The 95% confidence interval of the primary analysis excluded zero but included the target difference of six (mean difference favouring debridement only: –4·2 95% CI –8·2 to –0·26). Outside of the ...START-REACTS study, the authors report no personal financial conflict of interest with Stryker or any other related commercial organisation. AM, HP, and MU are co-investigators on two other National Institute for Health and Care Research (NIHR)-funded trials (RACER-Knee and RACER-Hip; AM leads RACER-Knee), for which Stryker also funds treatment costs and some imaging costs.