How to Distinguish Correlation From Causation in Orthopaedic Research

Isabella Zaniletti, Dirk R. Larson, David G. Lewallen, Daniel J. Berry, Hilal Maradit Kremers

Research output: Contribution to journalReview articlepeer-review


Correlations in observational studies are commonly misinterpreted as causation. Although correlation is necessary to establish a causal relationship between two variables, correlations may also arise due to chance, reverse causality, or confounding. There are several methods available to orthopaedic researchers to determine whether the observed correlations are causal. These methods depend on the key components of the study including, but not limited to, study design and data availability on confounders. In this article, we illustrate the main concepts surrounding correlation and causation using intuitive real-world examples from the orthopaedic literature. Please visit the following for a video that explains the highlights of the paper in practical terms.

Original languageEnglish (US)
Pages (from-to)634-637
Number of pages4
JournalJournal of Arthroplasty
Issue number4
StatePublished - Apr 2023


  • arthroplasty
  • causation
  • chance
  • confounding
  • correlation
  • orthopaedics

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine


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