ease of exposure in the sub-vastus approach was significantly worse. There was no significant difference in length of stay or analgesia intake. The sub-vastus approach to total knee arthroplasty was more effective than a medial parapatellar approach at both one week and one year post-operatively, but surgeons reported a less easy exposure in the sub-vastus group.

Orthopaedic fractures: trends in randomised controlled trials

AIM To ascertain and describe the number and epidemiology of randomised controlled trials (RCTs) focused on orthopaedic fractures. METHODS A sensitive literature search was carried out for the period 1966-May 1999. Labels were applied to each identified RCT to indicate the fracture type, and the main type of intervention. RESULTS 648 RCTs related to surgery of which 123 focused on adjuvant therapies and 88 related mainly to anaesthesia, analgesia, and radiography. The number of trials have increased exponentially with time so that the present decade has seen more RCTs published than all the other years added together. CONCLUSION There is clearly an encouraging trend in the number of RCTs published. However there is a need to ensure that trials are on fracture types where there is most need for guidance. This growing evidence base should fuel systematic reviews and clinical guidelines within orthopaedics.