While evidence-based orthopaedics is sometimes perceived as a blinkered adherence to randomized trials, it more accurately involves informed and effective use of all types of evidence in patient care, particularly evidence from the medical literature. Since the adoption of the levels-of-evidence reporting by The Journal of Bone and Joint Surgery in January 2003, surgeons have seen a shift in paradigm toward the validity assessment of available studies and the appropriate application of research evidence to individual patients.
Despite a preponderance of observational studies in orthopaedics, randomized trials represent the optimal resource to guide practice. The caveat, however, remains in the design, quality, and execution of a trial. The arguments against orthopaedic trials have been largely fueled by the lack of methodological safeguards to ensure valid answers to the field’s most important questions.
Realizing that the methods for surgical trials continue to evolve, and that critics have been valid in their concerns about trial design and methodology, we have engaged a leading group of researchers and surgeons to share their insights in the field. Specifically, we have aimed to provide fundamental concepts in the design and execution of orthopaedic trials and leading-edge advances in research for The Journal’s readership.
The current supplement brings together sixty-one authors who have contributed to twenty-three papers in this series. We focus on the fundamentals, tactics, and future directions of surgical trials with an emphasis in the evolving field of orthopaedic surgical research. We believe that this compendium of papers represents the single most comprehensive resource for the state of the art and future prospects in the design, execution, and interpretation of randomized trials in our field.