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

{"title":"Evaluating if ChatGPT Can Answer Common Patient Questions Compared With OrthoInfo Regarding Rotator Cuff Tears.","authors":"Alexander Jurayj, Julio Nerys-Figueroa, Emil Espinal, Michael A Gaudiani, Travis Baes, Jared Mahylis, Stephanie Muh","doi":"10.5435/JAAOSGlobal-D-24-00289","DOIUrl":"10.5435/JAAOSGlobal-D-24-00289","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate ChatGPT's (OpenAI) ability to provide accurate, appropriate, and readable responses to common patient questions about rotator cuff tears.</p><p><strong>Methods: </strong>Eight questions from the OrthoInfo rotator cuff tear web page were input into ChatGPT at two levels: standard and at a sixth-grade reading level. Five orthopaedic surgeons assessed the accuracy and appropriateness of responses using a Likert scale, and the Flesch-Kincaid Grade Level measured readability. Results were analyzed with a paired Student t-test.</p><p><strong>Results: </strong>Standard ChatGPT responses scored higher in accuracy (4.7 ± 0.47 vs. 3.6 ± 0.76; P < 0.001) and appropriateness (4.5 ± 0.57 vs. 3.7 ± 0.98; P < 0.001) compared with sixth-grade responses. However, standard ChatGPT responses were less accurate (4.7 ± 0.47 vs. 5.0 ± 0.0; P = 0.004) and appropriate (4.5 ± 0.57 vs. 5.0 ± 0.0; P = 0.016) when compared with OrthoInfo responses. OrthoInfo responses were also notably better than sixth-grade responses in both accuracy and appropriateness (P < 0.001). Standard responses had a higher Flesch-Kincaid grade level compared with both OrthoInfo and sixth-grade responses (P < 0.001).</p><p><strong>Conclusion: </strong>Standard ChatGPT responses were less accurate and appropriate, with worse readability compared with OrthoInfo responses. Despite being easier to read, sixth-grade level ChatGPT responses compromised on accuracy and appropriateness. At this time, ChatGPT is not recommended as a standalone source for patient information on rotator cuff tears but may supplement information provided by orthopaedic surgeons.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626277","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":"Cephalobturator Neoacetabuloplasty: A Therapeutic Solution in Vicious Ankylosis After Developmental Dislocation of the Operated Hip-Case Study.","authors":"Gheorghe Burnei, Maricela Dragomir, Mihaela Banculescu, Răzvan Cătălin Popescu, Nicoleta Leopa, Ionuț Eduard Iordache","doi":"10.5435/JAAOSGlobal-D-24-00284","DOIUrl":"10.5435/JAAOSGlobal-D-24-00284","url":null,"abstract":"<p><p>In this report, we present the case of a female patient with rigid fibrous ankylosis of the hip after undergoing two surgeries to reduce developmental hip dislocation, which was successfully treated with neoacetabuloplasty that helped her to regain hip mobility. An 18-year-old female patient was diagnosed with developmental dislocation of the hip after 1 year of age. After two surgeries, the patient's hip was dislocated and showed rigid fibrous ankylosis. Treatment of rigid fibrous ankylosis in preschool children remains debatable. After the first surgery at the age of 3 years, her hip redislocated and mobility was limited; after the second surgery performed at the age of 4 years, the hip redislocated the second time, leading to immobility. The loose fibrous ankyloses became rigid. She underwent neoacetabuloplasty at the age of 6 years. The patient started walking after physiotherapy, 3 months postoperatively. After neoacetabuloplasty, the patient enjoyed an unrestricted lifestyle with a normal school and life schedule for 12 years. At the age of 18 years, her hip mobility was within normal limits without any pain.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626275","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":"Experience as an Orthopaedic Patient as a Motivating Factor for Pursuing a Career in Orthopaedic Surgery.","authors":"Clay B Townsend, Melissa Soderquist, Robert C Hoy, J Milo Sewards, David Galos","doi":"10.5435/JAAOSGlobal-D-24-00380","DOIUrl":"10.5435/JAAOSGlobal-D-24-00380","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to investigate the influence a personal experience with an orthopaedic injury or condition has on applicants' decisions to pursue orthopaedic surgery and to investigate current applicant motivations for pursuing orthopaedic surgery.</p><p><strong>Methods: </strong>This was a cross-sectional survey study of orthopaedic surgery applicants during the 2023 to 2024 application cycle who applied to the residency program at a single academic institution.</p><p><strong>Results: </strong>Of the 290 respondents (38.5% response rate), approximately two-fifths (37.6%) reported experiencing a musculoskeletal injury/condition that influenced their decision to pursue orthopaedic surgery, with 64.2% requiring surgical intervention. Injuries were most commonly sustained while playing soccer (21.0%), American football (19.0%), and basketball (10.0%). The most common injuries reported included anterior cruciate ligament rupture (14.1%), ankle fracture (9.4%), and meniscus tear (6.3%). Applicants with a history of an anterior cruciate ligament rupture represented 6.2% (18/290) of the entire applicant cohort. Approximately one-fifth (21.7%, 63/290) of applicants reported that a musculoskeletal injury or condition experienced by a family member or friend had influenced their decision to pursue orthopaedic surgery. The most commonly selected motivating factor for deciding to pursue orthopaedic surgery was intellectual curiosity (86.6%), followed by clinical rotation experience (84.8%), mentor/faculty interactions (75.9%), personal experience with a musculoskeletal injury/condition (60.0%), and academic opportunities (51.7%).</p><p><strong>Conclusion: </strong>A large portion of current orthopaedic surgery applicants were motivated to pursue orthopaedic surgery by a personal experience with an orthopaedic injury or condition. This study revealed many novel findings related to current orthopaedic applicant motivations for pursuing orthopaedic surgery as a career.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11888968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576024","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":"Chronic Osteomyelitis of Patella in a Child.","authors":"Bijay Poudel, Shreejana Pandey, Jagadamba Gupta Teli, Aashutosh Chaudhary, Amartya Dahal","doi":"10.5435/JAAOSGlobal-D-24-00192","DOIUrl":"10.5435/JAAOSGlobal-D-24-00192","url":null,"abstract":"<p><p>Osteomyelitis, an infection of bone, commonly affects long bones. Chronic osteomyelitis of patella is a rare entity, and diagnosis is often delayed. We present a case of an 11-year-old boy with chronic osteomyelitis of patella who underwent treatment at our center. We conclude that diagnosis of patellar osteomyelitis needs a high index of suspicion. Early treatment is essential to save the patella and the knee of the patient.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568474","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":"Simultaneous Intra-articular and Extra-articular Corrective Osteotomies Using a Patient-Matched Surgical Guide and Plate for Malunion After Distal Radius Fractures: A Report of Two Cases.","authors":"Hiroki Kondo, Ryoya Shiode, Satoshi Miyamura, Arisa Kazui, Natsuki Yamamoto, Tasuku Miyake, Toru Iwahashi, Hiroyuki Tanaka, Tsuyoshi Murase, Seiji Okada, Kunihiro Oka","doi":"10.5435/JAAOSGlobal-D-24-00328","DOIUrl":"10.5435/JAAOSGlobal-D-24-00328","url":null,"abstract":"<p><p>Malunion after distal radial fractures with intra-articular and extra-articular deformities is difficult to treat. We report two cases of simultaneous intra-articular and extra-articular corrective osteotomies for malunion after distal radius fractures using a patient-matched surgical guide and plate (patient-matched instruments [PMIs]) created based on a preoperative computer simulation. Both patients experienced pain and limited range of motion in the wrist and forearm. Three-dimensional models were created using CT to simulate corrective osteotomy. Two types of PMIs were created to correct the extra-articular deformity and intra-articular step-off. Intra-articular and extra-articular corrective osteotomies were simultaneously performed using the PMIs. In postoperative imaging evaluations, the average step-offs were reduced from 4.5 to 0 mm and extra-articular deformities were anatomically corrected. The average visual analog scale score decreased from 55/100 to 12/100 mm, indicating substantial pain relief. In addition, there was a notable improvement in range of motion: flexion increased from 42.5° to 62.5°, extension from 57.5° to 75°, pronation from 67.5° to 85°, and supination from 47.5° to 82.5°. Simultaneous intra-articular and extra-articular corrective osteotomy using a patient-matched surgical guide and plate is a valuable technique for correcting complex deformities and ensuring precise osteotomy.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568476","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":"Short-Term Outcomes of Noncemented Total Knee Arthroplasty in Patients With Morbid Obesity.","authors":"Michelle R Shimizu, Hanna E House, Nicholas M Brown","doi":"10.5435/JAAOSGlobal-D-24-00299","DOIUrl":"10.5435/JAAOSGlobal-D-24-00299","url":null,"abstract":"<p><strong>Introduction: </strong>Noncemented primary total knee arthroplasty (TKA) compromises over 14% of all primary TKA procedures reported in the American Joint Replacement Registry. While studies have indicated similar outcomes for cemented and noncemented TKA in obese individuals, the efficacy and safety of noncemented TKA in morbidly obese patients (body mass index [BMI] ≥ 40 kg/m2) remain unexplored. This study compares short-term postoperative outcomes and complications between noncemented and cemented TKA in morbidly obese patients.</p><p><strong>Methods: </strong>A retrospective review of 605 cases of patients with a BMI of at least 40 kg/m2 (22.5% of 2,691 total cases at a single tertiary center) who underwent TKA was conducted. All patients had a minimum follow-up of 1 year. Data collected included age, BMI, sex, race, ethnicity, American Society of Anesthesiologists status, and the Charlson Comorbidity Index. Postoperative complications were tracked, including 90-day readmission, 1-year mortality, 1-year revision surgery, wound complications, fractures, and infections. Categorical variables were analyzed with chi-square tests and continuous variables with t-tests.</p><p><strong>Results: </strong>Of the included patients with a BMI ≥ 40 kg/m2, 40 (6.6%) received noncemented TKA. The noncemented TKA group had a lower mean BMI (43.3 ± 3.1 vs. 45.0 ± 4.4; P = 0.012) and a higher proportion of male patients compared with the cemented group (n = 17 [42.5%] vs. n = 143 [25.3%]; P = 0.028). Surgical time was shorter for noncemented TKA (97 ± 27 minutes) than for cemented TKA (118.0 ± 39.4 minutes; P = 0.001). No significant differences were found in length of stay and postoperative complications, including 90-day readmission, 1-year mortality, revision surgery rates, wound complications, fractures, and infections.</p><p><strong>Conclusion: </strong>The findings of the study suggest that noncemented TKA may be a feasible, safe alternative and not inferior to the standard cemented TKA in patients with morbid obesity with the benefit of decreasing surgical time.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11845207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558144","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":"Below-Knee Amputations: A Qualitative Social Media Analysis of Perceived Outcomes.","authors":"Jacob Anderson, Paul Gaschen, Neil Jain, Caroline Cushman, Evan J Hernandez, Brendan J Mackay","doi":"10.5435/JAAOSGlobal-D-24-00198","DOIUrl":"10.5435/JAAOSGlobal-D-24-00198","url":null,"abstract":"<p><strong>Introduction: </strong>Below-knee amputations (BKAs) treat lower-limb conditions such as ischemia, peripheral artery disease, and trauma. This study uses social media to examine patient outcomes and perspectives post-BKA.</p><p><strong>Methods: </strong>Data from Facebook, Instagram, and X (formerly Twitter) from February 26, 2014, to February 26, 2024, were analyzed. Posts from the Facebook groups \"Amputee Support Group\" and \"Below Knee Amputee,\" along with posts tagged with #belowkneeamputation and #belowkneeamputee on Instagram and X, were examined for demographics, perspective, and perceived outcomes.</p><p><strong>Results: </strong>Analysis of 571 Facebook posts, 520 Instagram posts, and 64 X posts revealed 67% positive outcomes, 20.1% neutral, and 12.9% negative. Instagram showed the most positive responses, often from patients resuming physical activities. Facebook was predominant with neutral posts seeking advice, while X displayed mostly positive feedback. Negative feedback on Facebook centered on phantom pain and reduced quality of life.</p><p><strong>Discussion and conclusion: </strong>Most BKA patients reported positive postoperative outcomes. Facebook emerged as a vital platform for individuals to share their challenges and seek support, enabling them to join specialized support groups where they can connect with others facing similar issues and receive advice and encouragement. Negative outcomes, often related to persistent pain and dissatisfaction with life quality, underscore the need for surgeons to manage expectations and address physical and emotional recovery aspects of BKA.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558023","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":"Pediatric Rupture of Hallux Interphalangeal Joint Lateral Collateral Ligament.","authors":"Mazen Zamzam, Colin Van Wagoner, Imran Bitar, Ehab Saleh","doi":"10.5435/JAAOSGlobal-D-24-00307","DOIUrl":"10.5435/JAAOSGlobal-D-24-00307","url":null,"abstract":"<p><p>Ligamentous injuries of the hallux are rare, and when seen, they are most commonly treated conservatively. Surgical treatment of such injuries is also rare, making reports on the postoperative outcome and complications even less frequent. A case report of a hallux interphalangeal joint (IPJ) lateral collateral ligament tear in a 16-year-old gymnast is presented. Initially, she presented to the clinic with pain in her left hallux. She injured her toe while doing a gymnastic maneuver in which it got stuck and hyperextended. Physical examination revealed pain in her left great toe metatarsophalangeal and IPJs. Her medical history included the diagnosis of Ehlers-Danlos syndrome. She was managed conservatively with a controlled ankle motion boot for 4 weeks. When she returned for follow-up, her physical examination showed increased laxity to the great toe IPJ lateral collateral ligament compared with the other foot. A left foot MRI was done, which showed a complete rupture of the IPJ lateral collateral ligament origin (Figure 1). She underwent surgical intervention 6 weeks following her injury, in which the collateral ligament was repaired with suture anchors along with IP joint pinning to protect the repair (Figure 2). Following surgery, she returned to the clinic because of persistent drainage from a small hole near the incision site. During further incision and débridement, we discovered granulomatous tissue surrounding an embedded suture. The suture was removed, and the wound was irrigated. Following this procedure, the patient recovered fully in 3 weeks. She was provided a home exercise program and returned to gymnastics without limitations, toe pain, or instability. This case demonstrates an interesting complication following collateral ligament repair in the hallux.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11878989/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558024","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":"Effectiveness of a Supervised Patient Ambulation Program in Reducing Fall Risk Following Total Joint Arthroplasty.","authors":"Steven G Kenney, Kishan S Shah, Jenna M Tabbaa, Audree S Evans, William D Bugbee, Steven N Copp","doi":"10.5435/JAAOSGlobal-D-24-00407","DOIUrl":"10.5435/JAAOSGlobal-D-24-00407","url":null,"abstract":"<p><strong>Background: </strong>Total hip arthroplasty and total knee arthroplasty rank among the most prevalent orthopaedic procedures performed globally. Early mobilization postarthroplasty reduces complications, shortens length of stay, and optimizes recovery. However, the incidence of falls remains high, leading to complications and increased costs. Ensuring patient safety during mobilization is critical to minimizing fall risks.</p><p><strong>Methods: </strong>In 2014, our institution created a supervised patient ambulation program called \"No One Walks Alone\" (NOWA). A retrospective review of patients undergoing total knee arthroplasty or total hip arthroplasty between 2011 and 2017 was conducted. The inclusion criteria spanned the preimplementation group (2011 to 2013) (N = 3069) and the postimplementation group (2015 to 2017) (N = 3947). Patients in the postimplementation group were enrolled in the \"No One Walks Alone\" supervised ambulation program. Data on patient demographics, procedures, hospital stay, fall rates, and postfall complications were collected. A logistic regression analysis was done to identify fall risk factors, and statistical analyses were used to compare outcomes between the patient groups.</p><p><strong>Results: </strong>Inpatient fall rates decreased from 2.5 to 1.0 per 1000 inpatient days between the preimplementation and postimplementation groups, respectively. The difference in fall rates between the two periods was statistically significant (P value < 0.002). Fall-related complications were notably reduced in the postimplementation group. In addition, the postimplementation group saw a statistically and clinically notable reduction in average length of stay in the hospital compared with the preimplementation group by 0.75 days (P value < 0.001).</p><p><strong>Conclusion: </strong>Implementation of a supervised ambulation program was found to markedly reduce fall rates, length of stay, and fall-related complications, demonstrating the importance of proactive interventions to improve patient safety following arthroplasty.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 3","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11875583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543981","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 Burden of Revision Arthroplasty: An Ergonomic Analysis of Surgeon Posture in the Operating Room.","authors":"Cody Green, Zachary Gapinski, Eric Mason, Ezan Kothari, Pratik Desai, George Haidukewych","doi":"10.5435/JAAOSGlobal-D-24-00290","DOIUrl":"10.5435/JAAOSGlobal-D-24-00290","url":null,"abstract":"<p><strong>Background: </strong>Revision total joint arthroplasties are physically demanding cases. Recent studies have shown increased cardiovascular stress in surgeons performing revision total knee arthroplasty (rTKA) and revision total hip arthroplasty (rTHA) compared with primary cases. To our knowledge, no study has compared surgeon ergonomics during these cases. The purpose of this study was to analyze surgeon posture during primary and revision THA and TKA.</p><p><strong>Methods: </strong>We prospectively evaluated 286 consecutive cases (103 primary TKAs, 95 primary THAs, 57 rTKAs, and 31 rTHAs) performed by three high-volume, fellowship-trained arthroplasty surgeons. Throughout each case, surgeons wore a posture-tracking device to evaluate time spent slouching. The threshold for slouching was set to 30 degrees of flexion from the neutral spinal axis. Demographic and surgical factors were collected. Two-tailed t-tests and multivariate analysis were used to assess differences between groups.</p><p><strong>Results: </strong>After controlling for individual differences in posture, we found an increase in percentage and duration of time spent slouching between rTHA and primary THA cases (58.9% vs. 43.2%, P < 0.001; 65.1 vs. 32.6 minutes, P < 0.001). In the multivariate analysis, patient body mass index and rTHA were found to be an individual contributor to slouching percentage in THAs (P = 0.001). We found increased duration of time spent slouching between rTKA and primary TKA (80.2 vs. 45.7 minutes, P < 0.001); however, percentage time slouching showed no difference (67.1% vs. 58.5%, P = 0.175). Active fellow involvement was an individual contributor to decreased time slouching in both TKA and THA groups (P < 0.001).</p><p><strong>Conclusions: </strong>Surgeons performing revision total joint arthroplasty spend markedly more case time in a slouched posture compared with primary arthroplasty, particularly in patients with a higher body mass index. Awareness of the surgical and patient factors that can affect posture in TKAs and THAs can help arthroplasty surgeons gain more awareness about injury prevention and potentially help prolong their career.</p>","PeriodicalId":45062,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons Global Research and Reviews","volume":"9 2","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442380","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}