[Orthopedics between reason and passion. Guidelines and shadow lines.]

Area of Science:

• Orthopaedics and Traumatology
• Evidence-Based Medicine (EBM)
• Clinical Epidemiology

Background:

• The Evidence-Based Orthopaedics Working Group (GLOBE) has promoted EBM in orthopaedics for over 20 years.
• Despite extensive efforts, the orthopaedic community struggles to fully adopt the EBM model.
• Challenges include a scarcity of guidelines, low awareness of their utility, and complex production methodologies.

Purpose of the Study:

• To analyze the reasons behind the limited recognition of EBM in orthopaedics.
• To propose solutions for improving the integration of EBM into orthopaedic practice.
• To advocate for a simplified approach to guideline development and adaptation.

Main Methods:

• Analysis of the causes contributing to the disconnect between EBM and orthopaedic practice.
• Reflection on potential strategies to overcome identified barriers.
• Proposal for collaborative efforts to simplify guideline production methodologies.

Main Results:

• The complexity of EBM methodology and guideline production creates a gap between clinical epidemiology and orthopaedic practice.
• Limited availability and awareness of guidelines hinder the recognition and application of EBM.
• Innovative literature review models, proven effective during the COVID-19 pandemic, are suggested for faster knowledge dissemination.

Conclusions:

• Simplifying the methodology for producing orthopaedic guidelines is crucial for wider EBM adoption.
• Collaborative efforts are needed to bridge the gap between EBM principles and real-world orthopaedic application.
• Adopting innovative literature review techniques can accelerate the availability of best practices in orthopaedics.