User's guide to the orthopaedic literature: How to use a systematic literature review

Investigators who perform a systematic review address a focused clinical question, conduct a thorough search of the literature, apply inclusion and exclusion criteria to each potentially eligible study, critically appraise the relevant studies, conduct sensitivity analyses, and synthesize the information to draw conclusions relevant to patient care or additional study. A meta-analysis is a quantitative (or statistical) pooling of results across eligible studies with the aim of increasing the precision of the final estimates by increasing the sample size. The current increase in the number of small randomized trials in orthopaedic surgery provides a strong argument in favor of meta-analysis; however, the quality of the primary studies included ultimately reflects the quality of the pooled data from a meta-analysis.