Summary

Reporting bias in the form of spin is highly prevalent in the abstracts of systematic reviews and meta-analyses evaluating MPFLR. Greater efforts are needed to ensure that the abstracts of publications accurately represent the results in the full text, so orthopaedic surgeons can make well-informed clinical decisions regarding patient care.

Abstract

Objectives: Medial patellofemoral ligament reconstruction (MPFLR) is a successful surgical treatment for patients with recurrent patellofemoral instability. To ensure that the results of MPFLR are accurately portrayed in the literature, it is important to review published studies for reporting bias in the form of spin. The purpose of this study was to analyze reporting bias in the form of spin present in the abstracts of systematic reviews and meta-analyses evaluating medial MPFLR.

Methods

This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer-reviewed systematic reviews were collected from PubMed, Scopus, and Embase databases using the search “medial patellofemoral ligament reconstruction” or “MPFLR” AND “systematic review” OR “meta-analysis” in January of 2024. The abstracts were assessed for the 15 most common types of spin. A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) was used to assess the quality of the studies. Several study characteristics were analyzed, and their association with the presence of spin and the number of spin types present was determined using descriptive statistics.

Results

A total of 57 studies published from 2007-2024 were included in this review. Spin was present in 51 out of 57 studies (89.5%). Each type of spin was observed in at least one study with the exceptions of spin types 1, 7, 13, and 15. The median number of spin types identified per study was 3 (range: 0-5, mean = 3.02 ± 1.45). The three most common types of spin were type 5 (48/57, 84.2%), type 3 (32/57, 56.1%), and type 9 (30/57, 52.6%). The category of spin that was most prevalent was misleading reporting (spin types 3, 5, 6, 10, 11, 13, 14), present in 50 out of the 51 studies that contained spin (98.0%). Misleading reporting (spin types 3, 5, 6, 10, 11, 13, 14), also had the highest frequency, with a total of 107 instances across the 50 studies. Forty-seven of 51 (92.2%) studies contained spin within the category of misleading interpretation (spin types 1, 2, 4, 9, 12). The frequency of misleading interpretation was lower than that of misleading reporting, with a total of 62 instances across the 47 studies. There was a statistically significant negative correlation between the numerical AMSTAR-2 rating and the presence of spin. The AMSTAR-2 confidence interval was significantly associated with the number of spin types present. Additionally, there was a statistically significant positive correlation between the Clarivate Impact Factor and the presence of spin.

Conclusion

Spin was present in most systematic reviews and meta-analyses evaluating MPFLR. Spin types 5, 3, and 9 were the most prevalent, indicating a tendency for authors to assert in their abstracts that MPFLR was a beneficial treatment. Systematic reviews and meta-analyses contain the most comprehensive evidence regarding a clinical question, so it is important to identify spin that may be included in these studies. Greater efforts are needed to ensure that study abstracts accurately represent the results in the full text, so orthopaedic surgeons can make well-informed clinical decisions regarding patient care.