Apophysitis and Osteochondrosis: Common Causes of Pain in Growing Bones.

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Abstract

[Indexed for MEDLINE] 4. Bone Joint J. 2024 Feb 1;106-B(2):121-127. doi: 10.1302/0301-620X.106B2.BJJ-2023-0391.R2. Positive outcome reporting in orthopaedic literature. Filtes P(1), Sobol K(2), Lin C(3), Anil U(3), Roberts T(4), Pargas-Colina C(3), Castañeda P(3). Author information: (1)Rutgers Robert Wood Johnson Medical School, Piscataway, New Jersey, USA. (2)Department of Orthopaedic Surgery, Einstein Medical Center Philadelphia, Philadelphia, Pennsylvania, USA. (3)NYU Langone Orthopedic Hospital, New York, New York, USA. (4)Medical Library - New York University Langone Health Sciences Library, New York, New York, USA. AIMS: Perthes' disease (PD) is a relatively rare syndrome of idiopathic osteonecrosis of the proximal femoral epiphysis. Treatment for Perthes' disease is controversial due to the many options available, with no clear superiority of one treatment over another. Despite having few evidence-based approaches, many patients with Perthes' disease are managed surgically. Positive outcome reporting, defined as reporting a study variable producing statistically significant positive (beneficial) results, is a phenomenon that can be considered a proxy for the strength of science. This study aims to conduct a systematic literature review with the hypothesis that positive outcome reporting is frequent in studies on the treatment of Perthes' disease. METHODS: We conducted a systematic review of all available abstracts associated with manuscripts in English or with English translation between January 2000 and December 2021, dealing with the treatment of Perthes' disease. Data collection included various study characteristics, surgical versus non-surgical management, treatment modality, mean follow-up time, analysis methods, and clinical recommendations. RESULTS: Our study included 130 manuscripts. Overall, 110 (85%) reported positive (beneficial) results, three (2%) reported negative results, and 17 (13%) reported no significant difference. Despite only 10/130 studies (8%) having a testable hypothesis, 71 (55%) recommended the use of their studied treatment methods for the patients, five (4%) made recommendations against the use of the studied treatment modality, and 54 (42%) did not make any recommendations. CONCLUSION: The overall rate for positive outcomes among included manuscripts regarding different treatment methods for Perthes' disease (85%) is higher than the 74% positive outcome rate found among studies for other surgically treated disorders and significantly higher than most scientific literature. Despite the lack of testable hypotheses, most manuscripts recommended their studied treatment method as a successful option for managing patients solely based on the reporting of retrospective data. © 2024 The British Editorial Society of Bone & Joint Surgery. DOI: 10.1302/0301-620X.106B2.BJJ-2023-0391.R2