Spin reporting is common in pilot and feasibility trials in hip and knee arthroplasty: a methodological analysis of a cross-sectional sample

BACKGROUND: Pilot and feasibility trials help identify methodological and logistical challenges. However, biased reporting, known as "spin," may distort overall study findings and mislead readers, presenting content through a subjective lens. Accurate assessments of feasibility are critical in orthopedic research, where the continued popularity of procedures such as hip and knee arthroplasties emphasizes a need for rapid advancement through research and development. The prevalence of spin practices among pilot and feasibility trials in hip and knee arthroplasties remains unclear. To evaluate the prevalence of spin reporting practices in pilot and feasibility trials focused on hip and knee arthroplasty. The secondary objective is to identify factors associated with the level of spin featured in the analyzed manuscripts. METHODS: A search of PubMed identified 147 trials published between 2017 and 2023, selected using stratified random sampling. Studies were screened for the presence of three spin criteria defined in previous literature, and summarized descriptively. RESULTS: Spin appeared in 88.4% of studies (95% CI 83.3-93.6). Emphasis on intervention effectiveness (81.6%) and statistical significance rather than feasibility (60.5%) were the most common types. Spin was frequent in abstracts (78.9%) and discussions (79.6%), with the highest rates also observed in privately funded (95.7%) and pharmacologic (100%) studies. No clear trend was observed over time. CONCLUSIONS: Spin is widespread in pilot and feasibility trials involving hip and knee arthroplasty, particularly in abstracts and discussions. Greater adherence to reporting guidelines and explicit communication of feasibility objectives and study limitations are necessary to improve transparency and reduce interpretive bias in this field.