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Orthopedic surgeries are common, costly, and potentially risky. And many common orthopedic surgical procedures lack strong evidence of effectiveness. Researchers conducted an “umbrella review” of meta-analyses of randomized clinical trials to evaluate the effectiveness of the 10 most common orthopedic surgical procedures versus nonsurgical management of underlying conditions. For each procedure, the investigators used standard assessment tools to evaluate the quality of the meta-analyses and the underlying randomized trials. Where meta-analyses were unavailable, they assessed other available evidence.
For carpal tunnel release, the only available meta-analysis showed that surgery was superior to nonsurgical management. For total knee replace…