Journal of the American Academy of Orthopaedic Surgeons最新文献

{"title":"Surgeon Age, Years in Practice, and Location of Training Are Associated With Patient Satisfaction.","authors":"Laura Y Lu, Mitchel B Harris, Christopher Chiodo, Antonia F Chen","doi":"10.5435/JAAOS-D-24-00941","DOIUrl":"10.5435/JAAOS-D-24-00941","url":null,"abstract":"<p><strong>Introduction: </strong>Patient satisfaction is associated with communication-related measures, empathy, and meeting expectations. However, it is not clear what surgeon characteristics are associated with patient satisfaction. As such, the purpose of this study was to investigate the surgeon sociodemographic, training, and practice parameters that may be associated with patient satisfaction.</p><p><strong>Methods: </strong>A retrospective study of patient satisfaction scores was conducted from 7,856 patients who rated 62 orthopaedic surgeons in 2021 within a single hospital system. Three questions from the National Research Corporation survey were used to assess patient satisfaction. Bivariate analyses and multiple linear regression analyses were performed. For chi-square analyses, patient satisfaction scores were recoded into either above the mean or below/equal to the mean score.</p><p><strong>Results: </strong>Overall, 57 male (91.9%) and five female orthopaedic surgeons (8.1%) participated. Mean age was 49.3 ± 9.9 years. Median years in practice was 14 years (range, 1 to 38 years). More years in practice was associated with lower patient satisfaction scores for careful listening ( P = 0.048), likelihood to recommend the provider ( P = 0.021), and total score ( P = 0.029). Older surgeon age was associated with lower total scores ( P = 0.039). Surgeons with 30 or more years of practice were more likely to be recommended ( P = 0.030). Surgeons who trained in the Northeast for fellowship and/or residency were more likely to be recommended. Older surgeon age and training in the Northeast were associated with higher patient satisfaction.</p><p><strong>Conclusion: </strong>Older surgeon age and fellowship and/or residency training in the Northeast were associated with higher patient satisfaction, whereas 30 or more years of practice was associated with lower patient satisfaction. In bivariate analysis, female surgeons and foot and ankle training were associated with higher patient satisfaction, whereas spine surgeons had lower patient satisfaction scores. These findings suggest that patient-centered communication, patient-surgeon concordance, and appropriate help may improve patient satisfaction.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"275-284"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Death of the P Value? Bayesian Statistics for Orthopaedic Surgeons.","authors":"Michael Polmear, Terrie Vasilopoulos, Nathan O'Hara, Thomas Krupko","doi":"10.5435/JAAOS-D-24-00813","DOIUrl":"10.5435/JAAOS-D-24-00813","url":null,"abstract":"<p><p>Statistical interpretation is foundational to evidence-based medicine. Frequentist ( P value testing) and Bayesian statistics are two major approaches for hypothesis testing. Studies analyzed with Bayesian methods are increasingly common with a 4-fold increase in the past 10 years. The Bayesian approach can align with clinical decision making by interpreting smaller differences that are not limited by P values and misleading claims of \"trends toward significance.\" Both methods follow a workflow that includes sampling, hypothesis testing, interpretation, and iteration. Frequentist methodology is familiar and common. However, the limitations are the misunderstanding, misuse, and deceptively simple utility of interpreting dichotomous P values. Bayesian approaches are relatively less common and provide an alternative approach to trial design and data interpretation. Marginal differences elucidated by Bayesian methods may be perceived as less decisive than a P value that may reject a null hypothesis. The purposes of this review are to introduce Bayesian principles and Bayes theorem, define how pretest probability and known information may inform diagnostic testing using an example from prosthetic joint infection, contrast Bayesian and frequentist approaches using an example from the VANCO orthopaedic prospective trial, and describe the criteria for critically reviewing Bayesian studies.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"285-300"},"PeriodicalIF":2.6,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Five-Year Revision Surgery Rates After Total Ankle Arthroplasty and Ankle Arthrodesis in Patients With Prior Bariatric Surgery: A Retrospective Cohort Study.","authors":"Sanjay Kubsad, Arman Kishan, Mohini Gharpure, Prasenjit Saha, Victoria E Bergstein, James R Ficke, Amiethab A Aiyer","doi":"10.5435/JAAOS-D-24-01267","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01267","url":null,"abstract":"<p><strong>Introduction: </strong>It is unclear how bariatric surgery for the treatment of obesity may affect outcomes of surgical treatment for ankle conditions. The purpose of this study was to compare rates of revision surgery after primary ankle arthrodesis (\"arthrodesis\") and total ankle arthroplasty (\"arthroplasty\") for patients who had undergone bariatric surgery and those who had not (\"control group\").</p><p><strong>Methods: </strong>In this retrospective study, we used data from the PearlDiver database to compare 5-year revision surgery rates after arthroplasty and arthrodesis in patients with and without a history of bariatric surgery. Cohorts were propensity-matched by age, sex, and Charlson Comorbidity Index value in a 1:4 ratio. We explored the following surgical outcomes: arthroplasty revision, joint infection, instrumentation removal, open reduction and internal fixation (ORIF), and adjacent joint fusion. Cumulative incidence was calculated through Kaplan-Meier survival analysis and compared using Cox proportional hazard ratios.</p><p><strong>Results: </strong>At 5 years after arthrodesis, the likelihood of adjacent joint fusion was higher among patients with a history of bariatric surgery than among control patients (hazard ratio: 1.8, 95% confidence interval, 1.2 to 2.6); however, we found no differences in surgical outcomes for joint infection, instrumentation removal, or ORIF. At 5 years after arthroplasty, surgical outcomes did not differ between those with a history of bariatric surgery versus control patients.</p><p><strong>Discussion: </strong>These findings suggest that a history of bariatric surgery is not an important predictor of joint infection, instrumentation removal, or ORIF within 5 years after primary total ankle arthroplasty or arthrodesis. When choosing between arthroplasty or arthrodesis in patients who have undergone bariatric surgery, higher incidence of adjacent joint fusion should be a consideration.</p><p><strong>Level of evidence: </strong>III, Retrospective cohort study.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Strategies in Regional Anesthesia for Shoulder Surgery.","authors":"Linda L Zhang, Sanjay K Sinha, Anand M Murthi","doi":"10.5435/JAAOS-D-24-00738","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00738","url":null,"abstract":"<p><p>As arthroscopic and open shoulder surgery is increasingly performed on an outpatient basis, optimal and prolonged pain control is becoming more important while minimizing associated adverse effects. Traditional analgesic strategies relying on opioid and nonopioid medications provide inadequate pain control and are associated with undesirable adverse effects, such as opioid-related adverse effects (postoperative nausea and vomiting, respiratory depression, sedation), gastric lining irritation, and renal and hepatic adverse effects. Advances in ultrasonography-guided regional anesthesia have made placement of interscalene brachial plexus nerve blocks more reliable and precise and aided development of novel phrenic nerve-sparing peripheral nerve block techniques that decrease the risk of diaphragmatic paresis and dyspnea. Using a brachial plexus block combined with multimodal medications is the preferred method to provide comprehensive analgesia to target multiple pain pathways for additive or synergistic pain control effects in the perioperative period while minimizing opioid medication usage. An understanding of current anesthetic and analgesic strategies can lead to an improved pain management pathway and outcomes in patients undergoing shoulder surgery.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public Insurance and Language Preferences Are Associated With a Longer Time to Surgery for Distal Radius Fractures.","authors":"Jeffrey W Kwong, Katherine R Miclau, Emma Tapp, Angel X Xiao, Ashley Mulakaluri, Lauren M Shapiro","doi":"10.5435/JAAOS-D-24-01062","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01062","url":null,"abstract":"<p><strong>Introduction: </strong>Insurance type can result in disparities in access to specialist orthopaedic care. Here, we sought to quantify how insurance type affects time to surgery in patients with a distal radius fracture that needs surgical treatment.</p><p><strong>Methods: </strong>A retrospective cohort study of patients ≥18 years with surgically managed, closed distal radius fractures was conducted. We measured the time from injury to surgery, the time from injury to clinic visit, and the time from clinic visit to surgery. Data were analyzed using linear regression models.</p><p><strong>Results: </strong>We included 131 patients (69.0%) with private insurance and 56 patients (29.5%) with public insurance. The mean time from injury to surgery for the entire cohort was 12.4 ± 0.6 days. Private insurance patients had an average time from injury to surgery of 11.0 ± 0.5 days; public insurance patients had an average of 16.2 ± 1.3 days (P < 0.001). The increased time from injury to surgery for publicly insured patients was due to a 4.3-day longer (P < 0.001) time from injury to clinic visit; the time from clinic visit to surgery was similar (0.9 days, P = 0.216). In a stratified analysis, age was an effect modifier of the relationship between insurance type and time to surgery, with greater delays for younger patients. Preferred language other than English was associated with a 5.4 day longer time to surgery (P = 0.022) in a multivariate model.</p><p><strong>Discussion: </strong>In patients with surgically treated distal radius fractures, public insurance was associated with a longer time to surgery, with such effect more pronounced for younger patients. Patients who spoke a language other than English also experienced greater delays. These findings warrant system-level efforts to address inequitable delays in care.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Widespread or Selective Invasive Monitoring Increase the Rate of Fasciotomies for Tibial Shaft and Plateau Fractures, or Affect the Incidence of Possible Missed Compartment Syndrome?","authors":"Cassandra Ricketts, Mir Ibrahim Sajid, Meghan McCaskey, Meghan Maseda, Connor Diaz, Christopher Flanagan, Thomas Stang, Benjamin Maxson, Anthony Infante, Anjan Shah, Roy Sanders, David Donohue, David Watson, Hassan R Mir","doi":"10.5435/JAAOS-D-24-00885","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00885","url":null,"abstract":"<p><strong>Introduction: </strong>To report the incidence of lower leg fasciotomies in tibial shaft and plateau fractures and explore the incidence of potential missed acute compartment syndrome (ACS) with widespread, selective, or no invasive monitoring (IM).</p><p><strong>Methods: </strong>This is a retrospective review of adult patients with diaphyseal tibial fractures (Orthopaedic Trauma Association 42A-C), and proximal tibial fractures (Orthopaedic Trauma Association 41A-C) treated surgically at a Level 1 trauma center from 2001 to 2020. Main outcomes of interest include lower extremity fasciotomy rates and incidence of potential missed ACS (abnormal neurovascular examination, sensory changes, chronic pain, claw toes, or amputation) in diaphyseal and proximal tibial fractures at three time intervals: widespread use of IM (w-IM) (2000 to 2010), selective IM (s-IM) (2011 to 2015), and clinical examination with a high index of suspicion alone without IM (CES), 2016 to 2020.</p><p><strong>Results: </strong>Fasciotomy rates decreased from 4.96% (93 in 1,873) in 2001 to 2010 (w-IM) to 2.61% (32 in 1,226) in 2011 to 2015 (s-IM) and to 1.11% (16 in 1,438) in 2016 to 2020 (CES) (P < 0.001). Random samples of 317 patients with tibial shaft and plateau fractures that did not undergo fasciotomy from 2001 to 2010 (w-IM), 304 patients from 2011 to 2015 (s-IM), and 285 patients from 2016 to 2020 (CES) found that 96.5% had a normal neurovascular examination in the w-IM group, 98.4% in the s-IM group, and 96.8% in the CES group, P = 0.210. No differences were found in sensory changes in the three groups (0.6% for w-IM vs. 1.6% for s-IM vs. 0.4% for CES, P = 0.235) or severe pain (0.6% vs. 0.3% vs. 0.7%, P = 0.589). No patients had late amputation or claw toes in any group. The combined complication rate was slightly lower in the s-IM group (2.0%) and the CES group (2.8%) compared with the w-IM group (4.4%) (P = 0.214).</p><p><strong>Conclusions: </strong>The rate of fasciotomy for ACS in proximal and diaphyseal tibial fractures has declined over time at our center coinciding with the decreased use of IM with no apparent increase in missed ACS.</p><p><strong>Level of evidence: </strong>Diagnostic Level III.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ergonomics in the Operating Room: Recommendations for Orthopaedic Surgeons.","authors":"Rosa S Valtanen, Maike van Niekerk, Constance R Chu","doi":"10.5435/JAAOS-D-24-01206","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01206","url":null,"abstract":"<p><p>Orthopaedic surgeons face notable occupational hazards, including suboptimal ergonomics in the operating room (OR). This results in high rates of musculoskeletal injuries that affect at least four in 10 orthopaedic surgeons. Sex disparities exacerbate these issues, with female surgeons reporting markedly higher rates of occupational injuries and discomfort with surgical instrument use compared with male surgeons. Factors such as sustained nonergonomic positions, poor instrument design, improper OR setups, and forceful and repetitive movements contribute to these injuries. With upward of one in three injured orthopaedic surgeons taking leaves, modifying their practices, or retiring prematurely, there is a need to safeguard the health and longevity of the orthopaedic workforce. Surgeons can mitigate the risk of musculoskeletal injuries by maintaining neutral body positions, adjusting their OR environment (e.g., table height), and incorporating brief interventions (e.g., position changes and regular microbreaks). Educating surgeons on these interventions is important for reducing harm. Institutions can consider adapting policies and conducting research focused on enhancing ergonomics to further contribute to creating safer surgical environments. Improving OR ergonomics not only influences orthopaedic surgeon well-being and practice longevity but also enhances patient care and reduces the economic toll of occupational injuries.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Retrospective Comparison of Cephalomedullary Nail Fixation of Intertrochanteric Femur Fractures Treated With Locked Versus Backed-off Set Screws.","authors":"Byron A Ward, Joshua A Parry","doi":"10.5435/JAAOS-D-24-01196","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01196","url":null,"abstract":"<p><strong>Introduction: </strong>Excessive lag screw sliding after cephalomedullary nail fixation of intertrochanteric fractures can be problematic. Set screws are typically inserted to engage the lag screw and backed off to allow for sliding. The purpose of this study was to determine whether statically locking set screws affected lag screw sliding or cutout.</p><p><strong>Methods: </strong>A retrospective review was done at a single level 1 trauma center. Patients treated with locked versus backed-off set screws were compared in terms of lag screw sliding, loss of reduction, and lag screw cutout.</p><p><strong>Results: </strong>There were 186 patients included. The median age was 67.0 years (IQR 57.0 to 79.0 years) and 56.4% (n = 105) were male. Locked versus backed-off set screws were used in 23.7% (n = 44) and 76.3% (n = 142). The locked set screw group, compared with the backed-off set screw group, had a longer follow-up (4.0 vs. 3.0 months, P = 0.02), had a greater median tip-apex distance (21.3 vs. 19.0, P = 0.04), and did not differ in age, sex, acute varus displacement (vertical displacement of greater trochanter above the femoral head on injury radiographs), postoperative neck-shaft angle, or calcar gapping. The locked set screw group, compared with the backed-off set screw group, had less lag screw sliding (2.3 vs. 3.6 mm, P = 0.02) and no difference in lag screw sliding ≥10 mm (6.7% vs. 7.8%, P = 1.0), loss of reduction ≥10 mm (6.8% vs. 9.2%, P = 0.7), or cutout (0.0% vs. 1.4%, P = 1.0). Patients who had ≥10 mm of lag screw sliding were older (76.5 vs. 66.0, P = 0.04), more likely to have acute varus displacement (50.0% vs. 23.2%, P = 0.04), and had more varus postoperative neck-shaft angles (129° vs. 132°, P = 0.03).</p><p><strong>Conclusion: </strong>Locked set screws, compared with backed-off set screws, resulted in a median of 1.3 mm less of lag screw sliding and did not affect the rate of lag screw sliding ≥10 mm, loss of reduction, or cutout.</p><p><strong>Level of evidence: </strong>Level III, retrospective comparison.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connecting Underrepresented Medical Students to Resources and Role Models in Orthopaedic Surgery: A Virtual Diversity, Equity, Inclusion, and Accessibility Summit.","authors":"Shayom Debopadhaya, Christopher Saker, Maike van Niekerk, Amil R Agarwal, Amy Zhao, Sheena Amin, Vincenzo Bonaddio, Lauren Bracey, Elizabeth Cho, Natalia Czerwonka, Alexander Dawes, Alex Gu, Isaiah Hughes, Maria Kammire, Tammy Phillips, Rachel Ranson, Christina Stach, Lisa K Cannada, Kevin Shea, Mary K Mulcahey","doi":"10.5435/JAAOS-D-24-00949","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00949","url":null,"abstract":"<p><strong>Introduction: </strong>Limited access to resources and stereotypes about orthopaedic surgeons may contribute to the low percentage of women and people of underrepresented in medicine (URiM) backgrounds in orthopaedic surgery. Several organizations have created resources to address these barriers, but medical students are unlikely to be exposed to the initiatives through traditional curricula. The purpose of this study was to (1) evaluate the ability of a 1-day virtual Diversity, Equity, Inclusion, and Accessibility (DEIA) summit to effectively reach URiM medical students, (2) increase medical students' knowledge of DEIA resources, and (3) augment the perception of diverse backgrounds in orthopaedic surgery.</p><p><strong>Methods: </strong>A 1-day nationwide virtual summit was convened in October 2023. The summit invited residents and faculty leaders of diversity-focused orthopaedic organizations to speak with students in panel discussions and topic-focused breakout rooms. Pre- and postsummit surveys were used to determine whether the summit met the three goals.</p><p><strong>Results: </strong>One hundred ninety-six medical students attended the summit. One hundred seventy-four surveys were received presummit, 106 surveys were received postsummit, and 60 students completed both. Most of the participants were female (n = 109, 63.0%), and many represented URiM backgrounds (n = 70, 41.7%). Postsummit, a notable number of survey respondents increased their knowledge about diversity-related opportunities (3.3% to 40%, P < 0.001). Participants who felt that their identity was welcome in orthopaedics nearly quadrupled from presummit (16.7%) to postsummit (63.3%) (P < 0.001), and the likelihood of recommending orthopaedic surgery to another medical student from an URiM demographic increased by 58.6% (P < 0.001). Among the 135 students who did not initially feel that their identity was welcome in the field of orthopaedic surgery, 124 (91.9%) rated changing stereotypes of the field as important to their decision to pursue a career in orthopaedics.</p><p><strong>Conclusions: </strong>This study supports the ability for virtual summits to reach URiM students, increase their knowledge of DEIA resources, and augment their perceptions of diversity in orthopaedics.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Based Disparities in Academic Orthopaedic Surgery Physician Compensation in 2023.","authors":"Dhun Chauhan, Joshua K DeYoung, Ezra Goodrich, Kimberly Templeton, Charles S Day","doi":"10.5435/JAAOS-D-24-01256","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-01256","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedic surgery remains one of the least diverse specialties in medicine. Parity in opportunity and recognition are key factors in attracting and retaining a diverse group of individuals in the field. The primary purpose of this study was to assess gender-based discrepancies in total salary compensation by rank for academic orthopaedic surgery faculty.</p><p><strong>Methods: </strong>Aggregate data were obtained from the Association of American Medical Colleges for fiscal year 2023. Mean compensation was compared for orthopaedic surgery faculty and total surgery faculty at all academic ranks based on gender and race.</p><p><strong>Results: </strong>Men received markedly higher total compensation for all ranks except chair within orthopaedic surgery. At the instructor level, men earned an average annual income of $554,245 while women received $229,204, demonstrating a significant pay gap (P = 0.0019). At the assistant professor (men: $628,346; women: $475,857), associate professor (men: $732,381; women: $575,877), and professor (men: $743,822; women: $472,140) levels, there existed significant pay disparities (P < 0.0001 for all three academic levels, respectively). At the chief position, men earned an average of $1,185,873 annually while women received $596,270 (P = 0.0006). Aggregate data for other surgical specialties demonstrated similar results, with women receiving lower total compensation at all ranks compared with men.</p><p><strong>Conclusion: </strong>This analysis of the 2023 American Medical Colleges Faculty Salary Report demonstrates a notable pay differential between men and women in orthopaedic surgery and surgical specialties, in general, across multiple academic levels including instructor, assistant professor, associate professor, professor, and chief of division. Although there has been increasing awareness of gender-based compensation disparities within surgical specialties, particularly in orthopaedic surgery, these disparities are still clearly present.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617714","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}