JBJS Open Access最新文献

{"title":"Clinical and Radiographic Outcomes in Kienbock Disease Following Radial Closing Wedge Osteotomy: An Age Comparative Study and Literature Review.","authors":"Takeru Yokota, Soichi Ejiri, Nobuyuki Sasaki, Yuto Akiyama, Narihiro Toshiki, Takuya Kameda, Yoshihiro Matsumoto","doi":"10.2106/JBJS.OA.24.00066","DOIUrl":"10.2106/JBJS.OA.24.00066","url":null,"abstract":"<p><strong>Background: </strong>Age is a preoperative prognostic factor for radial closing wedge osteotomy (RCWO) in Kienbock disease. Specifically, for cases classified as Lichtman stage III, clear criteria for selecting RCWO have not been established. We believe that age can provide vital information for determining the appropriate surgical procedure for Kienbock disease. The aim of this study was to investigate RCWO outcomes for Lichtman stage III by examining different age groups from clinical and radiological perspectives.</p><p><strong>Methods: </strong>Sixteen patients with Lichtman stage III Kienbock disease underwent RCWO. The median age was 59 years, and the median follow-up period was 2.9 years. We determined the age cutoffs for clinical and radiological outcomes using a receiver operating characteristic curve. Subsequently, we conducted intergroup comparisons of postoperative outcomes between the younger and older age groups.</p><p><strong>Results: </strong>Age cutoffs were established at 52.5 and 30 years for clinical and radiological outcomes, respectively. In the comparative analysis, the younger age group (≤52 years; n = 7) demonstrated significantly superior clinical results, including improved range of motion and pain relief, higher postoperative Mayo Wrist Score, and lower Disability of the Arm, Shoulder, and Hand scores. From a radiological perspective, the younger age group (≤30 years; n = 3) experienced segmented lunate bone fragments healing, indicating an improved disease stage compared with the older group.</p><p><strong>Conclusion: </strong>Based on previous literature and our research findings, it is reasonable to conclude that RCWO results in improved clinical outcomes for patients up to their mid-50s and enhanced radiological outcomes for those up to approximately at the age of 30 years. Further studies on these age cutoffs will contribute to refining the surgical selection criteria for RCWO.</p><p><strong>Level of evidence: </strong>Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548087","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":"Research Fellowships for Unmatched Orthopaedic Applicants: What Can They Expect?","authors":"Robert B Ponce, Ridge Maxson, Sean P Wrenn, Cade Morris, Craig Louer, Phillip M Mitchell","doi":"10.2106/JBJS.OA.24.00131","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00131","url":null,"abstract":"<p><strong>Introduction: </strong>Unmatched orthopaedic surgery applicants often pursue research fellowships to strengthen their residency applications. The aims of this study were to (1) report the trend of the number of orthopaedic research fellowships offered online between 2019 and 2024, (2) describe the characteristics of research fellowships available to unmatched applicants, and (3) assess the quality of support received by unmatched applicants who complete research fellowships.</p><p><strong>Methods: </strong>An online orthopaedic forum was retrospectively reviewed to identify job postings for medical student research fellowships in the 2019 to 2020 and 2024 to 2025 academic years. Information regarding expected mentorship and funding described in these postings was collected. Surveys were administered electronically to assess the funding received and perceived levels of mentor advocacy among unmatched orthopaedic applicants who had completed research fellowships between 2022 and 2024.</p><p><strong>Results: </strong>The number of orthopaedic research fellowships offered online increased by 165% (54-143) between 2019 and 2024, corresponding with a rate of 18 new fellowships offered per year. For the 2024 to 2025 academic year, 80 fellowships (56%) were available to unmatched applicants. The minority of online postings for these positions described support in the match (49%), the specific amount of funding offered (36%), a successful match track record for prior fellows (20%), and contact information of current or prior fellows (11%). The average amount of publicly offered funding was $32,537 (range, $18,000 to $65,000). Among 31 unmatched applicants who responded, the average amount of funding received was $38,180 ± 11,719. Most respondents rated advocacy from research fellowship mentors as high (53%) or moderate (40%), met with their mentors weekly or biweekly (63%), and received feedback on their residency applications (83%).</p><p><strong>Conclusion: </strong>Over the past 5 years, the number of orthopaedic research fellowships available to unmatched applicants has more than doubled. Although perceived advocacy was rated highly by most unmatched research fellows, fewer than half of the online postings for these positions provided details regarding financial compensation and support during the match cycle. Improvements in transparency related to fellowship characteristics are warranted to assist unmatched orthopaedic applicants in making informed decisions when pursuing research years between match cycles.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509697","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":"Can Artificial Intelligence Fool Residency Selection Committees? Analysis of Personal Statements by Real Applicants and Generative AI, a Randomized, Single-Blind Multicenter Study.","authors":"Zachary C Lum, Lohitha Guntupalli, Augustine M Saiz, Holly Leshikar, Hai V Le, John P Meehan, Eric G Huish","doi":"10.2106/JBJS.OA.24.00028","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00028","url":null,"abstract":"<p><strong>Introduction: </strong>The potential capabilities of generative artificial intelligence (AI) tools have been relatively unexplored, particularly in the realm of creating personalized statements for medical students applying to residencies. This study aimed to investigate the ability of generative AI, specifically ChatGPT and Google BARD, to generate personal statements and assess whether faculty on residency selection committees could (1) evaluate differences between real and AI statements and (2) determine differences based on 13 defined and specific metrics of a personal statement.</p><p><strong>Methods: </strong>Fifteen real personal statements were used to generate 15 unique and distinct personal statements from ChatGPT and BARD each, resulting in a total of 45 statements. Statements were then randomized, blinded, and presented to a group of faculty reviewers on residency selection committees. Reviewers assessed the statements by 14 metrics including if the personal statement was AI-generated or real. Comparison of all metrics was performed.</p><p><strong>Results: </strong>Faculty correctly identified 88% (79/90) real statements, 90% (81/90) BARD, and 44% (40/90) ChatGPT statements. Accuracy of identifying real and BARD statements was 89%, but this dropped to 74% when including ChatGPT. In addition, the accuracy did not increase as faculty members reviewed more personal statements (area under the curve [AUC] 0.498, p = 0.966). BARD performed poorer than both real and ChatGPT across all metrics (p < 0.001). Comparing real with ChatGPT, there was no difference in most metrics, except for Personal Interests, Reasons for Choosing Residency, Career Goals, Compelling Nature and Originality, and all favoring the real personal statements (p = 0.001, p = 0.002, p < 0.001, p < 0.001, and p < 0.001, respectively).</p><p><strong>Conclusion: </strong>Faculty members accurately identified real and BARD statements, but ChatGPT deceived them 56% of the time. Although AI can craft convincing statements that are sometimes indistinguishable from real ones, replicating the humanistic experience, personal nuances, and individualistic elements found in real personal statements is difficult. Residency selection committees might want to prioritize these particular metrics while assessing personal statements, given the growing capabilities of AI in this arena.</p><p><strong>Clinical relevance: </strong>Residency selection committees may want to prioritize certain metrics unique to the human element such as personal interests, reasons for choosing residency, career goals, compelling nature, and originality when evaluating personal statements.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11498924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509692","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":"Operative First Web Contracture Management: Current Strategies.","authors":"Doyle R Wallace, Waldo E Floyd","doi":"10.2106/JBJS.OA.24.00025","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00025","url":null,"abstract":"<p><p>» First web contractures can be due to nonthermal trauma, burns, congenital differences, and Dupuytren contracture.» Mild cases are managed with contracture release and full-thickness skin graft or when surrounding skin is pliable, Z-plasty.» Release of severe contractures creates a tetrahedral void that may require local or distant flap coverage. Reconstructive options include dorsal transposition flaps, regional rotation flaps, free tissue transfer, first metacarpal distraction osteogenesis with web deepening, or pollicization.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509695","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":"Musculoskeletal Learning and Knowledge Retention Among Postgraduate Physicians: Evaluating the Long-Term Impact of a New Preclerkship Curriculum at a Nationally Accredited Medical Program.","authors":"Taylor Orchard, Alexa Hryniuk, Jason Peeler","doi":"10.2106/JBJS.OA.24.00117","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00117","url":null,"abstract":"<p><strong>Introduction: </strong>Musculoskeletal (MSK) injuries and disorders are exceptionally prevalent in the clinical setting. Despite this, physician training in MSK medicine has been historically inadequate contributing to a lack of MSK knowledge, confidence, and clinical skills among postgraduate physicians. The goal of this investigation was to examine the long-term impact of a new preclerkship MSK curriculum implemented by a nationally accredited medical program on postgraduate physician's learning and knowledge retention in the area of MSK medicine.</p><p><strong>Methods: </strong>Five hundred sixty-eight postgraduate physicians (years 1-6) who had previously completed the new curriculum over a 6-year period were recruited to complete a standardized and validated MSK examination that consisted of 30 multiple-choice questions on core or must-know topics in MSK medicine that could be directly mapped to learning objectives within the new preclerkship MSK curriculum.</p><p><strong>Results: </strong>Ninety postgraduate physicians completed the examination, obtaining an average score of 75.0% (±10.2; range 57.0-100.0). Physicians who completed MSK-related electives during clerkship training or specialized in fields related to MSK medicine (i.e., orthopaedics, PM&R, sports medicine, and rheumatology) performed significantly better on the MSK examination (p ≤ 0.01).</p><p><strong>Conclusion: </strong>Data indicated that the program's new preclerkship curriculum supports high levels of MSK learning and knowledge retention among postgraduate physicians. These findings are expected to assist with the establishment of minimum curriculum standards and can be used to guide MSK curricular reform at other medical programs.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509694","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":"Disparities in Rotator Cuff Tear Progression Definitions and Rates: A Systematic Review.","authors":"Mason J Garcia, Daniela Caro, Maria Velasquez Hammerle, Juan B Villarreal, Joseph P DeAngelis, Arun J Ramappa, Ara Nazarian","doi":"10.2106/JBJS.OA.24.00097","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00097","url":null,"abstract":"<p><strong>Background: </strong>While rotator cuff tears are prevalent in the general population, the natural history of this disease is unclear. Understanding rotator cuff tear progression is crucial for refining surgical indications and evaluating the necessity of early interventions. This study presents an in-depth analysis of the existing literature on the definitions and progression rates of rotator cuff tears, aiming to enhance clinical decision making and patient outcomes.</p><p><strong>Methods: </strong>A systematic literature search was conducted based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, using Medline (PubMed), Embase (Elsevier), and Web of Science databases on January 12, 2023. Articles were identified as relevant to the natural history and progression of asymptomatic and symptomatic partial-thickness (PT) and full-thickness (FT) rotator cuff tears. Those written in English reporting rotator cuff progression rates of tears in adults, based on magnetic resonance imaging (MRI) or ultrasound, were included. After reviewing the articles, the data on the rates of tear progression and associated risk factors were extracted, compiled, and analyzed. The risk of bias was determined using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>Twenty-one articles met the inclusion criteria, with 1,831 tears included. The progression rate for all partial thickness tears was 26.7% ± 12.8% at an average follow-up of 2.2 ± 0.9 years, with 5 definitions for tear progression. For FT tears, the progression rate was 54.9% ± 18.6% at a follow-up time of 3.0 ± 2.0 years, with 8 definitions for tear enlargement. A significant difference (p < 0.0001) was found between the progression rates of PT and FT tears. Patients who were initially asymptomatic and became symptomatic had higher progression rates (33%-63%) than those who remained asymptomatic (4%-38%).</p><p><strong>Conclusion: </strong>Further research would benefit by identifying a clinically relevant and standardized definition of rotator cuff tear progression, to describe the natural history of rotator cuff disease, making results more comparable and optimizing treatment planning.</p><p><strong>Level of evidence: </strong>Level II. See Instructions for Authors for a complete description of levels of evidence.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509693","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":"Professional Behavior Assessment During Residency Training: Can We Identify Outliers?","authors":"Ann Van Heest, Steven Frick, John Harrast, David Martin, Mona Saniei, Lisa Taitsman, April Armstrong","doi":"10.2106/JBJS.OA.24.00102","DOIUrl":"https://doi.org/10.2106/JBJS.OA.24.00102","url":null,"abstract":"<p><strong>Introduction: </strong>The American Board of Orthopaedic Surgery (ABOS) Knowledge, Skills, and Behavior (KSB) project sets up a framework for competency-based medical education for orthopaedic surgery residency training. The Behavior aspect of KSB includes use of the American Board of Orthopaedic Surgery Behavior Tool (ABOSBT) to assess 5 domains of professional behavior. The purpose of this study was to analyze the results of 2 years of ABOSBT assessments and to characterize the low score ratings.</p><p><strong>Methods: </strong>All ABOSBT assessments from January 1, 2022, to December 31, 2023, were reviewed totaling 51,678 completed assessments with 48,648 (94%) assessments from a 360° process and 3,030 (6%) as end-of-rotation assessments.</p><p><strong>Results: </strong>Distribution of 51,678 ABOSBT assessments with 258,390 scores demonstrated low scores (disagree or strongly disagree) in 0.9% of assessments. All 5 domains identified low scores in a small percentage at all years-in-training with the greatest number in second- and third-year residents. Comparison of scores from 360° vs. end-of-rotation requests demonstrated a higher percentage of low scores given during the 360° process (p < 0.0001). Three thousand seven hundred seven unique evaluators completed ABOSBT assessments, with attending physicians as the most frequent evaluator type (44%); inpatient nurses assessed residents with low ABOSBT scores more frequently (4.5%) than any other evaluator type. Residents with 2 or more low scores by 2 or more different evaluators were analyzed for each of the 5 domains; low scores were most frequently observed in the reliability domain.</p><p><strong>Discussion: </strong>The ABOSBT was originally validated 5 years ago in 18 programs with 9,892 assessments; this article updates results using the ABOSBT across 95 programs assessing 2,397 residents with 3,707 evaluators. The ABOSBT demonstrates that most residents demonstrate professional behavior across 5 domains of assessment; the ABOSBT identifies residents with low scores. A strength of KSB is the ability to identify professionalism deficiencies while residents are in training and can focus on individualized educational improvement. Tracking residents with low scores on the ABOSBT assessment over time will help determine its effectiveness in identifying unprofessional behavior.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509696","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":"Increasing Diversity in Orthopaedic Surgery Residency: A Case Report of One Program's Experience Using Pipeline Programs.","authors":"Hans K Owuor, Eric J Strauss, Toni McLaurin, Joseph D Zuckerman, Kenneth A Egol","doi":"10.2106/JBJS.OA.24.00077","DOIUrl":"10.2106/JBJS.OA.24.00077","url":null,"abstract":"<p><strong>Introduction: </strong>African American, Hispanic, Asian, and Pacific Islanders are groups who are underrepresented in medicine (URM groups). Similarly, although women comprise more than 50% of medical students in the United States, women comprise a smaller percentage of all orthopaedic surgery trainees. Therefore, underrepresented in orthopaedics (URiO) represents the URM groups and women. The purpose of this study is to examine the impact of specific steps to recruit a qualified, diverse trainee complement within a single academic orthopaedic surgery residency program between 2000 and 2023. We aim to explore changes in the representation of URiO during this period as well as explore the strategies and programs implemented by the department that may have impacted recruitment of a diverse complement of trainees.</p><p><strong>Methods: </strong>Match lists from a large, academic, orthopaedic surgery residency between 2000 and 2023 were collected and reviewed for racial and gender data. Match lists were then divided into 6-year quantiles to identify any trends in the recruitment of URiO students. Self-reported racial and gender data from Electronic Residency Application Service applicant reports and the Accreditation Council for Graduate Medical Education (ACGME) data books between 2018 and 2022 were collected and reviewed. In addition, the department's strategies implemented during the study period with the goal of enhancing URiO exposure to orthopaedic surgery were also explored.</p><p><strong>Results: </strong>The department implemented proactive strategies to increase exposure to orthopaedic surgery for URiO students. An increase in URiO representation was noted between 2000 and 2023 with Hispanic, Black/African American, and Native Hawaiian/Pacific Islander resident representation increasing by 5%, 11%, and 1%, respectively. In addition, women representation increased by 27% between 2000 and 2023. The overall attrition rate among URiO residents was 1% with only one resident not completing the program. Self-reported racial and gender data from ACGME data books demonstrated that Black/African American, Hispanic, and Native Hawaiian/Pacific Islander residents comprised 5%, 4%, and 0.04%, respectively, of orthopaedic surgery residents between 2018 and 2022.</p><p><strong>Conclusions: </strong>These results provide insight for other programs to use similar strategies to potentially improve recruitment, retain, and provide support to URiO residents.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11449418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381859","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":"Exploring Impact and Variability of Research Productivity Among Academic Orthopaedic Leaders.","authors":"Hassan Farooq, Andrew Gaetano, Krishin Shivdasani, Nickolas Garbis, Dane Salazar","doi":"10.2106/JBJS.OA.24.00085","DOIUrl":"10.2106/JBJS.OA.24.00085","url":null,"abstract":"<p><strong>Introduction: </strong>Assessing scholarly contributions in academic orthopaedic surgery remains challenging, despite the importance of publication productivity in evaluating academic leaders. The Hirsch (h)-index and its derivative, the m-index, offer objective measures to compare and evaluate publication productivity. The primary aims of this study were to compare h- and m-indices of department chairs and residency program directors of orthopaedic training programs in the United States and assess the association between h-index and program rank.</p><p><strong>Methods: </strong>A publicly available Doximity report was used to identify and rank orthopaedic surgery residency programs in the United States. Internet-based searches of institution-specific websites were performed to confirm current department chairs and residency program directors as of January 2024. H-index data were collected from a publicly available database known as Scopus. The m-index was calculated as the quotient of h-index and years in practice. Gender and years in practice were obtained through available biographies on institution-specific websites.</p><p><strong>Results: </strong>Department chairs had significantly higher h- and m-indices at both the career and 5-year time intervals compared with program directors. Upon subgroup analysis, department chairs and program directors at top-10 ranked programs had significantly higher h- and m-indices compared with the entire population of department chairs and program directors. Linear regression analyses demonstrated a direct linear association between department chair/program director h- and m-indices and program rank.</p><p><strong>Conclusions: </strong>Publication productivity was higher for department chairs than residency program directors. Orthopaedic leaders at top-10 institutions had higher publication productivity compared with those at institutions outside of the top 10, per Doximity rankings. Finally, there is substantial variation in publication productivity of orthopaedic surgeons in leadership roles at academic institutions in the United States.</p><p><strong>Clinical relevance: </strong>This study highlights the publication productivity of orthopaedic surgery department chairs and residency program directors and describes the linear association between publication productivity of academic orthopaedic leaders and program rank. This information can be utilized by those interested in learning more about the publication productivity among academic orthopaedic surgeons across different institutions and can assist those who are involved in the hiring and promotion process at these academic institutions.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373146","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":"Intrarater and Inter-rater Reliability of Tibial Plateau Fracture Classifications: Systematic Review and Meta-Analysis.","authors":"Fardis Vosoughi, Iman Menbari Oskouie, Nazanin Rahimdoost, Amir Kasaeian, Arash Sherafat Vaziri","doi":"10.2106/JBJS.OA.23.00181","DOIUrl":"10.2106/JBJS.OA.23.00181","url":null,"abstract":"<p><strong>Background: </strong>The interobserver and intraobserver reliability of various tibial plateau fracture (TPF) classifications has been examined in recent literature using radiography, computed tomography, and magnetic resonance imaging. The question remains as to which classification system provides the highest reliability. In this systematic review, we are going to evaluate the overall interobserver and intraobserver reliability of various TPF classifications in different imaging modalities.</p><p><strong>Methods: </strong>We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. In February 2023, predefined terms were used for database search (Embase, PubMed, Scopus, Cochrane, and Web of Science). Meta-analysis of intrarater and inter-rater kappa coefficients was performed for each of the classifications in each modality.</p><p><strong>Results: </strong>Thirty-four studies were included in this review. Schatzker's classification was more frequently used than others. It had a better intrarater kappa coefficient than the Hohl and Moore and Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association (AO/OTA) classifications in radiography (κ = 0.72, 95% confidence interval [CI] = 0.67-0.76, p < 0.01). The Schatzker and AO/OTA classifications had similar inter-rater reliability in the radiography modality (κ = 0.53, 95% CI = 0.51-0.54, p < 0.01; κ = 0.53, 95% CI = 0.5-0.55, p < 0.01; respectively). In 3-dimensional computed tomography, the Luo classification system showed the highest intrarater (κ = 0.85, 95% CI = 0.35-0.66) and inter-rater (κ = 0.77, 95% CI = 0.73-0.81) kappa coefficients.</p><p><strong>Conclusion: </strong>Three-column classification proposed by Luo et al. was able to reach the highest degree and was the only classification with near-excellent inter-rater reliability.</p>","PeriodicalId":36492,"journal":{"name":"JBJS Open Access","volume":"9 4","pages":""},"PeriodicalIF":2.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11444555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373147","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}