JBJS Open Access最新文献

{"title":"Management of Glenoid Bone Loss in Primary Reverse Total Shoulder Arthroplasty: A Critical Analysis Review.","authors":"Erick Marigi, Kristin E Yu, Amanda Vasquez-Loret, Michael D Baird, Christopher M Hart, John W Sperling, Joaquin Sanchez-Sotelo","doi":"10.2106/JBJS.OA.25.00131","DOIUrl":"10.2106/JBJS.OA.25.00131","url":null,"abstract":"<p><p>» A thorough understanding of glenoid deformity is essential to anticipate intraoperative needs and manage bony deficiencies. Management strategies include eccentric reaming, alternate scapular line baseplate orientation, bone grafting, or metallic augmentation as either \"off-the-shelf\" or custom baseplates. Accurate implantation of the glenoid component in the presence of glenoid bone loss (GBL) may also benefit from shoulderspecific guides, navigation, or robotic assistance. » GBL can negatively affect outcomes due to compromised bony fixation, altered soft tissue tensioning, and component malposition, which can contribute to impingement, dislocation, aseptic loosening, polyethylene wear, and component failure. » In this article, we provide a comprehensive review of published literature regarding the management of GBL in primary RSA and provide additional insight on the effectiveness of current approaches to manage bony deficiency.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors for Stiffness After Fixation of Tibial Tubercle Fractures: A Multicenter Study From the TITUS Group.","authors":"Konstantin Brnjoš, O Folorunsho Edobor-Osula, John S Blanco, Lindsay M Crawford, Dustin A Greenhill, Alexander H Griffith, Neil K Kaushal, David M Kell, Abhi Rashiwala, John A Schlechter, Evelyn S Thomas, Haley N Tornberg, Brendan A Williams, Neeraj M Patel","doi":"10.2106/JBJS.OA.25.00142","DOIUrl":"10.2106/JBJS.OA.25.00142","url":null,"abstract":"<p><strong>Background: </strong>Persistent stiffness after operative treatment of tibial tubercle fractures (TTFs) can inhibit functional recovery and interfere with activities of daily living. Given the rare nature of this fracture, little data exist to help identify risk factors for this complication. The purpose of this multicenter study was to identify risk factors for stiffness after fixation of TTFs.</p><p><strong>Methods: </strong>Operatively managed TTFs at 7 tertiary children's hospitals in patients younger than 18 years were included in this retrospective comparative study. Fractures with <3 months of documented postoperative range of motion and those fixed with nonscrew implants were excluded. Demographic, clinical, and radiographic data were reviewed. Persistent stiffness was defined as lacking ≥20° of flexion compared with the contralateral knee at 3 months after surgery. Univariable analysis was followed by multivariate regression to adjust for confounders.</p><p><strong>Results: </strong>The incidence of prolonged stiffness among the 369 included patients was 3.0%. The median time between initial presentation and surgery was longer in those who developed stiffness (24 versus 14 hours, p = 0.002). Furthermore, those who had surgery >24 hours after presentation developed stiffness more often than those who underwent fixation within 24 hours (12.7% versus 1.6%, p < 0.001). The median duration of postoperative immobilization was longer in patients who developed stiffness (45 versus 28 days, p = 0.006). Children immobilized >4 weeks after surgery developed stiffness more frequently than those who initiated mobilization within 4 weeks (5.7% versus 0.6%, p = 0.009). When adjusting for confounders such as age and fracture classification, fixation >24 hours after presentation was associated with 9.7 times higher odds of stiffness (95% CI 2.0-46.5, p = 0.004) and postoperative immobilization >4 weeks had 10.3 times higher odds of stiffness (95% CI 1.1-95.0, p = 0.04).</p><p><strong>Conclusions: </strong>Persistent stiffness after surgical fixation of TTFs occurs in 3.0% of children. Prolonged postoperative immobilization (>4 weeks) and delayed surgical fixation (>24 hours) are associated with higher odds of a persistent flexion deficit 3 months after surgery. Surgeons should consider this information when determining timing of treatment and postoperative protocols.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparative study. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323985/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution and Impact of Preference Signaling on Orthopaedic Residency After Two Years.","authors":"Matthew J Folkman, Angela Mihalic, Christopher G Sanford","doi":"10.2106/JBJS.OA.25.00036","DOIUrl":"10.2106/JBJS.OA.25.00036","url":null,"abstract":"<p><strong>Background: </strong>Residency programs have begun to offer preference signaling as a method for applicants to demonstrate commitment to programs. Orthopaedic surgery, which began signaling in 2022, allows applicants to use up to 30 signals. Early studies have evaluated the effects of signaling, demonstrating decreased application volume, varying effects on interviews, and high levels of applicant and faculty satisfaction. While the effects of signaling are beginning to be studied, multiple year evaluations are absent from the literature. The purpose of this study was to explore the impacts of signaling on the orthopaedic surgery match over its first two years.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using a prospectively collected <i>Texas Seeking Transparency in Application to Residency</i> database. The database contains survey data from 2017 to 2024 including applicants' demographics, academic performance, and application data. Applicants were first placed into cohorts comparing presignaling and postsignaling data. A second analysis organized applicants into the first year and second year of signaling. Cohorts were compared using descriptive statistics, chi-square tests, and independent samples <i>t</i>-tests.</p><p><strong>Results: </strong>There were 1786 orthopaedic surgery applicants from 2017 to 2024. In the first two years of signaling, the mean applications decreased by 23 (p < 0.001), interview offers decreased by three (p < 0.001), publications increased by one (p < 0.001), and volunteer experiences decreased by one (p < 0.001). When compared with the first year, the second year of signaling decreased applications by 15 (p < 0.001), decreased interviews by one (p = 0.030), decreased volunteer experiences by four (p < 0.001), and decreased publications by one (p = 0.015). There was no significant difference in match rate.</p><p><strong>Conclusions: </strong>Orthopaedic surgery preference signaling after two years significantly decreased mean applications, interview opportunities, and extracurricular experiences of applicants without affecting match success. These findings suggest that preference signaling continues to be an effective method at reducing application volume for programs and applicants while creating equitable opportunities for applicants after two years.</p><p><strong>Level of evidence: </strong>Level III-Retrospective Cohort Study. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Pulmonary Function After Surgical Treatment of Early-Onset Scoliosis.","authors":"Scott Yang, Apeksha Gupta, Michael E Trask, Natalie M Maharaj, Anna V Faino, Sean Pirkle, Kelson Roy Adcock, Jennifer M Bauer, Burt Yaszay, Gregory Redding","doi":"10.2106/JBJS.OA.25.00120","DOIUrl":"10.2106/JBJS.OA.25.00120","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal pulmonary outcomes after surgical treatment of early-onset scoliosis (EOS) are not well reported. This study aims to evaluate change in serial pulmonary function in children with EOS after surgery.</p><p><strong>Methods: </strong>A retrospective review was performed at a single academic hospital. All patients who had surgical treatment of EOS and repeated pulmonary function test (PFT) data were included. Pulmonary function test (PFT) measures included forced vital capacity (FVC), FVC % of predicted norms (FVC%), forced expiratory volume in 1 second (FEV1), and FEV1% of predicted norms (FEV1%). To determine whether PFT changed postsurgery, a random-effects mixed model was used. Predicted marginal means of PFT measures were calculated, and Bonferroni adjusted p-values were reported. Spearman correlation was used to analyze the relationship between radiographic measures and PFTs.</p><p><strong>Results: </strong>Fifty-one patients with EOS were included (mean age 7.2 years at index surgery). The index distraction-based growth-friendly construct was 31 (60.8%) vertical expandable prosthetic titanium rib implants, 9 (17.6%) traditional growing rods, and 11 (21.6%) magnetically controlled growing rods; 23 patients (45%) underwent final fusion. The median duration from the first to the most recent PFT was 44 months. The random-effects model showed no significant change in FVC, FVC%, and FEV1 over time since surgery. When changes in PFTs were analyzed by scoliosis etiology, there was no significant change in PFT measures after surgical treatment with any etiology except in congenital scoliosis where both FVC% and FEV1% significantly decreased during growth-friendly treatment and fusion compared with before surgery. T1-T12 length significantly correlated moderately with FVC (rho = 0.46, p < 0.0001), but not FVC%. Major curve Cobb angle did not significantly correlate with PFT measures.</p><p><strong>Conclusions: </strong>Growth-friendly EOS surgery did not improve pulmonary function, but at best prevented further pulmonary decline, except in children with congenital scoliosis who had worsening function over time.</p><p><strong>Level of evidence: </strong>Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Finite Element Analysis of Patellofemoral Contact Pressure with Varying Fixation of Transverse Patella Fractures.","authors":"Farid Amirouche, Majd Mzeihem, Jasper Hoag, Rohan Wangikar, Jason Koh","doi":"10.2106/JBJS.OA.25.00032","DOIUrl":"10.2106/JBJS.OA.25.00032","url":null,"abstract":"<p><strong>Background: </strong>Understanding patellofemoral contact pressure is crucial for knee biomechanics, as abnormalities can lead to joint issues. This study investigates the changes in contact pressure after surgical fixation of patellar fractures.</p><p><strong>Methods: </strong>Finite element model of the knee was created using cadaveric data on transverse patellar fractures. Models were analyzed and evaluated at 0°, 45°, and 90° flexion under quadriceps force to assess peak pressure, contact pattern, and pressure irregularity.</p><p><strong>Results: </strong>The plate and wire fixation models exhibited distinct stress distribution patterns at 45° and 90° flexion angles. At 45°, the plate model had a higher peak stress (6.14 MPa) in a 21.0-mm ovular contact area, while the wire model had lower peak stress (2.42 MPa) in a smaller, more fragmented region. At 90°, the plate model exhibited concentrated stress (13.26 MPa) in a heart-shaped area, whereas the wire model had 3 dispersed stress points (9.88 MPa) over a broader surface. These findings highlight the plate model's greater stress concentration and the wire model's more irregular distribution of stress. At 0°, the plate model exhibited minimal contact pressure compared with the wire model, with a pressure of 6.67 MPa.</p><p><strong>Conclusion: </strong>The plate model better preserves patellofemoral biomechanics, potentially reducing complications and improving long-term outcomes. Further research is needed to confirm its superiority as a fixation method.</p><p><strong>Clinical relevance: </strong>Although the prevalence of patellar fractures remains high, the gold-standard method for surgical fixation has a postoperative complication rate as high as 52.5%. Addressing the lack of understanding surrounding patellofemoral contact pressure in this scenario is an essential step toward improving outcomes for these patients.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12263017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extended Trochanteric Osteotomy Increases the Risk of Tapered Splined Stem Subsidence in Revision Total Hip Arthroplasty.","authors":"Josef E Jolissaint, Samuel Rodriguez, Leonardo Albertini Sanchez, Travis R Weiner, Elizabeth B Gausden, Jason L Blevins, Peter Sculco, Jose Rodriguez","doi":"10.2106/JBJS.OA.25.00110","DOIUrl":"10.2106/JBJS.OA.25.00110","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;In the United States, tapered splined titanium stems (TSTSs) are the most frequently used femoral stem design in revision total hip arthroplasty. Despite encouraging and favorable results with TSTS, complications including femoral stem subsidence persist and subsidence &gt;5 mm has been associated with implant failures and the need for aseptic rerevision surgery. We sought to investigate whether an extended trochanteric osteotomy (ETO) at the time of TSTS insertion increased mean subsidence and whether the amount of cortical contact was associated with subsidence, failure, and revision.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This is a single-center retrospective cohort study of a prospectively collected database including all patients who received a TSTS from 2016 to 2020. Data collected include surgery type, presence of an ETO, and stem specifications. Radiographs were reviewed to analyze cortical contact and postoperative subsidence. Pearson's correlation coefficient was used to determine the association between contact length and subsidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;This cohort consisted of 299 hips, and 66 hips necessitated an ETO at the time of TSTS. Patients who required an ETO were more likely to subside (2.5 ± 0.2 mm vs 5.0 ± 0.7 mm, p &lt; 0.001) and were more likely to subside &gt;5 mm (32.3% vs 14.5%, p = 0.001). After controlling for other variables, an ETO was an independent risk factor for significant subsidence (adjusted OR: 3.4, p = 0.02). Contact length below the ETO was inversely related to stem subsidence (correlation coefficient of -0.26; p = 0.037), and multivariable logistic regression demonstrated bicortical contact &gt; 30 mm to be a protective factor for significant subsidence (adjusted OR: 0.12, p &lt; 0.001). Patients who received an ETO had a higher aseptic rerevision rate than patients who had a TSTS implanted without an ETO (16.1% vs 6.6%, p = 0.018).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Patients who receive an ETO during revision hip arthroplasty have a higher mean subsidence and 3-fold increase in odds for subsiding &gt;5 mm. However, bicortical contact of 30 mm or greater below the ETO was protective against significant TSTS subsidence. Although not all patients with &gt;5 mm of subsidence were revised, the aseptic rerevision rate was significantly higher in patients who received an ETO.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical relevance: &lt;/strong&gt;An extended trochanteric osteotomy is an excellent technique to gain direct visualization of the femoral canal. However, it is not without its associated morbidity and postoperative complications, specifically stem subsidence. The results of this study suggest that when preparing for a TSTS after an ETO, careful consideration should be taken to confirm 3 cm of cortical engagement below the transverse limb of the ETO. The scaffolding technique, which prioritizes stem preparation followed by ETO closure, facilitates achieving sufficient cortical contact in the intact canal below","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Cow Hitch Cerclage Suture Fixation of the Greater Tuberosity in Reverse Total Shoulder Arthroplasty Performed for Proximal Humerus Fractures: A Retrospective Cohort Study With a Minimum Follow-up of 2 Years.","authors":"Flamur Zendeli, Philipp Kriechling, Samy Bouaicha, Sabine Wyss, Karl Wieser, Florian Grubhofer","doi":"10.2106/JBJS.OA.ER.24.00152","DOIUrl":"10.2106/JBJS.OA.ER.24.00152","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2106/JBJS.OA.24.00152.].</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650835","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Older Patients Undergoing Bipolar Hemiarthroplasty Face a Higher Risk of Intraoperative Fractures and Longer Hospital Stays on Delayed Surgery After Injury: A Multicenter Study.","authors":"Hirotaka Kawakami, Hiromi Sasaki, Junichi Kamizono, Hiroaki Sawazono, Yoshitaka Yamashita, Yusuke Fujimoto, Noboru Taniguchi","doi":"10.2106/JBJS.OA.25.00014","DOIUrl":"10.2106/JBJS.OA.25.00014","url":null,"abstract":"<p><strong>Background: </strong>Intraoperative fractures are a significant complication of bipolar hemiarthroplasty for hip fractures in older patients. Femoral geometry classified as Dorr C is associated with a high risk of intraoperative fractures when a cementless stem is used. However, the impact of the duration from injury to surgery on the risk of intraoperative fractures remains unclear. We hypothesized that a prolonged duration from injury to surgery increases the likelihood of intraoperative fractures. The aim of this study was to evaluate the relationship between the duration from injury to surgery and the occurrence of intraoperative fractures.</p><p><strong>Methods: </strong>This case-control study analyzed 548 patients who underwent bipolar hemiarthroplasty for hip fractures at 2 hospitals between April 2017 and March 2024. The patients were categorized into 2 groups based on the occurrence of intraoperative fractures: the \"intraoperative fracture (+) group\" and \"intraoperative fracture (-) group.\" The relationship between intraoperative fractures and the duration from injury to surgery was assessed.</p><p><strong>Results: </strong>Intraoperative fractures occurred in 37 of 548 cases. The duration from injury to surgery was 6.05 and 3.56 days in the intraoperative fracture (+) and (-) groups, respectively (p = 0.002). The canal flare index (CFI) was 3.30 and 3.73 in the intraoperative fracture (+) and (-) groups, respectively (p < 0.001). Logistic regression analysis revealed that the regression coefficient for the duration from injury to surgery was 0.04 (p = 0.04), and for CFI -1.09 (p < 0.001), both associated with an increased risk of intraoperative fracture. In patients with intraoperative fractures, an investigation into delays in surgery beyond 48 hours showed that more than half of these delays were due to hospital-related concerns.</p><p><strong>Conclusions: </strong>Intraoperative fractures increase with the CFI and duration from injury to surgery. In some cases, medical facilities may be able to reduce this duration. To minimize the risk of intraoperative fractures in bipolar hemiarthroplasty for older patients, reduction of the duration from injury to surgery is essential.</p><p><strong>Level of evidence: </strong>Level III, Case-control study. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12262978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum: Health Equity Research in Orthopaedic Surgery: A Systematic Review and Needs Assessment.","authors":"Eric Durudogan, Peter C Shen, Jasmin S Vargas, Abdullah Arif, Amin Alayleh, Neeraj M Patel","doi":"10.2106/JBJS.OA.ER.24.00246","DOIUrl":"10.2106/JBJS.OA.ER.24.00246","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.2106/JBJS.OA.24.00246.].</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225988/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144576539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedic Representation in Medical School Leadership: Implications for Musculoskeletal Education.","authors":"Winston Scambler, Mitchel Hawley, Anne Boeckmann, David Shau, Robert Schmidt","doi":"10.2106/JBJS.OA.25.00047","DOIUrl":"10.2106/JBJS.OA.25.00047","url":null,"abstract":"<p><strong>Background: </strong>Musculoskeletal disorders are a leading cause of disability worldwide, yet contemporary medical school curricula continue to inadequately address musculoskeletal (MSK) education. Multiple orthopaedic-related organizations have made recommendations over the past 2 decades with little subsequent progress in both curricula design and residency preparedness. This study aims to quantify the representation of orthopaedic surgeons in medical school leadership positions and discuss its potential impact on MSK education.</p><p><strong>Methods: </strong>We analyzed publicly available data from US allopathic medical schools accredited by the Liaison Committee on Medical Education (LCME) as of December 2024. We reviewed medical school websites to identify the specialties of deans, senior level, and other-level dean positions.</p><p><strong>Results: </strong>Of 156 qualified allopathic schools, 22 of 3,012 (0.7%) dean-level positions were held by individuals with an orthopaedic surgery training background. This included 2 of 156 (1%) head deans, 8 of 1,114 (0.7%) senior-level dean, and 12 of 1741 (0.7%) other-level dean positions). One (0.9%) of the Association of American Medical Colleges (AAMC) Governing Board members, AAMC leadership, or LCME Membership Roster positions were held by orthopaedic surgeons.</p><p><strong>Conclusion: </strong>The significant underrepresentation of orthopaedic surgeons in medical school leadership positions and national medical education organizations may contribute to the persistent deficiency of MSK education in our US medical school curriculum. Ongoing efforts should be made to develop new strategies to improve collaboration with educational leaders in MSK disorders to ensure that our undergraduate MSK education receives the appropriate attention and resources.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"10 3","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12225996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}