Consultant Orthopaedic Surgeon, AKG Memorial Cooperative Hospital, India.
Received Date: March 14, 2016; Accepted Date: April 19, 2016; Published Date: April 22, 2016
Citation: Sunku N. Evidence Based Orthopaedics–History and Present Scenario–Need of the Hour. J Bone Rep Recomm. 2017, 3:1. doi: 10.4172/2469-6684.100034
Copyright: © 2017 Sunku N. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Evidence based medicine is a kind of approach which guides to the current and best practices in medicine. This was initially coined by Gordon Guyatt in 1991. Hirearchy of evidence was established with a pyramid as representation. Randomised control trials to meta-analysis have led to a lot of research in different sub specialities in medicine. Meta analyses is a much powerful tool as it pools up many small trials and gives a more clear picture of the effectiveness of a particular treatment.
Evidence-based Orthopaedics begin with a clinical question, conduct a comprehensive search to identify high-quality publications, critically evaluate and appraise the content of the resultant publications, assimilate the findings across the literature, and use this new knowledge (or evidence) to plan their next action. The challenge is not the theory of the evidence cycle, but its practicality to busy clinicians and health care providers.
The “KEY” to considerate all type disorders of the joint met in clinical practice actually rests on a various despot approach and also contains a broad understanding of kinematics, joint anatomy, biology of soft tissue healing, biomechanics . Randomised Controlled trials form a base for these evidence based research. Current medical schools should teach the students of the need and importance of research.
The main challenge of a clinician is to provide the best clinical care for his patient who is in best practice with giving the least pain and providing reasonable faster cure. It is the clinician’s own experiences and training which are important assets in organising a particular treatment regimen. Present Orthopaedics has evolved as the most rapidly progressing field. Evidence-based orthopaedics is a contrast to this paradigm and has arisen from a need of effectively solving clinical problems .
One such rapid progression is in the field of joint replacements. The era of computer navigated knee replacements started around the beginning of the 21st century. The advantages were compared with the regular procedure. Many parameters such as learning curve of surgeon, operating time, infection, cost factor, functional outcome at short and long term. All these are compared to bring out as better as possible evidence based principles to be used in day to day practice.
At present in this era of internet there is burst of research being published in various journals. The evidence-based orthopaedics is the need of the hour to give best treatment but only by critically appraising the evidence and integrating it with the clinician’s own judgment and knowledge. So regularly updating the clinicians with current knowledge by conducting workshops, CMEs and online educational material are important in the progress of professional career. Hence among these are the online peer reviewed journals which form a major chunk to decide the direction of management. One such endeavour is the present journal doing to improve the thinking, application and implementation of the management principles based on current evidences in orthopaedics.
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