Randomized surgical trials and "sham" surgery: relevance to modern orthopaedics and minimally invasive surgery.

Surgical techniques are constantly changing and evolving, though research trials supporting the value of a specific surgical intervention are often limited by the lack of a legitimate control group. In surgical trials, the use of a placebo, or a "sham" surgery, is controversial. This article explores the debate regarding the use of sham surgeries and summarizes the few surgical studies that have used them. Arguments for and against their use in research are presented.