This article is more than 5 years old. Information may no longer be current.
Landmark trials can significantly impact orthopedic treatment methodologies
Click Here to Manage Email Alerts
COLORADO SPRINGS, Colo. — According to a paper presented here, a landmark clinical trial can have a significant impact on the management of acute Achilles tendon ruptures and other orthopedic conditions.
“There [was] a change in practice that occurred just 5 months following [the presentation of Willis and colleagues’ landmark trial],” Ujash Sheth, MD, said in the presentation of his Herodicus Award-winning paper. “This large, well-designed randomized controlled trial has shown it can significantly change the practice patterns of academic and non-academic orthopedic surgeons.”
Ujash Sheth
Sheth and his colleagues culled data from provincial health administrative databases regarding residents of Ontario, Canada. The data included adult patients who sustained an acute Achilles tendon rupture between April 2002 and March 2014. The rate of surgical repair for these injuries was calculated each calendar quarter and year. Whether changes in this rate were chronologically linked to the dissemination of results from a trial by Willis and colleagues was determined by a time series analysis utilizing an interventional autoregressive integrative moving average model. Critical times of change in the surgical repair rate were identified by a Spline regression model, while a multivariate logistic regression model aided in assessing differences in predictors of surgical repair before and after Willis and colleagues’ trial (first quarter, 2009) based on patient and provider factors.
The rate of surgical repair for acute Achilles tendon ruptures in Ontario, Canada went from approximately 19% in 2002 to 6.5% in 2014. This decrease was linked with Willis and colleagues’ trial being presented in February of 2009. Patients were 1.52-times more likely to undergo surgical repair if treated at a teaching hospital than at a non-teaching hospital prior to the presentation of Willis and colleagues’ work, a difference that no longer persisted following the presentation. Any other predictors of surgical repair were not affected by the presentation of Willis and colleagues’ trial, Sheth noted. – by Christian Ingram
Reference:
Sheth U, et al. Paper #118. Presented at: American Orthopaedic Society for Sports Medicine Annual Meeting; July 7-10, 2016; Colorado Springs, Colo.
Disclosure: Sheth reports no relevant financial disclosures.