THE JOURNAL OF BONE EDITORIALS I AND JOINT SURGERY

The status of many orthopaedic operations today is little better founded in science than was the status of most drug treatments 40 years ago. At that time there seemed to be almost as many therapeutic methods as there were physicians, each of whom pinned his faith to the treatment of his choice. From time to time, the more ambitious practitioners reported their last 100 results with this or that drug. Those in the latest cohort were almost always better than in the one before, giving a general impression of the steady march of medicine towards its own perfection. Observers of the progress of arthroplasty of the hip and knee during the past decade may recognise the syndrome. In the 1950s the randomised controlled trial was introduced and this method is now universally used t