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Twenty year follow-up of ACL reconstruction (AJSM)—the evidence of experience
  1. Bob McCormack1,
  2. Mark R Hutchinson2
  1. 1Department of Orthopedic Surgery, University of British Columbia, New Westminster, British Columbia, Canada
  2. 2Department of Orthopaedics, University of Illinois at Chicago, Chicago, Illinois, USA
  1. Correspondence to Dr Mark R Hutchinson, Department of Orthopaedics, University of Illinois at Chicago, 835 South Wolcott, 270 Medical Sciences Building, Chicago, IL 60612, USA; mhutch{at}uic.edu

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As clinicians and academics, we are challenged to sift through a myriad of publications with the key goal and purpose of assessing whether the quality of the data and research is good enough to have an impact on the way we practice and on our responsibility to optimise the care of our patients.1–6 Various categorisations of the quality of evidence are available with one of the classics being level of evidence 1 used for high-quality randomised control trials, level of evidence 2 for prospective cohort studies, level of evidence 3 for cohort studies, level of evidence 4 for descriptive case series, and level of evidence 5 for ‘expert’ opinion.

For some, systematic reviews and meta-analyses have taken a pre-eminent place in the hierarchy of evidence superseding even a high-quality, well-targeted, randomised control trial. However, one must bear in mind that the weak link of any systematic review/meta-analysis is the fact that the authors may not have performed …

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