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Evidence-Based Orthopaedics   |    
Meta-Analyses in Joint Arthroplasty: A Review of Quantity, Quality, and Impact
Rajrishi Sharma, MD1; Christopher Vannabouathong, MSc1; Simrit Bains, MSc1; Amanda Marshall, MD, FRCS2; Steven J. MacDonald, MD, FRCSC3; Javad Parvizi, MD, FRCS4; Mohit Bhandari, MD, PhD, FRCSC1
1 Division of Orthopaedic Surgery, Department of Surgery, McMaster University, 293 Wellington Street North, Suite 110, Hamilton, ON L8L 2X2, Canada. E-mail address for R. Sharma: rajrishisharma@gmail.com
2 Department of Orthopedics, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229
3 Division of Orthopaedic Surgery, London Health Sciences Centre–University Hospital, 339 Windermere Road, London, ON N6A 5A5, Canada
4 Department of Orthopaedic Surgery, Rothman Institute at Thomas Jefferson University, 111 South 11th Street, Philadelphia PA 19107
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Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

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Investigation performed at McMaster University, Hamilton, Ontario, Canada

Copyright © 2011 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2011 Dec 21;93(24):2304-2309. doi: 10.2106/JBJS.J.01289
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Extract

A meta-analysis is a comprehensive systematic review in which statistical analyses are used to combine the results of two or more homogeneous clinical trials1-4. In the paradigm of evidence-based orthopaedics, meta-analysis can be an invaluable tool to increase study power and improve precision when study results are combined appropriately5. Evidence from a meta-analysis, however, is highly dependent on the quality of the primary studies included and on the overall methodological rigor6. Meta-analyses have impacted clinical practice, paved the way for clinical practice guidelines and health policies, and guided subsequent research6,7.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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