BMJ  2006;332:1153 (13 May), doi:10.1136/bmj.332.7550.1153-b

Letter

Hamstring v patellar tendon autografts

Author's reply

The first 150 words of the full text of this article appear below.

EDITOR—We hope that doctors will give more information about the outcome and problems related to both reconstructions and that young orthopaedic surgeons will take more interest in hamstring autografts.

Meta-analyses are not free of bias. The quality of reporting in surgical trials needs to be improved, and multicentre randomised controlled trials are needed to overcome sample size issues. We are currently performing a meta-analysis based on individual patient data with the help of the principal trial investigators. The issue of cost, both financial and the quality of life, was not reported in the trials selected.

The indication for operation was not the subject of the analysis but remains vague for some patients and therefore to some doctors. The prime indication for anterior cruciate ligament reconstruction is symptomatic instability; its aim is to restore functional stability without compromising other joint function.¹ Therefore what holds for a 20 year old . . . [Full text of this article]

Service de chirurgie orthopédique et traumatologique, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75679 Paris, France djmbiau@yahoo.fr

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