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Review
. 2016 Dec;17(4):291-295.
doi: 10.1007/s10195-016-0421-z. Epub 2016 Jul 21.

Hip surgery and its evidence base: progress over a decade?

Kamrul Hasan  1 , Shivakumar Shankar  2 , Aadhar Sharma  3 , Alison Carter  4 , Razi Zaidi  2 , Suzie Cro  5 , John Skinner  2 , Andy Goldberg  2
Affiliations
Review

Hip surgery and its evidence base: progress over a decade?

Kamrul Hasan et al. J Orthop Traumatol. 2016 Dec.

Abstract

Background: The burden of traumatic and elective hip surgery is set to grow. With an increasing number of techniques and implants against the background of an aging population, the emphasis on evidence-based treatment has never been greater. The purpose of this study was to assess changes in the levels of evidence in the hip literature over a decade.

Materials and methods: Articles pertaining to hip surgery from the years 2000 and 2010 in Hip International, Journal of Arthroplasty, Journal of Bone and Joint Surgery and The Bone and Joint Journal were analysed. Articles were ranked by a five-point level of evidence scale and by type of study, according to guidelines from the Centre for Evidence-based Medicine.

Results: 531 articles were analysed from 48 countries. The kappa value for the inter-observer reliability showed excellent agreement between the reviewers for study type (κ = 0.956, P < 0.01) and for levels of evidence (κ = 0.772, P < 0.01). Between 2000 and 2010, the overall percentage of high-level evidence (levels I and II) studies more than doubled (12 to 31 %, P < 0.001). The most frequent study type was therapeutic; the USA and UK were the largest producers of published work in these journals, with contributions from other countries increasing markedly over the decade.

Conclusions: There has been a significant increase in high levels of evidence in hip surgery over a decade (P < 0.001). We recommend that all orthopaedic journals consider implementing compulsory declaration by authors of the level of evidence to help enhance quality of evidence.

Level of evidence: Level 2: economic and decision analysis.

Keywords: Arthroplasty; Evidence-based medicine; Hip.

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Conflict of interest statement

The authors declare that they have no conflict of interest. Ethical standards This article does not contain any studies with human participants or animals performed by any of the authors.

Figures

Fig. 1
Fig. 1
Bar chart illustrating the contribution of each journal to the total volume of hip articles in the combined years 2000 and 2010 as well as each journal’s contribution to both high (I + II) level and low (III–V) level evidence
Fig. 2
Fig. 2
Bar chart illustrating the geographical variation of the volume of publications in the included journals by year
See this image and copyright information in PMC

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