Abstract：
Unnecessary care, where the potential for harm exceeds the potential for benefit, is widespread in medical care. Orthopaedic surgery is no exception. This has significant implications for patient safety and health care expenditure. This narrative review explores unnecessary care in orthopaedic surgery. There is wide geographic variation in orthopaedic surgical practice that cannot be explained by differences in local patient populations. Furthermore, many orthopaedic interventions lack adequate low-bias evidence to support their use. Quantifying the size of the problem is difficult, but the economic burden and morbidity associated with unnecessary care is likely to be significant. An evidence gap, evidence-practice gap, cognitive biases, and health system factors all contribute to unnecessary care in orthopaedic surgery. Unnecessary care is harming patients and incurring high costs. Solutions include increasing awareness of the problem, aligning financial incentives to high value care and away from low value care, and demanding low bias evidence where none exists.
摘要：
不必要的照顾，如果潜在的伤害超过潜在的利益，在医疗保健中普遍存在。骨科手术也不例外。这对患者安全和医疗保健支出具有重大影响。这篇叙述性综述探讨了骨科手术中不必要的护理。骨科手术实践中存在广泛的地理差异，无法用当地患者人群的差异来解释。此外，许多骨科干预措施缺乏足够的低偏倚证据来支持其使用.量化问题的大小是困难的，但与不必要护理相关的经济负担和发病率可能是巨大的。证据空白,证据-实践差距，认知偏见,和卫生系统因素都会导致骨科手术中不必要的护理。不必要的护理正在伤害患者并产生高昂的成本。解决方案包括提高对问题的认识，将财务激励与高价值护理相结合，远离低价值护理，并要求没有偏见的低偏见证据。
