Etude radio-clinique comparant les résultats à court terme des prothèses totales du genou implantées soit à l'aide d'une instrumentation manuelle soit à l'aide d'un système de navigation assisté par ordinateur

Résumé: La qualité de l'implantation d'une prothèse totale du genou est un facteur essentiel déterminant le résultat clinique à long terme. L'alignement postopératoire des membres inférieurs est considéré comme le facteur influençant le plus la survie à long terme d'une arthroplastie du genou. Au vu du haut degré de corrélation entre les complications post-opératoires et les malpositionnements prothétiques, les chirurgiens ont tenté de développer durant ces deux dernières décennies des instruments chirurgicaux améliorant la précision d'implantation. Depuis le début des années 90, de nouvelles instrumentations assistées par ordinateur ont été proposées. Actuellement, en chirurgie prothétique du genou, la plus utilisée de ces techniques est le système de navigation OrthoPilot® qui permet, grâce à une station de navigation et des émetteurs infrarouges, de contrôler en continu pendant l'opération, l'axe mécanique du membre inférieur et de vérifier la précision des coupes osseuses. Le but de cette étude de cohorte appareillée rétrospective est de comparer les résultats clinique et radiologiques de deux collectifs de patients (32 patients dans chaque groupe) comparables (âge, sexe, BMI, degré d'arthrose, recul postopératoire), opérés avec le même type de prothèse (prothèse à glissement tricompartimental postérieurement stabilisée), soit avec le système de navigation Orthopilot®, soit à l'aide de l'instrumentation ancillaire mécanique classique. Les résultats obtenus montrent que la technique chirurgicale supportée par le système de navigation Orthopilot® est fiable et aisément reproductible. Par rapport à l'instrumentation manuelle, l'instrumentation assistée améliore significativement la précision de pose du composant tibial dans le plan frontal. Cependant entre des mains expérimentées, la technique d'alignement mécanique classique, plus simple, reste performante (coût modique, temps opératoire plus court et sans risque de défaillance technique).

Surrogate science: The idol of a universal method for scientific inference

The application of statistics to science is not a neutral act. Statistical tools have shaped and were also shaped by its objects. In the social sciences, statistical methods fundamentally changed research practice, making statistical inference its centerpiece. At the same time, textbook writers in the social sciences have transformed rivaling statistical systems into an apparently monolithic method that could be used mechanically. The idol of a universal method for scientific inference has been worshipped since the "inference revolution" of the 1950s. Because no such method has ever been found, surrogates have been created, most notably the quest for significant p values. This form of surrogate science fosters delusions and borderline cheating and has done much harm, creating, for one, a flood of irreproducible results. Proponents of the "Bayesian revolution" should be wary of chasing yet another chimera: an apparently universal inference procedure. A better path would be to promote both an understanding of the various devices in the "statistical toolbox" and informed judgment to select among these.

Authorship in scientific publications: analysis and recommendations.

In 2008, a Swiss Academies of Arts and Sciences working group chaired by Professor Emilio Bossi issued a "Memorandum on scientific integrity and the handling of misconduct in the scientific context", together with a paper setting out principles and procedures concerning integrity in scientific research. In the Memorandum, unjustified claims of authorship in scientific publications are referred to as a form of scientific misconduct - a view widely shared in other countries. In the Principles and Procedures, the main criteria for legitimate authorship are specified, as well as the associated responsibilities. It is in fact not uncommon for disputes about authorship to arise with regard to publications in fields where research is generally conducted by teams rather than individuals. Such disputes may concern not only the question who is or is not to be listed as an author but also, frequently, the precise sequence of names, if the list is to reflect the various authors' roles and contributions. Subjective assessments of the contributions made by the individual members of a research group may differ substantially. As scientific collaboration - often across national boundaries - is now increasingly common, ensuring appropriate recognition of all parties is a complex matter and, where disagreements arise, it may not be easy to reach a consensus. In addition, customs have changed over the past few decades; for example, the practice of granting "honorary" authorship to an eminent researcher - formerly not unusual - is no longer considered acceptable. It should be borne in mind that the publications list has become by far the most important indicator of a researcher's scientific performance; for this reason, appropriate authorship credit has become a decisive factor in the careers of young researchers, and it needs to be managed and protected accordingly. At the international and national level, certain practices have therefore developed concerning the listing of authors and the obligations of authorship. The Scientific Integrity Committee of the Swiss Academies of Arts and Sciences has collated the relevant principles and regulations and formulated recommendations for authorship in scientific publications. These should help to prevent authorship disputes and offer guidance in the event of conflicts.