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To The Editor: We read with interest the article by Khan et al. entitled "Treatment of Acute Achilles Tendon Ruptures. A Meta-Analysis of Randomized, Controlled Trials" (2005;87: 2202-210 ), and we have some concerns regarding the papers that they included in the meta-analysis. The authors state that their intention was to provide a meta-analysis of randomized, controlled trials, and they clearly state their selection criteria and methodology scoring system. However, we found that four papers 1-4 had a score of 0 for the method of randomization and were thus recognized to be poorly randomized, if randomized at all. On our review of these papers, we noted that Kerkhoffs et al. 1 clearly stated that their study was only quasi-randomized and that the study by Maffulli et al. 2 was not randomized for patient selection, with treatment selection being only quasi-randomized on the basis of the day of attendance. We believe that the inclusion of these papers in the meta-analysis may invalidate the results as they do not conform to the aims of the article—a meta-analysis of randomized, controlled trials. We would be interested in the reasons why the authors included these papers in their meta-analysis.
Journal of Bone and Joint Surgery – Wolters Kluwer Health
Published: May 1, 2006
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