Arthroplasty Today最新文献

{"title":"One-Stage Primary Total Knee Arthroplasty as the Treatment of Acute Septic Arthritis of the Native Osteoarthritic Knee: Report of 3 Cases and Review of Literature","authors":"Mohammad Mahdi Sarzaeem MD,&nbsp;Davood Feizi MD,&nbsp;Hamidreza Jamshidi Kouhsari MD,&nbsp;Farzad Amouzadeh Omrani MD,&nbsp;Ali Pourmojarab MD","doi":"10.1016/j.artd.2025.101777","DOIUrl":"10.1016/j.artd.2025.101777","url":null,"abstract":"<div><div>We present three cases of acute septic arthritis in osteoarthritic knees managed with one-stage primary total knee arthroplasty and followed for 2 years. This approach, diverging from conventional staged protocols, combines thorough debridement, immediate biomechanical restoration, and extended antibiotic therapy. Patients exhibited significant symptomatic relief, functional recovery, and no recurrent infections. Literature supports the efficacy of single-stage revisions in chronic periprosthetic infections, yet its application to acute septic arthritis remains underexplored. Our findings highlight the importance of meticulous patient selection, considering host immunity, microbial virulence, and comorbidities. One-stage total knee arthroplasty offers a viable, streamlined alternative for well-selected patients, mitigating the morbidity of multiple surgeries and protracted recovery.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101777"},"PeriodicalIF":1.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144714315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"It Takes a Village!","authors":"Brett R. Levine MD, MS (Editor-in-Chief)","doi":"10.1016/j.artd.2025.101781","DOIUrl":"10.1016/j.artd.2025.101781","url":null,"abstract":"","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101781"},"PeriodicalIF":1.5,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144703005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Restoration of Constitutional Alignment Improve Outcomes in Total Knee Arthroplasty?","authors":"Hallie B. Remer BS ,&nbsp;Bryan S. Brockman MD ,&nbsp;Chukwuemeka U. Osondu MD, MPH ,&nbsp;Hannah Mosher BS ,&nbsp;Yvette Hernandez CCRP ,&nbsp;Giovanni Paraliticci MD ,&nbsp;Charles M. Lawrie MD, MSc ,&nbsp;Juan C. Suarez MD","doi":"10.1016/j.artd.2025.101776","DOIUrl":"10.1016/j.artd.2025.101776","url":null,"abstract":"<div><h3>Background</h3><div>While neutral mechanical alignment has been the gold standard for total knee arthroplasty (TKA), constitutional knee alignment is commonly nonneutral and varies widely among individuals. We aimed to determine if a bounded functional alignment strategy in robotic assisted TKA restored constitutional alignment and if this restoration resulted in superior patient-reported outcomes (PROs).</div></div><div><h3>Methods</h3><div>We retrospectively reviewed patients who underwent robotic TKA with a bounded functional alignment strategy at a single institution. Final intraoperative knee alignment was compared to calculated constitutional alignment, which was unknown to the surgeons during the procedure. PROs (Knee injury and Osteoarthritis Outcome Score for Joint Replacement and Patient-Reported Outcomes Measurement Information System) with a 1-year follow-up were compared between patients with a final knee alignment within 2° of constitutional alignment compared with those &gt;2° from calculated constitutional alignment. Mean changes in PROs were analyzed, and proportions achieving minimally clinical important difference between groups was determined.</div></div><div><h3>Results</h3><div>Of the 188 knees included, 52% (n = 98) were balanced within 2° of constitutional alignment. Despite significant differences in alignment changes between groups (2.0° vs 4.5°), no significant differences were observed in PRO measures. Mean Knee injury and Osteoarthritis Outcome Score for Joint Replacement improvement (25.0 vs 29.5), Patient-Reported Outcomes Measurement Information System Physical Health (8.0 vs 7.7), and Mental Health (2.7 vs 1.2) scores were comparable. Similar proportions in both groups achieved minimally clinical important difference across all measures.</div></div><div><h3>Conclusions</h3><div>While robotic bounded functional strategy restored constitutional alignment in half of cases, this did not result in superior PROs at 1 year. Achieving soft tissue balance within acceptable parameters of alignment and bony excision may be more important than precise restoration of prearthritic alignment.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101776"},"PeriodicalIF":1.5,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimizing Instability in Isolated Head and Liner Exchange With the Direct Anterior Approach Using a Capsular-Sparing Technique","authors":"Ricardo J. Torres-Ramirez MD,&nbsp;Jose A. Rodriguez MD","doi":"10.1016/j.artd.2025.101768","DOIUrl":"10.1016/j.artd.2025.101768","url":null,"abstract":"<div><h3>Background</h3><div>Dislocation is a common complication after head and liner exchange. Although surgical approach has been shown to influence instability rate following primary total hip replacement, the same has not been demonstrated for head and liner exchange. The effect of additional soft tissue release to achieve exposure in revision surgery has been implicated in this finding. We have sought to describe and report the effects on postoperative stability of a capsular sparing technique of head and liner exchange with the direct anterior approach, in a single surgeon case series.</div></div><div><h3>Methods</h3><div>A retrospective study of all isolated head and liner exchanges with a capsular-sparing direct anterior approach was conducted from 2017 to 2022. Patients without a 2-year follow-up or prior revision on the ipsilateral hip were excluded. A total of 39 hips in 36 patients were identified, with the most common indication for HLE being, liner wear + osteolysis in 44% of patients. The mean follow-up was 29.8 months.</div></div><div><h3>Results</h3><div>At the latest follow-up there were zero dislocations. Two patients required re-revision for acetabular component loosening, yielding a 95% survivorship free of re-revision at latest follow-up. A 36-mm head was utilized in 65% and a neutral liner in 85% percent of the hips. The average Hip Disability and Osteoarthritis Outcome Score for Joint Replacement score at latest follow-up was 80.81.</div></div><div><h3>Conclusions</h3><div>HLE with the DAA using a capsular sparing technique can yields favorable short-term outcomes with a 0% dislocation rate and a 95% survivorship free of re-revision at 2 years.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101768"},"PeriodicalIF":1.5,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accuracy of Sagittal Plane Component Alignment in Robotic-Assisted Total Knee Arthroplasty","authors":"Justin O. Aflatooni MD,&nbsp;Austin E. Wininger MD,&nbsp;Thomas C. Sullivan BS,&nbsp;Timothy S. Brown MD,&nbsp;Kwan J. Park MD","doi":"10.1016/j.artd.2025.101774","DOIUrl":"10.1016/j.artd.2025.101774","url":null,"abstract":"<div><h3>Background</h3><div>Robotic-assisted total knee arthroplasty (rTKA) is utilized to facilitate accurate and precise resection goals. Most literature has focused on postoperative limb and component alignment in the coronal plane. This study sought to evaluate the accuracy of 2 robotic systems in executing sagittal plane resections during rTKA.</div></div><div><h3>Methods</h3><div>This retrospective review analyzed 169 consecutive primary rTKAs at a single institution from January 2023 to January 2024. Surgeries were performed by two fellowship-trained arthroplasty surgeons, each using a different rTKA system (73 System 1 and 96 System 2). Femoral and tibial component sagittal alignment were measured on postoperative and compared to intraoperative plans.</div></div><div><h3>Results</h3><div>Both systems more frequently resulted in reduced tibial slope than planned slope (75.3% System 1, 84.4% System 2). The average absolute difference between planned and measured tibial slope was 1.4 ± 1.0° (<em>P</em> = .01) for System 1 and 2.4 ± 1.5° (<em>P</em> &lt; .001) for System 2 with 93.9% and 66.7% having a difference of &lt;3°, respectively. For femoral component sagittal alignment, both systems resulted in roughly an even split of cases with increased and decreased femoral flexion. The average absolute difference between planned and measured femoral flexion was 1.5 ± 1.1° (<em>P</em> = .23) for System 1 and 1.8 ± 1.5° (<em>P</em> = .28) for System 2 with 90.4% and 86.5% having a difference of &lt;3°, respectively.</div></div><div><h3>Conclusions</h3><div>These findings better elucidate discrepancies between planned and executed tibial and femoral sagittal component alignment of 2 popular robotic systems, which may play an important role as TKA limb alignment and component positioning goals become more individualized.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101774"},"PeriodicalIF":1.5,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144662061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who is Completing Patient-Reported Outcome Measures following Total Hip Arthroplasty? An Investigation of Completion Characteristics to Inform the Age of Mandatory Reporting Rates","authors":"Catherine M. Call MD ,&nbsp;Zoë A. Walsh MPH ,&nbsp;Aliyah A. Olaniyan MS ,&nbsp;George Babikian MD ,&nbsp;Brian J. McGrory MD, MS ,&nbsp;Adam J. Rana MD","doi":"10.1016/j.artd.2025.101763","DOIUrl":"10.1016/j.artd.2025.101763","url":null,"abstract":"<div><h3>Background</h3><div>The Centers for Medicare and Medicaid Services has mandated at least 50% institutional compliance of patient-reported outcome–based performance measures (PRO-PMs) for Medicare fee-for-service patients undergoing inpatient, elective total joint arthroplasty. The purpose of this study was to evaluate characteristics of patients undergoing primary total hip arthroplasty to identify risk factors for patient-reported outcome measures (PROMs) noncompletion using the Hip Dysfunction and Osteoarthritis Joint Replacement Outcome Score as a marker PROM.</div></div><div><h3>Methods</h3><div>A retrospective review was performed of patients undergoing primary total hip arthroplasty at a single large academic center between January 2013 and August 2020. Demographics, operative variables, hospital outcomes, and PROMs were compared between patients achieving and not achieving PRO-PM requirements and multivariable analysis was performed.</div></div><div><h3>Results</h3><div>A total of 5691 patients were included; 2547 patients did not complete either PROM, 2201 completed the preoperative PROM within 90 days of surgery, and 943 completed the PROM preoperatively and at 365 ± 60 days postoperatively. Demographics and outcomes between groups varied; patients not completing the PROM more often had a length of stay &gt;48 hours (<em>P</em> &lt; .001) and any complication (q = 0.07); these associations remained significant with adjusted multivariable analyses.</div></div><div><h3>Conclusions</h3><div>PRO-PM completion is necessary for compliance with the new Centers for Medicare and Medicaid Services mandate. We report on the characteristics of patients completing and not completing a marker PROM as well as risk factors for noncompletion from the era before this mandate, before substantial efforts were undertaken to increase response rate, to provide an organic overview of the patients at risk for noncompletion to guide further initiatives.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101763"},"PeriodicalIF":1.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Second-Generation Onlay Patellofemoral Prostheses: 14-Year Outcomes Redefining Isolated Patellofemoral Osteoarthritis Management","authors":"Pablo Ramos Guarderas ,&nbsp;Gonzalo Arteaga Guerrero ,&nbsp;Medardo Vargas Morante ,&nbsp;Pablo Ramos Murrillo ,&nbsp;Carlos Peñaherrera Carrillo ,&nbsp;Francisco Endara Urresta ,&nbsp;Daniel Ramos Murillo ,&nbsp;Alejandro Barros Castro ,&nbsp;Paul Vaca Perez","doi":"10.1016/j.artd.2025.101735","DOIUrl":"10.1016/j.artd.2025.101735","url":null,"abstract":"<div><h3>Background</h3><div>Isolated patellofemoral osteoarthritis is a frequent source of anterior knee pain in middle-aged patients. Second-generation onlay patellofemoral prostheses were developed to address limitations of earlier designs and improve clinical outcomes.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study of 231 patients (mean age 52.2 years) who underwent patellofemoral arthroplasty with a second-generation onlay implant between 2009 and 2023. Clinical outcomes were assessed using the Western Ontario and McMaster Universities Osteoarthritis Index and Kaplan–Meier survival analysis. Radiological evaluation included signs of loosening, progression of tibiofemoral osteoarthritis, and patellar alignment.</div></div><div><h3>Results</h3><div>At a mean follow-up of 9.3 years (range: 2–14), Western Ontario and McMaster Universities Osteoarthritis Index scores improved significantly from 92.14 to 8.40 (<em>P</em> &lt; .001). The implant survival rate was 96.6% at the final follow-up. Early clinical gains were significantly influenced by implant type, while long-term outcomes were associated with patient-specific factors such as body mass index and activity level. Radiological progression of tibiofemoral disease was observed in 6.1% of patients.</div></div><div><h3>Conclusions</h3><div>Second-generation onlay patellofemoral prostheses yield sustained functional improvement and low complication rates when used in carefully selected patients. These findings support their use as a reliable solution for isolated patellofemoral osteoarthritis.</div></div><div><h3>Level of Evidence</h3><div>III.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101735"},"PeriodicalIF":1.5,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Total Hip Arthroplasty Among Superobese Patients: Proceed With Caution","authors":"Sagar Telang MD ,&nbsp;Ryan Palmer MD ,&nbsp;Brian C. Chung MD ,&nbsp;Jacob R. Ball MD ,&nbsp;Kurt Hong MD PhD ,&nbsp;Jay R. Lieberman MD ,&nbsp;Nathanael D. Heckmann MD","doi":"10.1016/j.artd.2025.101770","DOIUrl":"10.1016/j.artd.2025.101770","url":null,"abstract":"<div><h3>Background</h3><div>Morbid obesity, defined as body mass index (BMI) ≥40 kg/m², increases perioperative risk following total hip arthroplasty (THA). However, limited contemporary data exists on outcomes of superobese patients (BMI ≥50 kg/m²) following primary THA. Using a large modern cohort, this study seeks to quantify the risk of infection and surgical, medical, and thromboembolic complications among superobese THA patients.</div></div><div><h3>Methods</h3><div>The Premier Healthcare Database was queried to identify all primary elective THA patients between 2016 and 2021. All superobese patients were compared to a normal BMI cohort (BMI 18.5-24.9 kg/m²). Univariate analysis and multivariable regression were utilized to assess differences in primary outcomes, including 90-day infectious, surgical, medical, and thromboembolic complications.</div></div><div><h3>Results</h3><div>Twenty-one thousand, thirty-five THA patients were identified; 888 patients (4.2%) had a BMI ≥50 kg/m², while 20,147 patients (95.8%) had a BMI 18.5-24.9 kg/m². On multivariable analysis, superobese patients demonstrated an increased risk of infectious and surgical complications, including periprosthetic joint infection (adjusted odds ratio [aOR]: 7.23, 95% confidence interval (CI): 3.95-13.24, <em>P</em> &lt; .001), sepsis (aOR: 4.24, 95% CI: 2.19-9.23, <em>P</em> &lt; .001), and wound dehiscence (aOR 7.61, 95% CI: 3.90-14.85, <em>P</em> &lt; .001). The risk of pulmonary embolism (aOR 4.32, 95% CI: 1.75-10.64, <em>P</em> = .001), acute respiratory failure (aOR: 2.31, 95% CI: 1.32-4.05, <em>P</em> = .003), acute renal failure (aOR: 3.15, 95% CI: 2.19-4.52, <em>P</em> &lt; .001), and hospital readmission (aOR: 2.31, 95% CI: 1.75-3.07, <em>P</em> &lt; .001) were similarly elevated within the superobese cohort.</div></div><div><h3>Conclusions</h3><div>Superobese patients face markedly increased risk for infection and surgical, medical, and thromboembolic complications following primary THA. Our findings emphasize the importance of preoperative risk stratification, optimization, and patient counseling in this high-risk cohort.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101770"},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Total Joint Arthroplasty and Surgical Complications in Patients With Valvular Heart Replacement: An Observational Study","authors":"Amir Human Hoveidaei MD, MSc ,&nbsp;Sina Esmaeili MD ,&nbsp;Homina Saffar MD ,&nbsp;Aref Ghanaatpisheh MD ,&nbsp;Fatemeh Zarepour MD ,&nbsp;Amirhossein Shirinezhad MD ,&nbsp;Henry Tout Shu MD ,&nbsp;Janet D. Conway MD, FAAOS","doi":"10.1016/j.artd.2025.101765","DOIUrl":"10.1016/j.artd.2025.101765","url":null,"abstract":"<div><h3>Background</h3><div>Valvular heart replacement (VHR) is associated with increased cardiac complications and mortality risk in patients undergoing noncardiac surgery. There are limited data on total joint arthroplasty outcomes in patients with a prior history of VHR.</div></div><div><h3>Methods</h3><div>In this retrospective cohort study, we identified patients who underwent elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) between 2010 and 2022 using the PearlDiver national database. Patients with a history of VHR were matched with a control group using propensity score matching. Statistical analyses were conducted using R statistical software.</div></div><div><h3>Results</h3><div>We identified 874 patients with THA and 1162 patients with TKA. No significant difference in surgical or medical complications was observed in THA patients with a history of VHR compared to the matched control group, regardless of the time interval between procedures. In contrast, for TKA patients, VHR was associated with a higher incidence of periprosthetic joint infection (odds ratio [OR] = 1.54; 95% confidence interval [CI]: 1.02-2.33; <em>P</em> = .049), particularly when performed within 3 months before TKA (OR = 4.71; 95% CI: 1.04-15.48). Additionally, patients who underwent VHR 3 to 6 months before TKA had a significantly higher incidence of cerebrovascular accident (OR = 2.61; 95% CI: 1.20-5.24; <em>P</em> = .011).</div></div><div><h3>Conclusions</h3><div>VHR was not associated with an increased risk of complications following THA. However, about TKA patients, a history of VHR was linked to a higher risk of periprosthetic joint infection, and an increased incidence of cerebrovascular accident in those who had VHR 3 to 6 months prior. Future studies are needed to develop strategies for reducing complications.</div></div><div><h3>Level of Evidence</h3><div>III (Retrospective cohort).</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101765"},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring ChatGPT’s Efficacy in Orthopaedic Arthroplasty Questions Compared to Adult Reconstruction Surgeons","authors":"Benjamin Nieves-Lopez BS ,&nbsp;Clayton Wing MD ,&nbsp;Bryan D. Springer MD ,&nbsp;Keith T. Aziz MD","doi":"10.1016/j.artd.2025.101772","DOIUrl":"10.1016/j.artd.2025.101772","url":null,"abstract":"<div><h3>Background</h3><div>Chat Generative Pre-trained Transformer (ChatGPT) is a language model designed to conduct conversations utilizing extensive data from the internet. Despite its potential, the utility of ChatGPT in orthopaedic surgery, particularly in arthroplasty, is still being investigated. This study assesses ChatGPT’s performance on arthroplasty-related questions in comparison to an Adult Reconstruction Fellow and a Senior level attending.</div></div><div><h3>Methods</h3><div>A total of 299 questions from the Adult Reconstruction self-assessment on OrthoBullets were evaluated using ChatGPT 4. Performance was analyzed across different question categories and compared with the performance of an Adult Reconstruction Fellow and Senior level attending arthroplasty surgeon with a <em>Chi</em>-square test. Further comparisons were performed to assess ChatGPT’s accuracy rate on image-based questions. Statistical significance was set to a <em>P</em> value ≤ .05.</div></div><div><h3>Results</h3><div>ChatGPT achieved a 66.9% accuracy rate compared to 84.3% and 85.3% obtained by the Fellow and Attending, respectively. No significant differences in performance were observed across question categories. ChatGPT demonstrated better results in text-only compared to image-based questions. Although not statistically significant, ChatGPT showed the highest accuracy rate in questions that included both an X-ray and a clinical picture.</div></div><div><h3>Conclusions</h3><div>ChatGPT performed inferior to an Adult Reconstruction Fellow and Attending and it provided more accurate answers when prompted with text-only questions. These findings suggest that while ChatGPT can serve as a useful supplementary resource for arthroplasty topics, it cannot substitute for the clinical judgment required in detailed assessments. Further research is necessary to optimize and validate the use of artificial intelligence in medical education and patient care.</div></div>","PeriodicalId":37940,"journal":{"name":"Arthroplasty Today","volume":"34 ","pages":"Article 101772"},"PeriodicalIF":1.5,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144614045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}