Editorial Commentary: Bone Marrow Stimulation for Osteochondral Lesions of the Tibial Plafond Shows Generally Favorable Results.

Osteochondral lesions of the ankle are common, but only a small proportion of these lesions are found on the tibial plafond (osteochondral lesions of the tibial plafond, ie, OLTP). By and large, surgical treatment strategies for OLTP have been derived from techniques employed for those of the talus (ie, osteochondral lesion of the talus). Despite the clinical success of surgical treatments for osteochondral lesion of the talus, namely bone marrow stimulation, it is quite possible that OLTP may not respond similarly, given the unique anatomy and biomechanical properties of the tibia. To this end, the literature surrounding OLTP is relatively sparse, and studies evaluating the clinical and radiographic outcomes of treatments specific to OLTP are necessary. Still, if it works for the talus, it seems sensible that it could work for the plafond. Pending future research, there is no need to reinvent the wheel.

Editorial Commentary: Cadaveric Biomechanical Orthopaedic Research Is Essential and Requires Quality and Validity Metrics.

Evidence-based medicine is the commanding philosophy of patient care in the field of orthopaedic surgery, and analysis of clinical research is facilitated by instruments and scales developed for assessing methodologic quality and validity of conclusions. In contrast, little consideration has been given to developing metrics to assess the quality and validity of orthopaedic ex vivo and laboratory research. This is easier said than done because these studies may be heterogeneous and complex in design, and methodologic details may not be intuitive to (non-engineer) readers. The recently described Biomechanics Objective Basic Science Quality Assessment Tool (BOBQAT) represents a reliable means to assess cadaveric biomechanical studies. The BOBQAT emphasizes essential study elements including a clinically relevant, answerable purpose; detailed description of the specimens studied; thorough description of surgical technique; and careful consideration of loading conditions including clinically relevant cyclic loading. The BOBQAT provides a logical recipe for the design of future studies, a mechanism of quality assessment for systematic reviews, and a framework for readers to assess biomechanical research consistent with the ethos of evidence-based medicine.