Journal of the American Academy of Orthopaedic Surgeons最新文献

{"title":"Changing Epidemiology of Distal Femur Fractures: Increase in Geriatric Fractures and Rates of Distal Femur Replacement.","authors":"Graham DeKeyser, Tyler Thorne, Brook I Martin, Justin M Haller","doi":"10.5435/JAAOS-D-24-00007","DOIUrl":"10.5435/JAAOS-D-24-00007","url":null,"abstract":"<p><strong>Introduction: </strong>Distal femur fractures (DFFs) are associated with high complication and mortality rates in the elderly. Using the National Inpatient Sample and Medicare data, we describe trends in the incidence of DFFs by fixation type and associated healthcare costs.</p><p><strong>Methods: </strong>Annual population rates and volume of inpatient DFFs were estimated using Poisson regression with the US Census as a denominator. We used Current Procedural Terminology codes in Medicare patients to determine episode-of-care cost by treatment, classified as intramedullary nail, open reduction and internal fixation, and distal femur arthroplasty (DFR).</p><p><strong>Results: </strong>The annual incidence of DFFs in the United States is approximately 27.4 per 100,000. Admission for DFFs increased from 2002 to 2020, with the highest volume and rate in those aged 85 years and older. DFF incidence increased (1.95×) from 142 per 1 million (95% CI: 140 to 144) in 2006 to 281 per 1 million (95% CI: 278-284) in 2019. From 2012 to 2019, the percentage of DFFs treated by intramedullary nail increased from 6.8% to 8.4%, open reduction and internal fixation decreased from 89.9% to 76.6%, and DFR increased from 3.3% to 14.9%. DFR cost was significantly greater than other treatment choices across all years for initial inpatient admission costs and 90-day episode-of-care costs (all P < 0.0001).</p><p><strong>Conclusion: </strong>DFF volume has increased in the past 20 years, predominantly in elderly patients. Greater than 4.5× increase was observed in the proportion of geriatric DFFs treated with DFR during this study period. The total cost of DFR treatment was consistently greater than other surgical treatments.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":"e1289-e1298"},"PeriodicalIF":2.6,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relative Citation Ratio Among Pediatric Orthopaedic Surgeons: Examining the Factors Associated With Higher Scores.","authors":"Scott J Halperin, Aidan Gilson, Meera M Dhodapkar, Maxwell Prenner, Dominick Tuason, Jonathan N Grauer","doi":"10.5435/JAAOS-D-24-00756","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00756","url":null,"abstract":"<p><strong>Introduction: </strong>Academic scholarship is often valued by clinicians, peers, and intuitions. Quantifying the effect of research publications is challenging. Various metrics have been used to assess this. This study aimed to examine the relatively new research metric, relative citation ratio (RCR), introduced by the National Institutes of Health, for pediatric orthopaedic surgeons to establish the benchmarking of research effect within the field and understand the distribution and basis for the use of this metric among pediatric orthopaedic surgeons.</p><p><strong>Methods: </strong>The RCR indices were assessed for members of the Pediatric Orthopaedic Society of North America using the iCite online web service. The mean RCR (mRCR, the yearly average RCR) and weighted RCR (wRCR, the cumulative RCR score) were assessed for each member. This information was used to perform univariate and two multivariate ordinary least squares regressions for the two metrics. Independent variables were physician sex, years since receiving national provider identifier, MD versus DO degree, whether the physician had a PhD, and geographic region of practice (Northeast, Southeast, Midwest, West, and Southwest).</p><p><strong>Results: </strong>A total of 770 pediatric orthopaedic physicians were identified. The median [interquartile range] wRCR was 15.6 [4.9 to 54.2], and median mRCR was 1.4 [1.0 to 1.9]. Multivariable squares regression for wRCR showed an independently increased wRCR associated with male sex (39.11), PhD (23.32), years since receiving national provider identifier (4.51), and northeast region (48.44). However, these trends were not notable for mRCR where only southeast region was notable.</p><p><strong>Conclusion: </strong>Although each has its caveats, both mRCR and wRCR have a place in evaluating an author's publication history and other research metrics. Furthermore, it is important to know the overall research metrics within a field to allow for inter- and intraspecialty comparisons. Understanding RCR is helpful because it allows for new comparisons within and across fields and career lengths.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856512","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":"Risk Factors for Complications in Reconstructing Congenital Femoral Deficiency.","authors":"Gholam Hossain Shahcheraghi, Mahzad Javid, Amin Nemati","doi":"10.5435/JAAOS-D-24-00090","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00090","url":null,"abstract":"<p><strong>Background: </strong>Congenital femoral deficiency (CFD) is a rare condition, often associated with other skeletal anomalies that make the management more difficult. This study aimed to present the risk factors associated with complications in reconstruction of CFD.</p><p><strong>Methods: </strong>This was a retrospective cohort study on patients with CFD who underwent femoral reconstruction between 2002 and 2022, from a single center. The preoperative demographic data, lengthening characteristics, complications, and the predisposing conditions were documented.</p><p><strong>Results: </strong>Thirty-four patients (24 Aitkin A and 10B CFD cases) had 39 lengthening procedures. Twelve cases had simultaneous leg lengthening for associated fibular hemimelia. The mean achieved length was 10.15 ± 3.89 cm, with 72.73 ± 56.19 months follow-up. Although each procedure had 1.8 ± 1.02 complications, 35.8% bowing of regenerate bone and 28.2% fracture; 17.9% hip and 7.7% knee instability were some of the major ones. Hip instability observed in 7 (17.9%) corelated with Aitken type of CFD, preoperative acetabular index, femoral length discrepancy, and achieved length. Bowing in regenerate bone and poor bone consolidation of 15.4% correlated with simultaneous tibial and femoral lengthening (P = 0.018) and higher initial leg-length discrepancy (P = 0.006). The age at reconstruction did not correlate with the number of complications or healing index (P = 0.68, P = 0.15). Five cases received second-time lengthening. Spanning the knee with fixator during lengthening had no notable association with knee instability.</p><p><strong>Conclusion: </strong>Femoral reconstruction in CFD is a challenging but effective task, with joint instability, bowing, fracture, and poor consolidation as potential adverse effects that correlate with simultaneous fibular hemimelia treatment besides the achieved length.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856534","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":"Surgical Trends in Use of Lumbar Disk Arthroplasty Versus Lumbar Fusion From 2010 to 2021.","authors":"Mitchell K Ng, Patrick P Nian, Jayson Saleet, Paul G Mastrokostas, Ariel N Rodriguez, Ameer Tabbaa, Jad Bou Monsef, Afshin E Razi","doi":"10.5435/JAAOS-D-24-00571","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00571","url":null,"abstract":"<p><strong>Introduction: </strong>Lumbar disk arthroplasty (LDA) is a relatively novel procedure with limited indications and use in the United States, especially relative to lumbar fusion (LF). This study aimed to determine surgical trends between LDA versus LF over the past 10 years to quantify absolute/relative surgical volume over time and compare baseline patient demographics, readmission, 2-year revision rates, and costs-of-care.</p><p><strong>Methods: </strong>A total of 714,268 patients were identified from a nationwide database who underwent LF (n = 710,527) or LDA (n = 3,741) from 2010 to 2021. The percentage of patients managed by each surgical procedure was calculated overall and subdivided annually. Baseline demographics were compared between surgical groups, comparing postoperative readmission rates and 2-year revision rates. Linear regression modeling was done to evaluate trends/differences in procedural volume by year.</p><p><strong>Results: </strong>Beginning in 2010 to 2011, LDA constituted 1.0% of procedures, before the number/proportion of LDA procedures to LF has slowly dropped (1% in 2010 to 0.6% in 2021, P > 0.05). Patients undergoing LDA were younger (42.7 vs. 60.9 years, P < 0.0001) with a higher male proportion (50.9 vs. 42.8, P < 0.0001) and a lower Elixhauser Comorbidity Index (2.5 vs. 4.6, P < 0.0001). Patients undergoing LDA had lower rates of readmission (3.8 vs. 7.6%, P < 0.0001). Both LDA and LF average same-day reimbursements elevated sharply from 2010 to 2015 before decreasing to values lower than initially at 2010, with LF demonstrating a greater reduction in costs ($10,600 vs. $2,600, P < 0.05), although LDA remains cheaper ($2,900 vs. $5,300, P < 0.05).</p><p><strong>Conclusion: </strong>The surgical volume of LDA has remained steady while dropping in proportion relative to LF over the past decade. Although patients undergoing LDA are younger and have both fewer baseline demographic comorbidities and lower readmission rates, surgeons remain hesitant to perform this procedure over LF.</p><p><strong>Study design: </strong>Retrospective Cohort Study, Level III Evidence.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856544","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":"Can Artificial Intelligence Deceive Residency Committees? A Randomized Multicenter Analysis of Letters of Recommendation.","authors":"Samuel K Simister, Eric G Huish, Eugene Y Tsai, Hai V Le, Andrea Halim, Dominick Tuason, John P Meehan, Holly B Leshikar, Augustine M Saiz, Zachary C Lum","doi":"10.5435/JAAOS-D-24-00438","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00438","url":null,"abstract":"<p><strong>Introduction: </strong>The introduction of generative artificial intelligence (AI) may have a profound effect on residency applications. In this study, we explore the abilities of AI-generated letters of recommendation (LORs) by evaluating the accuracy of orthopaedic surgery residency selection committee members to identify LORs written by human or AI authors.</p><p><strong>Methods: </strong>In a multicenter, single-blind trial, a total of 45 LORs (15 human, 15 ChatGPT, and 15 Google BARD) were curated. In a random fashion, seven faculty reviewers from four residency programs were asked to grade each of the 45 LORs based on the 11 characteristics outlined in the American Orthopaedic Associations standardized LOR, as well as a 1 to 10 scale on how they would rank the applicant, their desire of having the applicant in the program, and if they thought the letter was generated by a human or AI author. Analysis included descriptives, ordinal regression, and a receiver operator characteristic curve to compare accuracy based on the number of letters reviewed.</p><p><strong>Results: </strong>Faculty reviewers correctly identified 40% (42/105) of human-generated and 63% (132/210) of AI-generated letters (P < 0.001), which did not increase over time (AUC 0.451, P = 0.102). When analyzed by perceived author, letters marked as human generated had significantly higher means for all variables (P = 0.01). BARD did markedly better than human authors in accuracy (3.25 [1.79 to 5.92], P < 0.001), adaptability (1.29 [1.02 to 1.65], P = 0.034), and perceived commitment (1.56 [0.99 to 2.47], P < 0.055). Additional analysis controlling for reviewer background showed no differences in outcomes based on experience or familiarity with the AI programs.</p><p><strong>Conclusion: </strong>Faculty members were unsuccessful in determining the difference between human-generated and AI-generated LORs 50% of the time, which suggests that AI can generate LORs similarly to human authors. This highlights the importance for selection committees to reconsider the role and influence of LORs on residency applications.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856459","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":"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":"https://doi.org/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":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","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":"Training in Lumbar Pedicle Screw Instrumentation Using a 3D-Printed Model: From Validation to Transferability Onto a Cadaver Model.","authors":"Byron Delgado, Mauricio Campos, Daniel Lobos, Jorge Cuéllar, Cristian Ruz, Pablo Besa, Javier Castro, Catalina Vidal","doi":"10.5435/JAAOS-D-24-00699","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00699","url":null,"abstract":"<p><p>Lumbar pedicle screw placement in spinal surgery is complex and prone to errors, with notable risks to patients. Standard training methods, such as mentorship in operating rooms, pose safety concerns, prompting the need for alternative training tools. This study aimed to validate and use a three-dimensional (3D)-printed simulation model for lumbar pedicle screw insertion training and assess its effectiveness compared with standard methods. The study proceeded through four phases: model design and validation, construct validation, learning curve assessment, and transfer to a cadaver model. A 3D-printed lumbar spine model was created and refined based on expert feedback. Construct validation demonstrated the model's ability to differentiate between experts and novices. Training sessions with residents showed a notable improvement in performance over multiple attempts, but performance still lagged that of experts. However, skills learned on the simulation model were effectively transferred to a cadaver model, with no notable difference in performance observed. The trained group outperformed a control group trained using standard methods in the cadaver test. The study concludes that the 3D-printed simulation model is a valid training tool for lumbar pedicle screw insertion, effectively transferring skills to a cadaver setting and improving resident performance compared with standard training methods. Additional research is warranted to explore the sustainability of acquired skills and optimize training protocols.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856560","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":"Heterotopic Ossification After Shoulder Arthroplasty: A Systematic Review.","authors":"Fahad A Nadeem, Caleb V Hayes, James R Jones, Mathew D Hargreaves, Eugene W Brabston, Aaron J Casp, Amit M Momaya, Thomas B Evely","doi":"10.5435/JAAOS-D-24-00063","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00063","url":null,"abstract":"<p><strong>Introduction: </strong>Shoulder arthroplasty is increasing in incidence over time. One potential complication that is not well studied following shoulder arthroplasty is heterotopic ossification (HO), the abnormal growth of extraskeletal bone in soft tissue. HO has been described as a complication in total hip arthroplasty literature but less described in the setting of shoulder arthroplasty. The aim of this systematic review is to present available evidence regarding the incidence, risk factors, and potential management of HO after shoulder arthroplasty.</p><p><strong>Methods: </strong>A systematic search was conducted in June 2023 using Pubmed, Embase, and Ovid Medline databases to retrieve all relevant studies evaluating the occurrence of HO after shoulder arthroplasty. The search was done in duplicate, and a quality assessment of all studies was included.</p><p><strong>Results: </strong>A total of 170 studies were retrieved, of which 6 were included, involving 1,028 patients undergoing shoulder arthroplasty with 1,038 operated shoulders. HO developed postoperatively in 28% of the included shoulders and was symptomatic in 12% with most cases occurring in shoulders that developed osteoarthritis and cuff tear arthropathy. Men appear to have an increased risk of developing HO post shoulder arthroplasty. Fewer than 2% of HO shoulders went on to have revision surgery, and no notable differences were observed in the postoperative mean elevation and external rotation angles of non-HO and HO shoulders. In addition, no reported benefit of the use of nonsteroidal anti-inflammatory drugs was found against the formation of HO after shoulder arthroplasty.</p><p><strong>Conclusion: </strong>HO occurs in 28% of shoulder arthroplasties in our review. Most of these were asymptomatic in the reviewed articles. Male patients and revision surgery with osteoarthritis and cuff tear arthroplasty seem to be at higher risk of developing HO post shoulder arthroplasty. Nonsteroidal anti-inflammatory drugs seem to not prevent the development of HO after shoulder arthroplasty; yet, future studies are needed to verify this claim.</p><p><strong>Level of evidence: </strong>Level III; Systematic Review.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814852","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":"Journey of International Medical Graduates Toward Orthopaedic Surgery Residency in the United States.","authors":"Pablo Sanchez-Urgelles, Suleiman Y Sudah, Joaquin Sanchez-Sotelo, Mariano E Menendez","doi":"10.5435/JAAOS-D-24-00761","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00761","url":null,"abstract":"<p><p>International medical graduates (IMGs) are integral to the US healthcare system but are scarce in orthopaedic residency classes. Positive contributions of IMGs to the field of orthopaedic surgery in the United States are well documented, but successfully matching into an orthopaedic residency position as an IMG remains very challenging. The purpose of this study was to review current processes, strategies, and potential barriers of IMGs applying for orthopaedic surgery residency in the United States as an IMG.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814862","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":"Factors Associated With Increased Sex Diversity in Orthopaedic Trauma Association-Accredited Fellowship Training.","authors":"Jason Silvestre, Nazanin Kermanshahi, Jaimo Ahn, Mitchel B Harris, Niloofar Dehghan","doi":"10.5435/JAAOS-D-24-00457","DOIUrl":"https://doi.org/10.5435/JAAOS-D-24-00457","url":null,"abstract":"<p><strong>Introduction: </strong>This study quantifies the state of sex diversity in orthopaedic trauma training and analyzes fellowship program characteristics associated with greater sex diversity among trainees. We hypothesized that greater sex diversity among orthopaedic trauma fellows would be associated with the presence of female faculty.</p><p><strong>Methods: </strong>This was a retrospective, cross-sectional study of orthopaedic trauma faculty (2023 to 2024) and fellows (2009 to 2024). A trainee analysis for orthopaedic trauma fellows was done relative to orthopaedic surgery residents and allopathic medical students. Fellowship program characteristics associated with increased sex diversity among fellows were elucidated with chi square tests. Temporal analyses were done with linear regression.</p><p><strong>Results: </strong>Overall, 1,266 orthopaedic trauma fellows and 200 were female (15.8%). Sex diversity in orthopaedic trauma fellowships was similar to orthopaedic surgery residency programs (14.2%, P = 0.135) but less than allopathic medical schools (47.5%, P < 0.001). Female representation in orthopaedic trauma fellowship training increased over the study period (9.1% vs. 31.5%, P < 0.001); 349 orthopaedic trauma faculty at 65 orthopaedic trauma fellowships and 41 were female (11.7%). Of the 65 fellowship program directors, only four were female (6.2%). The presence of female faculty was associated with greater sex diversity among orthopaedic trauma fellows (P = 0.017). Additional program characteristics, like geographic region, accreditation status, and number of faculty, were not associated with greater sex diversity.</p><p><strong>Discussion: </strong>Sex diversity is increasing in orthopaedic trauma fellowship training and is associated with the presence of female faculty. Efforts to mentor and recruit female trainees in orthopaedic trauma fellowship training may lead to greater workforce diversity in orthopaedic trauma.</p>","PeriodicalId":51098,"journal":{"name":"Journal of the American Academy of Orthopaedic Surgeons","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814850","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}