Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews最新文献

{"title":"The Thai ICOAP-Hip: Cross-Cultural Adaptation and Validation for Assessing Intermittent and Constant Pain in Hip Osteoarthritis.","authors":"Witchaporn Witayakom, Niraphorn Chuenta, Kamolsak Sukhonthamarn, Weerachai Kosuwon, Rit Apinyankul","doi":"10.5435/JAAOSGlobal-D-25-00272","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-25-00272","url":null,"abstract":"<p><strong>Background: </strong>The Intermittent and Constant Osteoarthritis Pain (ICOAP) questionnaire, developed by the OARSI/OMERACT initiative, is a tool for assessing pain in patients with hip and knee osteoarthritis. The aim of this study was to develop a Thai version of the ICOAP for hip through standardized translation and cross-cultural adaptation and to evaluate its reliability and validity.</p><p><strong>Methods: </strong>In this prospective descriptive study, patients aged ≥18 years with hip osteoarthritis were enrolled. Thai Intermittent and Constant Osteoarthritis Pain for hip (ICOAP-Hip) was developed using a multilanguage translation and adaptation process. Forty-eight patients (24 men) completed the Thai ICOAP-Hip, pain subscale of the Thai Hip Osteoarthritis Outcome Score (HOOS), a Visual Analog Scale (VAS) for pain, and Thai Short Form-36 Health Survey version 2 (SF-36v2) during outpatient visits. Test-retest reliability was assessed by readministering ICOAP-Hip through telephone 48 hours later. Reliability was evaluated using the intraclass correlation coefficient (ICC) and Cronbach's alpha, while construct validity was examined using Pearson's correlation with comparator instruments.</p><p><strong>Results: </strong>The Thai ICOAP-Hip total score showed excellent test-retest reliability (ICC = 0.988) and high internal consistency (Cronbach's α = 0.941). Construct validity was supported by strong negative correlations with the HOOS pain subscale (r = -0.737, P < 0.001) and SF-36v2 bodily pain subscale (r = -0.737, P < 0.001), as well as a strong positive correlation with VAS pain (r = 0.796, P < 0.001).</p><p><strong>Conclusion: </strong>The Thai ICOAP-Hip is a reliable and valid instrument for evaluating pain in Thai patients with hip osteoarthritis.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784957","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":"Delays in Orthopaedic Care and Inferior Outcomes after Meniscus Repair in Young Patients With Medicaid versus Commercial Insurance.","authors":"Patrick A Massey, Margaret Boston, Tara Saxena, Robert Rutz, Phillip Garrett Fincher, Arjun Verma","doi":"10.5435/JAAOSGlobal-D-26-00056","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-26-00056","url":null,"abstract":"<p><strong>Introduction: </strong>Patient insurance type influences treatment timelines in meniscal injuries. This study assessed differences in time to presentation, time to treatment, and clinical outcomes of meniscal injuries in young patients with Medicaid versus commercial insurance. It was hypothesized that patients with Medicaid would have greater delays in time to presentation and treatment and inferior clinical outcomes.</p><p><strong>Methods: </strong>This retrospective cohort investigation included patients ages 21 years and younger who underwent meniscal repair by a single sports medicine surgeon. Demographics, injury specifications, and treatment timelines were analyzed. Preoperative, 3-, 6-, and 12-month postoperative pain, International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores were compared.</p><p><strong>Results: </strong>Time to presentation (163 vs 62 days, P = 0.008) and time from injury to surgery (228 vs 111 days, P = 0.006) were markedly increased in the Medicaid group. Pain (0.5 vs 0.3, P = 0.803), IKDC (89.3 vs 93.1, P = 0.060), Lysholm (94.9 vs 95.1, P = 0.576), and Tegner (7.3 vs 7.3, P = 0.977) scores of Medicaid vs commercial patients were similar at 12 months postoperative. Tegner score of the Medicaid group at 12 months postoperative (7.3) was markedly lower than the preinjury average (8.2) (P = 0.024). The 12-month postoperative IKDC score of Medicaid vs commercial patients with ACL and meniscus tears were markedly different (91.8 vs 97.4, P = 0.044).</p><p><strong>Conclusion: </strong>Young patients with Medicaid insurance undergo meniscal repair nearly 3 months later than those with commercial insurance, return to preinjury activity levels less frequently, and have lower 12-month IKDC scores with combined ACL and meniscus injury. Once established with an orthopaedic surgeon, patients have similar timelines for surgery. The discrepancy in time from injury to surgery is an inequality that deserves to be addressed.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785048","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":"Characteristics of the Top 50 Most Cited Orthopaedic Surgery Articles on Malpractice and Litigation: A Bibliometric Analysis of the Literature.","authors":"Aidan C O'Brien, Sawyer H Farmer, Brian S Tao, Jonathan J Light, Peter Boufadel, Xinning Li","doi":"10.5435/JAAOSGlobal-D-26-00044","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-26-00044","url":null,"abstract":"<p><strong>Background: </strong>Malpractice litigation shapes orthopaedic practice and has notable financial implications. Orthopaedic surgeons face disproportionately high claim exposure. The primary aim was to identify and characterize the 50 most-cited articles on orthopaedic malpractice and describe trends in topic, geographical region, institution, and impact.</p><p><strong>Methods: </strong>A bibliometric analysis was done for the most-cited orthopaedic malpractice or litigation articles using all Web of Science databases. Articles were included if their primary focus was orthopaedic malpractice. Articles addressing informed consent, defensive medicine, or orthopaedic-related procedures without explicit reference to malpractice or litigation were excluded.</p><p><strong>Results: </strong>The top 50 articles on orthopaedic malpractice accrued 1967 citations (mean 39 ± 24, range 18 to 127) with mean citations per year (CPY) of 3.4 ± 1.8. Publications peaked in 2018 (n = 9). Annual citations generally increased over time, while citation density declined. The most common malpractice articles clustered into total joint arthroplasty (26%), spine (22%), and general orthopaedic malpractice (22%). Most papers originated in the United States (64%); among US articles, the Northeast produced the largest share (47%). Articles with a J.D. author (18%) had higher mean citations compared with those without (55.9 ± 38.4 vs 35.7 ± 17.7), though not statistically significant (P = 0.294).</p><p><strong>Conclusion: </strong>Influential orthopaedic malpractice or litigation scholarship concentrates in arthroplasty and spine, increasingly leverages database-driven methods, and is geographically centered in the US Northeast region. Rising citation activity alongside decreasing citation density indicates a maturing yet expanding field of orthopaedic malpractice literature. Malpractice articles can inform clinical risk mitigation and may shape future insurance policy changes.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785028","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":"Academic Influence and Industry Funding in Platelet-Rich Plasma Injections: Coauthorship Network Analysis.","authors":"Matthew Michelberger, Christopher Waite, Samir Alkhouri, Saliha Ahmad, Ahmed Nadeem-Tariq, Christopher J Fang, Samantha Evans, Suknata Maitra, Karen Nelson","doi":"10.5435/JAAOSGlobal-D-26-00093","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-26-00093","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich plasma (PRP) injections have gained popularity in the fields of orthopaedics and sports medicine despite inconsistent evidence regarding clinical efficacy. Concerns have placed a role on industry funding in shaping the development of PRP injection literature. Therefore, the aim of this study is to investigate the relationship between industry funding and academic influence in PRP injection research.</p><p><strong>Methods: </strong>A systematic review was done of PRP injection literature published between 2017 and 2024, all from Q1 (top quartile) peer-reviewed journals based on Scopus journal ranking metrics. Overall, 81 studies were included in final analysis. Authors were linked to the Open Payments Database (OPD) and were identified through their national provider identifier (NPI) number. A coauthorship network analysis was used to map patterns of collaboration among authors in the field.</p><p><strong>Results: </strong>The majority of studies identified were randomized control trials (38.3%). From 2017 to 2024, total industry funding to PRP authors totaled $36.1 million. Markedly more general payments than research payments were there (P < 0.05). Funding did not markedly correlate with publication count (r = 0.368, P = 0.40). No notable association was found between funding type and study outcome for either general (P = 0.482) or research (P = 0.481) payments. A centralized structure of 621 unique authors revealed that the top 10% of contributors accounted for more than 40% of all betweenness activity among these authors.</p><p><strong>Conclusion: </strong>The majority of industry funding in PRP injection research is directed as general payments. A small cohort of authors hold disproportionate influence over the community.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147784992","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":"Effect of Sociodemographic Differences on Elective Lumbar Fusion Surgery.","authors":"Stevin Lu, Wyatt Vander Voort, Hania Shahzad, Aziz Saade, Zachary Booze, Jeffrey Fine, Yunyi Ren, Audrey Zhao, Gregory Harbison, Rolando Roberto, Eric Klineberg, Safdar Khan, Hai Le","doi":"10.5435/JAAOSGlobal-D-25-00238","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-25-00238","url":null,"abstract":"<p><strong>Introduction: </strong>Sociodemographic differences markedly affect postoperative outcomes in lumbar fusion surgery, often leading to higher infection rates, readmissions, emergency department (ED) visits, and prolonged hospital stays. This study examines the associations between sociodemographic factors and clinical outcomes after elective lumbar fusion surgery.</p><p><strong>Methods: </strong>We retrospectively analyzed medical records of patients aged ≥18 years who underwent lumbar or lumbosacral fusion for degenerative conditions from 2018 to 2022 at a single academic institution. ED returns and readmissions within 3 months were also recorded. Statistical analysis was conducted using chi-square tests, t-tests, ANOVA, and multivariate logistic regression models.</p><p><strong>Results: </strong>A total of 484 patients (54.1% male) were included. Most patients were White (80.4%) and non-Hispanic (91.5%). Men exhibited lower ED utilization (16% versus 23%) and readmission (11.5% versus 19.8%) rates than women. Men were more frequently discharged home (87%) compared with women (79.3%), with fewer discharges to skilled nursing or rehab facilities. No significant differences in length of stay, readmission, ED return, or discharge disposition were observed across racial groups. The private insurance group had shorter hospital stays (3.1 ± 1.7 days) than Medicare/Medicaid patients (3.8 ± 2.6 days) and other groups (4.7 ± 3.3 days, P = 0.005). Medicare/Medicaid patients had higher ED return and readmission rates and were less likely to be discharged home (P < 0.001). Multivariate models revealed that sex and payer status significantly affected readmissions and discharge dispositions.</p><p><strong>Conclusion: </strong>Women and Medicare/Medicaid patients experience poorer postoperative outcomes, with increased ED visits and readmissions after lumbar fusion surgery. Race did not significantly affect outcomes, although small sample sizes may have limited this analysis.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13105796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785039","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":"Variability in the Orthopaedic Residency Trainee Trauma Surgical Experience.","authors":"Todd Phillips, Benjamin Fiedler, Joshua T Morrow, Zbigniew Gugala, Melvyn Harrington, Douglas R Dirschl","doi":"10.5435/JAAOSGlobal-D-26-00007","DOIUrl":"https://doi.org/10.5435/JAAOSGlobal-D-26-00007","url":null,"abstract":"<p><strong>Background: </strong>The aim of this study was to analyze fracture fixation case logs from residents training at a level 1 trauma center to assess variability across residents' surgical experiences within a single residency program. The authors hypothesize that notable variability exists between residents' surgical experiences in fracture care.</p><p><strong>Methods: </strong>A retrospective case series was conducted at a single, urban residency program with a level 1 trauma center. Completed case logs were collected from program graduates from 2022 to 2024. All surgical cases involving fracture fixation at the level 1 trauma center were included for analysis. The anatomic region of the fracture surgery was determined by translating the case log current procedural terminology (CPT) code entry into the corresponding \"bone\" and \"segment\" per the Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association fracture classification system. For external validation and generalizability, resident cases were compared with those from a recent multicentered epidemiologic study using a two-proportion z-test. Variations in resident case logs were tested using analysis of covariance.</p><p><strong>Results: </strong>A total of 4,616 fracture fixation cases were identified across the 14 graduate case logs. The average number of fracture cases per resident was 329.7 (SD = ±80.3). No significant difference was observed in resident surgical experience at the home institution when comparing the anatomic region of the fracture surgery (P = 0.189). When compared with a multicenter epidemiologic study, our institution had significantly fewer proximal femur fractures (P < 0.001) and significantly more ankle fractures (P < 0.001).</p><p><strong>Conclusion: </strong>While assuring consistency of clinical experience within orthopaedic resident training is an exceptionally difficult task, it seems that residents in this program received similar exposure to varying fracture trauma pathologies. However, there may exist regional differences or other variables that contribute to differences in fracture location and/or volume from one institution to another. It remains essential for residents to take an active role in ensuring that they gain sufficient surgical volume to achieve clinical competence.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785073","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":"Effects of a Mandatory Orthopaedic Surgery Rotation on Medical Student Perceptions of the Field.","authors":"William H Huffman, Radhika Gupta, Amanda M Moser, Kathleen Collins, Mitchell Hallman, David Casper, Cara A Cipriano","doi":"10.5435/JAAOSGlobal-D-26-00005","DOIUrl":"10.5435/JAAOSGlobal-D-26-00005","url":null,"abstract":"<p><strong>Introduction: </strong>Exposure to orthopaedics has been shown to positively influence medical student perceptions of the field; however, fewer than half of medical schools require or even offer an orthopaedic rotation as part of the core clinical curriculum. We hypothesized that a mandatory rotation during the clerkship year would counteract stereotypes about the field. Therefore, we sought to characterize the perceptions of orthopaedic surgery before and after such a clinical rotation at our institution.</p><p><strong>Methods: </strong>Over a 2-year period, we administered an anonymous survey to all 320 medical students completing our mandatory 1-week orthopaedic surgery rotation. We received 267 prerotation and 153 postrotation survey responses. Students were asked for their sex, age, race/ethnicity, and \"three words that describe your perception of orthopaedic surgery.\" These words were categorized according to theme and positive/negative connotation by the study team and evaluated for association with medical student demographics.</p><p><strong>Results: </strong>The most frequent prerotation words were \"bones\" (10.1% of words), \"intense\" (6.5% of words), and \"bros\" (6.4% of words). The most frequent postrotation words were \"bones\" (6.2% of words), \"fun\" (5.9% of words), and \"intense\" (2.9% of words). The percentage of negative and neutral words decreased after the rotation (negative: 27.5% to 14.1%; P < 0.001; neutral: 50.2% to 38.3%; P < 0.001), whereas the percentage of positive words increased (21.3% to 47.4%; P < 0.001). Positive words increased postrotation for both men (23.4% to 54.7%; P < 0.001) and women (20.9% to 40.5%; P < 0.001), whereas negative words decreased for both men (20.1% to 10.4%; P < 0.001) and women (34.2% to 17.6%; P < 0.001).</p><p><strong>Conclusion: </strong>This study demonstrates that initially negative perceptions of orthopaedic surgery, particularly those related to its reputation as a male-dominated \"bro\" culture, markedly improved following a clinical rotation. This suggests that a mandatory orthopaedic surgery rotation may counteract stereotypes about the field, particularly among women students.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634718","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":"What Are Orthopaedic Sports Medicine Knee Surgeons Watching? Exploring Trends in Online Surgical Technique Videos on the VuMedi Education Platform.","authors":"Anser Daud, Meerab Majeed, Ashlee Chan, John Theodoropolous, Jaskarndip Chahal, Daniel B Whelan, Prabjit Ajrawat, Tim Dwyer","doi":"10.5435/JAAOSGlobal-D-25-00246","DOIUrl":"10.5435/JAAOSGlobal-D-25-00246","url":null,"abstract":"<p><strong>Introduction: </strong>Video-based education platforms are reshaping the landscape for surgical education. The purpose of this study was to evaluate trends in orthopaedic sports medicine knee surgery videos on VuMedi, a leading healthcare video-education platform, aiming to identify and discern trends and common attributes and shared by popular educational content.</p><p><strong>Methods: </strong>Common categories in orthopaedic sports surgery of the knee were shortlisted to include anterior cruciate ligament (ACL) reconstruction/pair, extensor mechanism reconstruction/repair, malalignment/osteotomy, medial collateral ligament reconstruction/repair, meniscus repair, meniscus transplant, osteochondral or cartilage defect, osteochondritis dissecans, patellofemoral instability, posterior cruciate ligament, and posterolateral corner injury. Within each category, top 20 most-viewed videos were identified, and metrics were recorded, including date, institution, authorship, topic, view count, and location of origin.</p><p><strong>Results: </strong>Among 207 included videos, ACL reconstruction (total 469,573 views, mean 26,087 [5,887 to 211,924]), meniscal repair (total 186,842 views, mean 10,380 [4,260 to 28,360]), and patellofemoral instability (total 163,031 views, mean 8,152 [2,675 to 20,126]) were the most watched categories. The top 10 most popular videos were produced in the 2008 to 2011 time frame, and 6 of 10 were related to ACL reconstruction. Across all topics, the most commonly viewed videos originated from academic institutions across North America (45.4%), followed by commercial/industry entities (38.7%) and independent institutions/surgeons (15.9%).</p><p><strong>Conclusion: </strong>ACL reconstruction, meniscal repair, and patellofemoral instability emerged as the most-viewed categories likely reflecting the prevalence of ACL tears and ACL reconstruction in clinical practice. Perceived reputation of producers may drive popularity of certain surgical videos, as North American academic institutions are the predominant contributors of the most popular videos.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634705","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":"Racial and Ethnic Representation Reporting in Orthopaedic Research.","authors":"Ahmad A Alnasser, Tim Kobes, Marilyn Heng","doi":"10.5435/JAAOSGlobal-D-25-00097","DOIUrl":"10.5435/JAAOSGlobal-D-25-00097","url":null,"abstract":"<p><strong>Introduction: </strong>Orthopaedic research informs clinical practice, making it critical to collect data that reflect diverse patient demographics, including race and ethnicity. Despite the importance of these variables in addressing healthcare disparities, race and ethnicity are often underreported in orthopaedic studies. The aim of this study was to evaluate the frequency of race and ethnicity reporting in high-impact orthopaedic journals and identify trends based on study characteristics.</p><p><strong>Methods: </strong>Original research published between January 1, 2018, and December 31, 2020, in Clinical Orthopaedics and Related Research (CORR), Journal of Bone and Joint Surgery, and Journal of Orthopaedic Trauma (JOT) was compiled for analysis. Data on publication date, study type, level of evidence, country, and demographic variables were collected. Reporting rates were compared with the US Census 2020 diversity index and the Historical Index for Ethnic Fractionalization for global reporting, creating a performance ratio (PR) to quantify underreporting or overreporting based on geographic diversity.</p><p><strong>Results: </strong>Among 1452 studies, 89.2% reported sex and 86.5% reported age, but only 18.9% included race and 6.1% included ethnicity. Reporting was highest in Level II studies (29.3% race, 10.2% ethnicity) and cross-sectional studies (31.0% race, 11.2% ethnicity). United States-based studies reported race and ethnicity more frequently (28.0%), with the highest PR in Hawaii, New Hampshire, and Washington DC. Internationally, Japan, Thailand, and Finland had the highest PR. Reporting varied by journal, with CORR leading in race reporting (23.9%) and JOT in ethnicity (8.0%).</p><p><strong>Discussion: </strong>Race and ethnicity are markedly underreported in orthopaedic research. Addressing this disparity through standardized guidelines and enforcement mechanisms is essential to improve research quality and identify healthcare inequities. Additional exploration of these variables can better characterize diverse patient populations and inform clinical practice.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634728","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 Utilization Trends of Robotic Assistance in Orthopaedic Surgery.","authors":"Anish K Ponna, Alec Giakas, Anthony A Khoudary, Spencer N Uggla, Sina Ramtin, Yousef A Soliman, Asif M Ilyas","doi":"10.5435/JAAOSGlobal-D-26-00028","DOIUrl":"10.5435/JAAOSGlobal-D-26-00028","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic-assisted surgeries in orthopaedics have increased, particularly in hip and knee arthroplasty and spine surgeries. This study evaluates national utilization trends of robotic-assisted orthopaedic surgeries and demographic and geographic distribution of patients undergoing these surgeries.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted on patients who underwent total hip arthroplasty, total and partial knee arthroplasty, or spine arthrodesis from 2017 to 2023 using the TriNetX database. Relevant International Classification of Diseases, 10th Revision, and Current Procedural Terminology codes identified patients who underwent a primary surgery with a corresponding robot-assisted code on the same day. Temporal trends in procedural volume were analyzed, and multivariable logistic regression assessed sociodemographic factors associated with receiving robotic surgery.</p><p><strong>Results: </strong>A total of 809,802 patients underwent 1,072,714 surgeries, of which 57,920 (5.1%) used robotics. Overall, utilization increased from 3.0% in 2017 to 6.7% in 2023, with knee arthroplasty rising from 5.7% to 13.8% and spine arthrodesis from 0.2% to 1.3% (P < 0.0001). Logistic regression demonstrated a higher utilization among female individuals (odds ratio [OR], 1.16), Asian patients (OR, 1.15), and married individuals (OR, 1.38). Black (OR, 0.39) and Hispanic/Latino (0.63) patients were less likely to receive robotic surgeries. Regionally, patients in the Midwest were more likely to receive robotic-assisted surgeries compared with the Northeast (OR, 2.43), whereas those in the South (OR, 0.72) and West (OR, 0.50) were less likely.</p><p><strong>Conclusions: </strong>Robotic-assisted orthopaedic surgery continues to expand, particularly in knee arthroplasty and spine fusion. Although advancements in surgical technology offer potential benefits, ensuring both clear demonstration of long-term clinical benefit and equitable access remains an ongoing challenge.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"10 4","pages":""},"PeriodicalIF":2.1,"publicationDate":"2026-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634773","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}