The Pulse  ·  OrthoEvidence

Vol. 4 · Issue 18 · 7 May 2026

Long-term follow-up data suggests arthroscopic partial meniscectomy provides no clinical benefits, and may even cause harm.

The FIDELITY Trial was one of the first major orthopaedic RCTs that called into question the usefulness of arthroscopic partial meniscectomy for meniscal tears. 

But there were always question marks as to whether the results would hold out in the long-term. Fortunately, the 10-year results are in.

No benefit vs. sham surgery in all outcomes. And in some outcomes, there was even evidence of inferiority with arthroscopic partial meniscectomy.

It's a major indictment on its use in middle-aged and older adults. And its valuable information for you when making your next clinical decision.

Full Analysis →

Randomized trial of 1900 patients finds no reduction in infection or wound complications with vancomycin powder, povidone-iodine lavage, or both in high-risk TJA cases.

If there's one thing every arthroplasty surgeon wants to avoid, it's periprosthetic joint infection.

Vancomycin powder use and dilute povidone-iodine lavage are high-prevalence strategies seen in thousands of operating rooms, but do they actually work?

In an RCT of 1,900 high-risk total joint patients, the evidence was clear: there were no reductions in wound complications or 3-month infection rates with either strategy, or both combined, vs placebo.

Long-term follow-up studies are certainly required, but the short-term evidence indicates that the decision can be considered a discretionary one.

Full Analysis →

In the latest instalment of the OrthoJoe interview series with JBJS editors, Dr. Mohit Bhandari and Marc Swointkowski sit down with Dr. James Heckman, who piloted the JBJS journal through a host of transformations through the first decade of the 2000s.

If you're interested in the evolution of JBJS, including the business challenges that were faced and the important editorial changes that were made, this is the episode for you!

Watch Now →

Impact of National Academy of Sports Medicine Corrective Exercises on Gait and Postural Control in Individuals With Chronic Ankle Instability: A Randomized Controlled Trial — In recreational and collegiate athletes with chronic ankle instability, does an 8-week National Academy of Sports Medicine corrective exercise program, compared with no intervention, improve gait kinetics and postural control over 8 weeks?

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Effect of Physical Therapy vs Arthroscopic Partial Meniscectomy in People With Degenerative Meniscal Tears: Five-Year Follow-up of the ESCAPE Randomized Clinical Trial — In adults aged 45 to 70 years with degenerative meniscal tears, does exercise-based physical therapy result in improved patient-reported knee function compared to arthroscopic partial meniscectomy over a five-year follow-up?

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Cast immobilisation versus surgery for unstable lateral malleolus fractures (SUPER-FIN): randomised non-inferiority clinical trial *Published in BMJ* — In skeletally mature patients with unstable Weber B ankle fractures and a congruent mortise, does cast immobilisation compared with surgical fixation improve functional outcomes at two years?

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