This story takes a skeptical look at the heavily marketed procedures known as minimally invasive total joint replacements. It does a nice job of pointing out the problems patients are experiencing, the surgeons’ relatively steep learning curve with the new techniques and tools, and the absence of long-term data comparing the new technique to traditional total joint replacement. It draws on a deep bench of sources representing a variety of viewpoints– three patients, three orthopaedic surgeons, and one industry spokesperson.
However, the story fails to describe the quality of evidence showing that the new techniques may cause more problems than the traditional approaches, and it omits mention of high-quality published studies that support this point. It also fails to quantify the purported benefits of the new techniques, though several studies have looked at them. What are readers to make of the suggestion that “proponents” say the new approach shortens recovery times or reduces postoperative pain? What do the data say? Do the purported benefits last beyond the first few weeks or months? The story does not mention published randomized controlled trials showing that there is no clinically important difference in outcomes beyond the immediate postoperative period in hips or beyond 9 months in knees.
By focusing on personal stories about complications, the story doesn’t deliver hard data about benefits. A more complete accounting of the evidence would help readers decide whether there are any extra benefits from the new approach that make added complications worthwhile.
The story cites a cost of ~$40,000 exclusive of hospital costs, and says this is roughly the same as traditional total joint replacement.
The story’s focus is on harms of treatment, but readers are left wondering about its purported benefits. (e.g. cutting less tissue and muscle, shorter scar, quicker recovery, less postoperative pain). The story provides no quantitative estimate of these (or other) potential benefits, though several studies have looked at them. This is a major limitation of the news story. By focusing on personal stories about complications, the story doesn’t give readers the hard data about benefits they need to make a well-informed medical decision. (See evidence above.)
The article provides ample reporting on the potential harms of minimally invasive surgery (e.g., “uneven leg lengths, broken hip bones, slightly off-kilter knee joints and pain in the knee because of hardened cement left in the wound”).
The story cites three studies to support its argument that minimally invasive surgery may not be as great as many people think. But the quality of the studies is unclear. And it’s puzzling why these particular studies are cited when better ones exist that would help support the same points.
The story does not provide any evidence to help readers judge whether the purported short-term advantages of minimally invasive procedures (promised “shorter recuperation times” and less postoperative pain) have proven true in carefully monitored studies. Yet published randomized controlled trials have shown that there is no clinically important difference in outcomes beyond the immediate postoperative period in hips (Dorr, J Bone Joint Surg Am. 2007;89(6):1153-60. Chimento, J Arthroplasty. 2005;20(2):139-44. Ogonda, J Bone Joint Surg Am. 2005;87(4):701-10) or beyond 9 months in knees (Karachalios, J Bone Joint Surg Br. 2008;90(5):584-91).
Hip and knee osteoarthritis afflict millions of Americans, and this story fairly represents their predicament.
The story cites three patients, three orthopaedic surgeons, and one spokesperson for a company that manufactures the implants and tools used in the new procedure.
The article compares the new surgical techniques to traditional total joint replacement, and explains why it may be better or worse than longstanding approaches.
The story says nearly half of all total joint surgeries are now being done with so-called “minimally invasive” approaches.
The article explains that minimally invasive hip replacements are relatively new and were “pioneered in the early part of this century.”
There is no obvious use of text from the press release.
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like