Research Updates, Literature and Evidence-Based Medicine

This section contains dated discussions of studies, guidelines and consensus statements relevant to clinical practice. We distinguish individual study findings from established standards of care and identify important methodological limitations.

Publications by Tomasz Poboży are collected under About the Author → Research and Publications. In discussions of directly relevant topics, they are considered alongside other relevant sources.

How an orthopaedic surgeon assesses evidence

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1. Clinical question. First, we identify the population, intervention and outcome addressed by the publication and whether it answers a real clinical question.
2. Methodological reliability. We assess study design, randomisation, blinding, completeness of follow-up, choice of control group and risk of bias.
3. Effect size and uncertainty. Statistical significance alone is not enough; absolute effect size, confidence intervals and clinical relevance also matter.
4. Applicability. We consider whether the population, technique and treatment setting correspond to patients seen in practice.
5. Balance of benefits and harms. Benefits must be weighed against complications, treatment burden, costs and available alternatives.
6. Impact on decisions. New research changes practice only when its quality and significance justify it; an individual study rarely justifies changing the standard of care on its own.

Scope of this section

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• Joint Replacement — Literature for Clinicians
• Sports medicine
• Trauma — Literature for Clinicians
• Ultrasound and procedures
• Non-operative treatment and rehabilitation

Topic filters make it easier to find relevant resources. A discussion may cover more than one clinical area, such as trauma and clinical decision-making.

Sports medicine

Selected discussions of instability, ligament reconstruction, rotational control and return-to-activity criteria. These are professional resources; patient guides on these problems remain separate.

• First shoulder dislocation — what do new guidelines change?
• LET during ACL reconstruction — fewer graft failures, without an advantage in return to sport
• ACL reconstruction with preserved tibial attachment — faster graft maturation on MRI
• Hop tests after ACL reconstruction — insufficient to predict another injury

Ultrasound and procedures

Studies and reviews of ultrasound in diagnosis, outpatient procedures and treatment monitoring. Technical resources are also available in the outpatient procedures and musculoskeletal ultrasound sections.

• Ultrasound after rotator cuff repair — can it guide rehabilitation?
• Wrist fracture reduction — ultrasound-guided nerve block or haematoma block?
• Ultrasound-guided carpal tunnel release — two-year results
• Hydrodilatation for frozen shoulder — does it outperform steroid alone?

Non-operative treatment and rehabilitation

Selected studies of non-operative treatments, their effectiveness and new ways to support rehabilitation. Individual findings are presented as literature, not as an automatic change in the standard of care.

• High-intensity laser for knee osteoarthritis — a large effect with important caveats
• Tai chi in musculoskeletal conditions — where is the evidence strong?
• Colchicine for knee osteoarthritis — biomarkers fell, pain did not
• Virtual knee rehabilitation — promising, but evidence remains uncertain