Joint Surgery, London, UK. ©2006 British Editorial

All surgeons attempt to give their patients the optimum level of treatment at their disposal. They search their knowledge in order to come to the best diagnostic and practical solution to the problems which they face. Their decisions are based upon the wisdom which they have gathered during their years of training and experience. They combine clinical expertise with an understanding of the current views on management based on the best available research and opinion. This has been the stan-dard approach to care of the patient since the time of Hippocrates. In recent years there has arisen the concept of ‘evidence-based medicine’, in which emphasis has been placed on attempt