I'm not accusing you of anything, jdistefa, just pointing out that it's wise to be careful about offering medical advice on the internet. If you offer advice that is incorrect based on details you didn't have at the time (like a complete medical history, a physical exam, and an MRI), you can potentially cause someone a great deal of distress. That is the "ethically problematic" issue.
In order to avoid the appearance of offering advice, or contradicting other people's doctors, I personally cite references when I discuss medical issues, but obviously that isn't a requirement. It is good practice, however. I wind up learning a lot when I look up references!
And yes, the literature does not adequately reflect what happens in real life, which is why people with cases need to write them up. Seriously, do you have a case series of skiers with periprosthetic fracture? Because if you do, just write up the narrative, scrounge up their films and publish it. Heck, I'll even write the background and conclusions if you don't have time. In writing up a response to the Knee Thread (I haven't posted it yet - these things take time), I realized I'm halfway to a review article, so if you've got a case or two - bingo! Another cha-ching on our publication lists.
Anyway, just to be clear, I'm not attacking you. I look forward to your continued contributions to Epic.