Sex Diversity in the Emerging United States Arthroplasty Workforce Is Limited.

Background: Sex diversity remains limited in the United States arthroplasty workforce. This study evaluates fellowship program characteristics associated with increased sex diversity in US-based fellowship programs and the pipeline of women trainees before arthroplasty fellowship.

Methods: Demographic data from 233,981 allopathic medical school graduates, 11,364 orthopaedic surgery residents, and 1,501 arthroplasty fellows were analyzed.

International medical graduates in orthopaedic surgery: An opportunity to improve diversity and inclusion?

Background/aims: Racial and ethnic minorities are under-represented in orthopaedic surgery despite efforts to promote diversity and inclusion in the specialty. The purpose of this study was to determine the proportion of international medical graduates (IMGs) in the surgical workforce and future residency pipeline. We further analyze IMG applicant qualifications relative to their US-based counterparts to assess the viability of recruiting IMG candidates as one strategy to advance diversity and inclusion in orthopaedic surgery.

Acute Total Hip Arthroplasty Following Acetabular Fracture is Associated With a High Risk of Revision, Dislocation, and Periprosthetic Fracture.

Background: The aim of this study was to compare outcomes between acute, subacute, and delayed arthroplasty for acetabular fractures occurring within 1 week, from 1 week to 6 months, or more than 6 months before the index total hip arthroplasty (THA), versus THA without a history of acetabular fracture as a control.

Methods: We analyzed the records of patients undergoing primary THA who were enrolled in a national database for at least 2 years before and after the index procedure. Patients who had an initial diagnostic code for acetabular fracture occurring less than 1 week, from 1 week to 6 months, or at least more than 6 months before the THA were classified as acute THA (aTHA), subacute THA (saTHA), or delayed THA (dTHA), respectively.

Patient satisfaction and patient-reported outcomes do not vary by BMI class in total hip arthroplasty.

Purpose: Obesity has been identified as a risk factor for postoperative complications in patients undergoing total hip arthroplasty (THA). This study aimed to investigate patient-reported outcomes, pain, and satisfaction as a function of body mass index (BMI) class in patients undergoing THA.

Methods: 1736 patients within a prospective observational study were categorized into BMI classes.

Impact of Chronic Opioid Use on Postoperative Mobility Recovery and Patient-Reported Outcomes: A Propensity-Matched Study.

Background: Opioid use prior to total joint arthroplasty may be associated with poorer postoperative outcomes. However, few studies have reported the impact on postoperative recovery of mobility. We hypothesized that chronic opioid users would demonstrate impaired objective and subjective mobility recovery compared to nonusers.

Sex Disparities Among Fellowship Program Directors in Orthopaedic Surgery.

Background: Women are underrepresented in the orthopaedic surgery workforce in the U.S. The purpose of this study was to elucidate the representation of women among fellowship program directors (PDs) in orthopaedic surgery.

Diversity of Backgrounds and Academic Accomplishments for Presidents Elected to Hip and Knee Arthroplasty Societies in the United States.

Background: Academic accomplishments and demographics for presidents of hip and knee arthroplasty societies are poorly understood. This study compares the characteristics of presidents nominated to serve the Hip Society, Knee Society, and American Association of Hip and Knee Surgeons.

Methods: This was a cross-sectional study of arthroplasty presidents in the United States (1990 to 2022).

Management of Femoral Neck Fractures in Patients Age ≥50 Years by American Board of Orthopaedic Surgery Part II Examination Candidates.

Objective: Assess associations between fellowship training, procedure, and performance in femoral neck fracture (FNF) surgery on adults by American Board of Orthopaedic Surgery (ABOS) Part II Examination candidates.

Setting: ABOS SCRIBE database exam years 2007-2020.

Participants: 6,777 candidates performing 39,283 FNF surgeries on adults age ≥ 50 years.

The Impact of Post-graduate Year and Program Accreditation Status on In-Training Examination Performance in Orthopaedic Surgery.

Introduction  The progression of medical knowledge competency during surgical residency training is poorly understood. This study measures the acquisition of medical knowledge as orthopedic surgery residents advance during training and the impact of accreditation status on orthopedic in-training examination (OITE) performance. Methods  Orthopedic surgery residents taking the OITE during 2020 and 2021 were included.

Analysis of Academic Accomplishments and Demographics for Elected Presidents of National Orthopedic Surgery Organizations in the United States.

This study analyzed the academic accomplishments and demographics of elected presidents of the American Academy of Orthopaedic Surgeons (AAOS), American Orthopaedic Association (AOA), and American Board of Orthopaedic Surgery (ABOS). Curriculum vitae and internet-based resources were reviewed to collect demographics, training characteristics, bibliometrics, and National Institutes of Health (NIH) research funding of contemporary presidents (1990-2020). Eighty presidents were included.

Women Are Underrepresented Among Principal Investigators of Hip and Knee Arthroplasty Clinical Trials in the United States.

Background: Leadership of clinical trials confers national recognition and promotes academic advancement. We hypothesized that women would be underrepresented among principal investigators (PIs) of hip and knee arthroplasty clinical trials in the United States.

Methods: A query of hip and knee arthroplasty clinical trials from 2015 to 2021 was performed on ClinicalTrials.

Trends in ACGME Accreditation of Orthopedic Surgery Fellowship Training.

Currently, most surgeons pursue subspecialty fellowship training. This study answers the following questions: (1) How does the rate of fellowship training in orthopedic surgery compare with that in other surgical specialties? (2) To what extent did adoption of Accreditation Council for Graduate Medical Education (ACGME) accreditation change from 2013 to 2021? Orthopedic subspecialties were analyzed for total number of fellowship programs and positions in the 2013 and 2021 Match. Rates of ACGME accreditation were analyzed via chi-square tests.

Acquisition of Medical Knowledge Varies During Allopathic and Osteopathic Orthopedic Surgery Residency Training.

Currently, little is known about the differences in medical knowledge acquisition between osteopathic and allopathic orthopedic surgery residents. The purpose of this study was to determine the relationship between Orthopaedic In-Training Examination (OITE) performance and training pathway in orthopedic surgery. This was a retrospective cohort study of all orthopedic surgery residents taking the OITE during the 2019-2020 academic year.

Diversity in Leadership at Musculoskeletal Oncology Fellowships in the United States.

Musculoskeletal oncology fellowship directors (MOFDs) possess the unique ability to influence treatment paradigms in musculoskeletal oncology through teaching and research. Currently, the characteristics that define this important role including demographics, training characteristics, research activity, and grant funding are poorly defined. A list of musculoskeletal oncology fellowship programs was obtained from the American Association of Hip and Knee Surgeons and Musculoskeletal Oncology Fellowship Match.

Prosthetic Hip Dislocations in Direct Anterior Versus Posterior Approach in Patients With Instrumented Lumbar Fusion.

Background: Instrumented posterior lumbar spinal fusion (IPLSF) has been demonstrated to contribute to instability following total hip arthroplasty (THA). It is unclear whether a supine direct anterior (DA) approach reduces the risk of instability.

Methods: A retrospective review of 1,773 patients who underwent THA through either a DA approach or a posterior approach at our institution over a 7-year period was performed.

Impact of COVID-19 on the Reported Case Volume of Orthopaedic Sports Medicine Fellows in the United States.

Background: The impact of the coronavirus 2019 (COVID-19) pandemic on reported case volume during orthopaedic sports medicine fellowship training remains poorly understood from a national perspective.

Hypothesis: It was hypothesized that reported case volume during orthopaedic sports medicine fellowship training would decrease during the 2019-2020 academic year, which corresponded to the COVID-19 outbreak. It was also hypothesized that there would be a subsequent rebound in case volume during the 2020-2021 academic year.

Hot Topics and Current Controversies in Total Knee Arthroplasty.

Total knee arthroplasty continues to evolve. It is important to review some of the current controversies and hot topics in arthroplasty. Optimal knee alignment strategy is now just a matter of debate.

Development of a personalized shared decision-making tool for knee osteoarthritis and user-testing with African American and Latina women.

Background: Patients with chronic knee pain are often unaware of treatment options and likely outcomes-information that is critical to decision-making. A consistent framework for communicating patient-personalized information enables clinicians to provide consistent, targeted, and relevant information. Our objective was to user-test a shared decision-making (SDM) tool for chronic knee pain.

Impact of Orthopaedic Surgeons on National Institutes of Health Funding for Hip and Knee Arthroplasty Research.

Background: The National Institutes of Health (NIH) remains one of the predominant sources of biomedical research funding in the United States, yet its impact on total hip and knee arthroplasty research is poorly understood. This study defines the portfolio of NIH funding for total joint arthroplasty (TJA) and the impact of orthopaedic surgeons on this portfolio.

Methods: The Research Portfolio Online Reporting Tools Expenditures and Results (RePORTER) database was queried for NIH grants that had been awarded for total hip and knee arthroplasty and total NIH funding from 2010 to 2020.

Variability in procedure volume of physical medicine and rehabilitation residents graduating from 2014 to 2021.

Background: Adequate exposure to commonly performed procedures during physical medicine and rehabilitation (PM&R) residency is an important issue.

Objective: To assess temporal trends and variabilities in reported procedural volumes, including the number of residents achieving procedure minimum requirements as established by the Accredited Council for Graduate Medical Education (ACGME) PM&R Residency Review Committee.

Design: This was a retrospective cohort study of PM&R residents graduating from 2013-2014 to 2020-2021.

Activating EGFR Signaling Attenuates Osteoarthritis Development Following Loading Injury in Mice.

Posttraumatic osteoarthritis (PTOA) results in joint pain, loss of joint function, and impaired quality of daily life in patients with limited treatment options. We previously demonstrated that epidermal growth factor receptor (EGFR) signaling is essential for maintaining chondroprogenitors during articular cartilage development and homeostasis. Here, we used a nonsurgical, loading-induced PTOA mouse model to investigate the protective action of EGFR signaling.

Surgical Benchmarks for ACGME-accredited Adult Reconstructive Orthopaedic Fellowship Training.

Introduction: Higher case volumes correlate with improved outcomes in total joint arthroplasty surgery. The purpose of this study was to understand the effect of adult reconstruction fellowship training on reported case volume in a contemporary cohort of orthopaedic surgeons.

Methods: The Accreditation Council for Graduate Medical Education provided case logs for orthopaedic surgery residents and adult reconstructive orthopaedic fellows from 2017 to 2018 to 2020 to 2021.

No Difference in Perioperative Complications for Bilateral Total Knee Arthroplasty Staged at 1 Week Compared With Delayed Staging.

Introduction: Controversy exists regarding the safety of simultaneous bilateral total knee arthroplasty (TKA) versus two TKA procedures staged months apart in patients with bilateral knee arthritis. Here, we investigated a third option: bilateral TKA staged 1 week apart. In this study, we examined the rate of complications in patients undergoing bilateral TKA staged at 1 week compared with longer time intervals.