Reevaluating Informed Consent: Integrating Shared Decision-Making into Spinal Surgery for Better Patient Outcomes.

Study Design: Narrative review.

Objectives: The objectives of this study were to answer the following questions: (1) What is the quality of informed consent in spine surgery, including both neurosurgery and orthopaedic spine surgery? (2) What limitations impede the ability of surgeons to engage in effective shared decision-making (SDM) and obtain adequate informed consent? (3) What strategies and solutions may improve the quality of informed consent and SDM? (4) What factors decrease the incidence of litigation in spine surgery?

Methods: N/A.

Results: SDM is a collaborative process where patients are involved in their treatment choices through open communication about risks, alternatives, and postoperative expectations.

The Impact of the Dobbs v. Jackson Supreme Court Decision on Orthopaedic Residency Programs: A Collaborative Orthopaedic Education Research Group (COERG) Survey.

Recent changes in reproductive health care policy have now led to state-specific differences in abortion care access across the United States. Members of the medical community in particular have issued concerns regarding these new policies and their potential impact on graduate medical training.  Objectives: The purpose of this study was to sample orthopaedic surgery residency programs to gauge their perceptions of the Dobbs decision and its impact on residency training.

Efficacy and Safety of a Patient Selection Tool for Predicted Discharge at an Ambulatory Surgical Center: A Pilot Study.

Background: There is a paucity of validated risk stratification tools to assess which patients can safely and predictably undergo outpatient total hip (THA) or knee arthroplasty (TKA) in an ambulatory surgery center (ASC).

Methods: Our novel patient selection tool was prospectively applied to 190 consecutive primary THA and TKA performed by a single surgeon at a single ASC. We identified the proportion of patients discharged home the same day, those requiring a one-night stay, or those with failed discharge within 23 hours.

Is Immediate Postoperative Radiograph Necessary Following Robotic-Assisted Total Knee Arthroplasty?

The necessity of immediate postoperative radiographs following total knee arthroplasty (TKA) has long been debated. With the increasing use of robotic-assisted TKA (RTKA), and thus more precise implant placement, the need for immediate postoperative radiographs to determine implant positioning may be unnecessary. We sought to evaluate implant position on the immediate postoperative radiographs following RTKA to determine their necessity.

Publication rates of abstracts presented at American Shoulder and Elbow Surgeons annual open and closed conferences: 2015-2019.

Background: The annual meetings hosted by the American Shoulder and Elbow Surgeons (ASES) present the latest prepublication literature in shoulder and elbow surgery, facilitating early dissemination of novel findings that impact clinical decision-making. Evaluating the publication rate of presented abstracts at ASES conferences becomes crucial in assessing the quality of research showcased, as these presentations often precede the peer-review process.

Methods: The ASES conference programs from 2015-2019 were reviewed to identify presented abstracts.

Academic Degree Bias Among Speaking and Leadership Roles at the American Academy of Orthopaedic Surgeons Annual Meetings, 2016-2021.

This study examined the proportion of Doctors of Osteopathic Medicine (DOs) across various speaking and leadership roles at recent American Academy of Orthopaedic Surgeons (AAOS) annual meetings.  Design: Meeting programs from the AAOS were publicly accessed and compiled between 2016 and 2021. Two categories of AAOS meeting participants were created.

Combined, Single-Anchor Subscapularis Tendon Repair and Proximal Biceps Tenodesis Leads to Improved Function and Decreased Pain at 1 Year.

Purpose: To evaluate the 1-year clinical outcomes of patients treated with combined proximal biceps tenodesis and repair of type II to III subscapularis tendon (SST) injuries according to Lafosse et al., using the Loop 'N' Tack (LNT) technique.

Methods: All patients undergoing proximal biceps tenodesis and rotator cuff repair between March 1, 2020, and January 30, 2022, were retrospectively identified.

Goals of Care Discussions in Orthopaedic Surgery: Geriatric Hip Fractures.

Background: Due to the severity of hip fracture complications in the geriatric population, including major morbidity and mortality, it is crucial to establish treatment goals and manage expectations as a patient-centered multidisciplinary team. Goals of care (GOC) are personalized treatment programs designed to align with the individual patient's values and preferences. There is a paucity of literature on the topic of GOC discussions, especially regarding orthopaedic injuries.

Analysis of Changing Practice Trends in Anterior Cruciate Ligament Reconstruction: A Multicenter, Single-Institution Database Analysis.

Purpose: To identify trends in anterior cruciate ligament reconstruction (ACLR), including graft choice, femoral tunnel drilling techniques, and augmentation techniques, and to assess how various surgeon factors impact these trends.

Methods: A retrospective review of primary ACLRs performed between 2014 and 2022 was completed using a multicenter institutional database. Patient demographic characteristics, graft type, femoral drilling technique, use of extra-articular tenodesis, and use of suture augmentation were recorded from the medical record.

Capsular Repair, Labral Repair, and Femoroplasty With Postless Traction Are Increasingly Performed for the Arthroscopic Treatment of Femoroacetabular Impingement Syndrome.

Purpose: To provide an updated assessment of hip arthroscopy use by using an institutional database that is specific to the treatment of femoroacetabular impingement syndrome (FAIS).

Methods: All patients undergoing hip arthroscopy for the treatment of FAIS were retrospectively identified between the years 2014 and 2022 via Current Procedural Terminology coding in a multi-institutional, single health system database. A longitudinal analysis was performed to identify trends in the use of arthroscopic techniques including capsular and labral treatment, osteoplasty, and traction set-up.

Do ChatGPT and Google differ in answers to commonly asked patient questions regarding total shoulder and total elbow arthroplasty?

Background: Artificial intelligence (AI) and large language models (LLMs) offer a new potential resource for patient education. The answers by Chat Generative Pre-Trained Transformer (ChatGPT), a LLM AI text bot, to frequently asked questions (FAQs) were compared to answers provided by a contemporary Google search to determine the reliability of information provided by these sources for patient education in upper extremity arthroplasty.

Methods: "Total shoulder arthroplasty" (TSA) and "total elbow arthroplasty" (TEA) were entered into Google Search and ChatGPT 3.

Seventy Percent of Abstracts Presented at the AANA Annual Meeting Are Later Published.

Purpose: To assess the future publication rates of abstracts presented at AANA annual meetings between 2015 and 2019.

Methods: Abstracts presented at the 2015-2019 AANA annual meetings were identified. The PubMed and Google Scholar databases were searched for a corresponding manuscript for each abstract using the name of the first author, abstract title, and keywords.

Publication Rates of Abstracts Presented at American Orthopaedic Society for Sports Medicine Annual Meetings From 2016 to 2019.

Background: Research in the form of poster and podium abstracts is disseminated at subspecialty society meetings. The quality of this research can be defined by exploring the ultimate publication rate of the presented abstracts.

Purpose: To investigate (1) the manuscript publication rate of abstracts presented at the American Orthopaedic Society for Sports Medicine (AOSSM) annual meeting; (2) whether abstract format (poster vs podium) influences overall or 2-year publication rates and time to publication; (3) the abstract factors that are associated with increased publication rate; and (4) whether publication quality as measured by journal of publication, level of evidence (LOE), and number of citations differs between posters and podiums.

Functional Considerations in Bilateral, Simultaneous Tendon Injuries of the Upper Extremity: A Narrative Review of Current Literature.

» Bilateral, simultaneous same-tendon injuries of the upper extremity are rarely encountered, yet their unique complexity poses a substantial challenge for treating orthopaedic surgeons.» In general, extremities with more tendon retraction should be repaired acutely while contralateral injuries can be treated in a staged or simultaneous manner depending on injury morphology, location, and anticipated functional impairment.» Combinations of accelerated and conventional rehabilitation protocols can be used for individual extremities to minimize the length of functional impairment.

A Novel Patient Selection Tool Is Highly Efficacious at Identifying Candidates for Outpatient Surgery When Applied to a Nonselected Cohort of Patients in a Community Hospital.

Background: There is a paucity of validated selection tools to assess which patients can safely and predictably undergo same-day or 23-hour discharge in a community hospital. The purpose of this study was to assess the ability of our patient selection too to identify patients who are candidates for outpatient total joint arthroplasty (TJA) in a community hospital.

Methods: A retrospective review of 223 consecutive (unselected) primary TJAs was performed.

The Risk of Acute Infection Following Intra-Articular Corticosteroid Injection During Total Knee Manipulation Under Anesthesia.

Background: Manipulation under anesthesia (MUA) is an established option for improving motion in patients presenting with early stiffness following total knee arthroplasty (TKA). Intra-articular corticosteroid injections (IACI) are sometimes administered adjunctively, yet literature examining their efficacy and safety remains limited.

Study Design: Retrospective, Level IV.

An updated analysis of shoulder and elbow questions on the Orthopedic In-Training Examination.

Background: The Orthopedic In-Training Examination (OITE) is an annual examination for orthopedic surgery residents used to assess orthopedic knowledge across a national standard. Having an updated understanding of currently tested topics and resources is useful to help residents guide their education.

Purpose: The purpose of this study is to analyze the shoulder and elbow domain of the OITE in an effort to provide current trends and commonly tested topics.

Particle-size and radiochemical purity evaluations of filtered 99mTc-sulfur colloid prepared with different heating times.

Unlabelled: Sentinel node lymphoscintigraphy using colloidal particles has become common practice at many institutions. The ideal particle size for colloids such as filtered (99m)Tc-sulfur colloid ((99m)Tc-FSC) in sentinel node studies is 15-100 nm. It is reported that the use of a reduced heating time during the reconstitution process results in an increased number of smaller particles (<30 nm).