Evidence map›Paper›PMID 34176011›Full record

SynthesisEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2022

Biomechanically superior treatments do not translate into improved outcomes in randomized controlled trials.

Grace X Xiong, Jason R Kang, Jigyasa Sharma, Andrea Finlay, Michael J Gardner, Julius A Bishop

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. The correlation between biomechanical experiments and clinical studies in orthopedics: a systematic review.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025
    Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Grace X XiongHarvard Combined Orthopaedic Residency Program, 55 Fruit St, Boston, MA, 02114, USA.
Jason R KangDepartment of Orthopaedic Surgery, Stanford School of Medicine, 450 Broadway St, Redwood City, CA, 94063, USA.
Jigyasa SharmaDepartment of Orthopaedic Surgery, Stanford School of Medicine, 450 Broadway St, Redwood City, CA, 94063, USA.
Andrea FinlayDepartment of Orthopaedic Surgery, Stanford School of Medicine, 450 Broadway St, Redwood City, CA, 94063, USA.
Michael J GardnerDepartment of Orthopaedic Surgery, Stanford School of Medicine, 450 Broadway St, Redwood City, CA, 94063, USA.
Julius A BishopDepartment of Orthopaedic Surgery, Stanford School of Medicine, 450 Broadway St, Redwood City, CA, 94063, USA. jabishop@stanford.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeSignificant time and resources are devoted to conducting orthopaedic biomechanics research; however, it is not known how these studies relate to their subsequent clinical studies. The purpose of the present study was to determine whether biomechanically superior treatments were associated with improved clinical outcomes as determined by analogous randomized controlled trials (RCTs).

methodsA systematic review was conducted to find RCTs that tested a research question based on a prior biomechanical study. PubMed and SCOPUS databases were queried for orthopaedic randomized controlled trials, and full text articles were reviewed to find RCTs which cited biomechanical studies with analogous comparison groups. A random-effects multi-level logistic regression model was conducted examining the association between RCT outcome and biomechanics outcome, adjusting for multiple outcomes nested within study.

resultsIn total, 20,261 articles were reviewed yielding 21 RCTs citing a total of 43 analogous biomechanical studies. In 7 instances (16.2%), the RCT and a cited biomechanical study showed concordant results (i.e. the superior treatment in the RCT was also the superior construct in the biomechanical study). RCT outcome was not associated with biomechanical outcome (β = -1.50, standard error = 0.78, p = .05).

conclusionThis study assessed 21 orthopaedic RCTs with 43 corresponding biomechanical studies and found no association between superior biomechanical properties of a given orthopaedic treatment and improved clinical outcomes. Favourable biomechanical properties alone should not be the primary reason for selecting one treatment over another. Furthermore, RCTs based on biomechanical studies should be carefully designed to maximize the chance of providing clinically relevant insights.

Indexed as

OrthopedicsHumansRandomized Controlled Trials as TopicBiomechanicsOutcomesRandomized controlled trialsTranslational researchTrial design

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.