Bulletin of the Hospital for Joint Disease (2013)最新文献

{"title":"Validation of imageless navigation in total knee arthroplasty using a postoperative radiographic approach.","authors":"Michelle A Zabat, Benjamin Fiedler, Jeffrey M Muir, Scott E Marwin, Morteza Meftah, Ran Schwarzkopf","doi":"10.1097/bh9.0000000000000027","DOIUrl":"10.1097/bh9.0000000000000027","url":null,"abstract":"<p><strong>Introduction: </strong>The integration of computer-assisted navigation systems (CASs) in total knee arthroplasty (TKA) procedures has gained popularity in recent years. However, additional validation of the accuracy of CAS feedback is necessary. We used short-length and full-length postoperative radiographs to quantify the differences between alignment parameters measured by a novel imageless CAS and alignment outcomes as evidenced on postoperative radiographs.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on prospectively collected data from a cohort of patients undergoing navigated primary TKA. Fifty-eight patients had met inclusion criteria, and intraoperative CAS measurements were obtained from device recordings. Alignment parameters were measured digitally and included femorotibial angle on short-length films and hip-knee-ankle axis, mechanical lateral distal femoral angle (mLDFA), and mechanical medial proximal tibial angle (mMPTA) on full-length films. These were compared between CAS and radiograph measurements using a 2-tailed t test.</p><p><strong>Results: </strong>The mean mLDFA measured by the CAS was 0.7° ± 1.1°, compared with 1.3° ± 1.4° as measured on full-body radiographs (P = .1). The mean mMPTA measured by the CAS was 0.2° ± 1.0°, compared with 0.9° ± 1.4° as measured on full-body radiographs (P = .06). On average, radiograph and CAS measurements differed by 0.5° ± 1.5° for mLDFA and 0.7° ± 1.5° for mMPTA. The average postoperative hip-knee-ankle axis was 177.6° ± 2.1°, and the average femorotibial angle was 176.0° ± 9.6° as measured on radiographs.</p><p><strong>Conclusion: </strong>No significant differences in either average or individual measured values for mLDFA or mMPTA were observed between the intraoperative CAS measurements and alignment outcomes postoperatively. Our data highlight the clinical utility of CASs to accurately achieve intended TKA alignment objectives.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"156-161"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121518","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 effect of a total hip arthroplasty bundled payment program on perioperative smoking and obesity.","authors":"Matthew S Galetta, Mackenzie A Roof, Shengnan Huang, Oren Feder, Lorraine Hutzler, James D Slover, Joseph A Bosco","doi":"10.1097/bh9.0000000000000034","DOIUrl":"10.1097/bh9.0000000000000034","url":null,"abstract":"<p><strong>Introduction: </strong>Medicare's Bundled Payments for Care Initiative is a risk-sharing, value-based alternative payment model. As such, Medicare providers are financially responsible for poor outcomes, potentially disincentivizing operating on high-risk individuals, including obese patients and smokers. We sought to describe the change in these modifiable risk factors among Medicare, Medicaid, and commercially insured patients in the 6-year period after implementation of Bundled Payments for Care Initiative.</p><p><strong>Methods: </strong>We analyzed a consecutive series of 11,790 patients who underwent total hip arthroplasty between January 1, 2013, and August 31, 2019. We categorized patients based on smoking status (current, former, or never) and body mass index (BMI; obese if BMI was >30 kg/m2, morbidly obese if BMI was >40 kg/m2, and superobese if BMI was >50 kg/m2). Correlations between each year's proportion of patients in each smoking category and obesity category were evaluated.</p><p><strong>Results: </strong>We included 11,582 patients with complete demographic and insurance information. There was a statistically significant decrease in the proportion of Medicare patients who were active smokers (7.91% in 2013, 5.99% in 2019, Pearson correlation coefficient = -0.759, P = .048). When looking at patients with BMI >40 kg/m2, commercially insured patients significantly increased (3.64% in 2013, 6.65% in 2019, Pearson correlation coefficient = 0.860, P = .013). Our study also demonstrated a significantly higher rate of active smokers among Medicaid patients compared with other insurance groups (P = .001), which is consistent with the general population.</p><p><strong>Discussion: </strong>Our results demonstrated that the proportion of Medicare-insured patients who were active smokers decreased significantly over the study period. In addition, the proportion of obese commercially insured patients increased, but the proportion of obese Medicare patients did not. These findings suggest the possibility that surgeons may be disincentivized to operate on both obese patients and those who are actively smoking who are enrolled in risk-sharing, value-based programs. Notably, we found a potential trickle-down effect to Medicare patients with our smoking cessation program. The same was not observed for patients with Medicaid or Commercial insurance or for weight reduction before surgery for any insurance group. A possible explanation is that obesity is not as modifiable as smoking and increased efforts to address obesity in the arthritis population are needed.</p><p><strong>Level of evidence: </strong>III, retrospective observational analysis.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"179-184"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121423","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":"Don't be sidelined: Winning strategies for care of the para athlete.","authors":"Hayley Sacks, Mara Karamitopoulos","doi":"10.1097/bh9.0000000000000004","DOIUrl":"10.1097/bh9.0000000000000004","url":null,"abstract":"<p><strong>Abstract: </strong>The aim of this study was to provide a review for orthopedic surgeons on the care of para athletes. The article focuses on common patient populations that present to orthopedic surgeons, including individuals with spinal cord injuries and related disorders, limb deficiencies, and neuromuscular conditions. The most common types of injuries affecting these para athletes will be discussed, as well as strategies for injury prevention and treatment. This review article also dives into the historical origins of para sports and discusses how treatment can potentially influence classification levels for para athletes. Orthopedic surgeons should encourage their patients with disabilities to participate in para sports, understand the types of injuries they may be at risk of based on disability and sports-specific factors, and work to help keep para athletes successfully competing in the sports they love.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"23-28"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121197","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":"Crutch use for 4 weeks vs. 1 week after hip arthroscopy for femoroacetabular impingement: A pseudorandomized clinical trial with 6-month follow-up.","authors":"Dhruv S Shankar, Edward S Mojica, Anna M Blaeser, Kinjal D Vasavada, Andrew S Bi, Thomas Youm","doi":"10.1097/bh9.0000000000000020","DOIUrl":"10.1097/bh9.0000000000000020","url":null,"abstract":"<p><strong>Background: </strong>The purpose of our study was to compare patient-reported outcomes at 6-month follow-up between primary hip arthroscopy patients who were partial weight bearing on crutches for 4 weeks vs. 1 week postoperatively.</p><p><strong>Methods: </strong>We conducted a pseudorandomized clinical trial involving patients who underwent arthroscopic treatment of femoroacetabular imipingement at a single center from September 2020 to April 2021. Subjects aged 18-65 years old were alternately assigned to one of the 2 rehabilitation regimens involving either 4-week or 1-week partial weight bearing on crutches. Subjects completed the modified Harris Hip Score (mHHS) and Nonarthritic Hip Score (NAHS) surveys before surgery and at 6-month follow-up. Achievement of the minimum clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) was assessed using published mHHS cutoff values. Outcomes were compared between groups with the Mann-Whitney U test and analysis of covariance, while MCID, SCB, and PASS rates were compared with the Fisher exact test. P-values < .05 were considered significant.</p><p><strong>Results: </strong>Fifty patients were included in the study of whom 28 (56.0%) were assigned to 4-week crutch use and 22 (44.0%) to 1-week crutch use. The 4-week crutch use group was significantly older on average (38.4 vs. 32.1 years, P = .03) and had significantly higher mean body mass index (27.6 vs. 24.5, P = .01), but there were no significant baseline differences between the 2 groups (P > .05). After adjusting for age and body mass index, there was no significant difference in preoperative to postoperative improvement in mHHS (P = .43) or NAHS (P = .46) between the 2 groups at 6-month follow-up. Furthermore, there were no significant differences in achievement rates for MCID (P = .50), SCB (P = .51), or PASS (P = .77) between the 2 groups.</p><p><strong>Conclusion: </strong>We identified no significant differences in improvement of mHHS and NAHS or achievement of the MCID, SCB, or PASS at 6-month follow-up between patients on crutches for 4 weeks vs. 1 week postoperatively.</p><p><strong>Level of evidence: </strong>II, Pseudorandomized clinical trial.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"129-134"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121099","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":"Orthopedic manifestations, complications, and outcomes for arthroplasty in patients with Parkinson disease.","authors":"Aidan G Papalia, Paul V Romeo, Lily Khabie, Matthew G Alben, Mandeep S Virk, Joseph D Zuckerman","doi":"10.1097/bh9.0000000000000025","DOIUrl":"10.1097/bh9.0000000000000025","url":null,"abstract":"<p><strong>Abstract: </strong>Parkinson disease (PD) is the second most common neurodegenerative disorder in the United States. Despite its rapid increase in prevalence over recent years, there remains a paucity of literature examining the optimal orthopedic management of populations affected by PD and the risk of complications. In this review, we provide insight into the pathophysiology, etiology, manifestations, and orthopedic management of PD, with an emphasis on adult reconstruction. Although limited outcome studies suggest that joint replacement may consistently offer improvement in pain, there is an increased risk of complications and reoperation, with significant functional improvement often being unpredictable.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"90-96"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121212","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":"Superior clavicle plating using low-profile, precontoured locking plates has low complication and low hardware removal rate.","authors":"Abhishek Ganta, Sanjit R Konda, Kenneth A Egol","doi":"10.1097/bh9.0000000000000024","DOIUrl":"10.1097/bh9.0000000000000024","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to describe our experience using superiorly applied low-profile locking plates for the operative fixation of displaced midshaft clavicle fractures (MCFs).</p><p><strong>Study design: </strong>This was a retrospective analysis performed at an academic institution.</p><p><strong>Results: </strong>Eighty-three patients who presented with displaced, shortened MCFs were treated operatively by a single surgeon at our institution over a 10-year period. All patients received a precontoured low-profile locking plate applied in the superior position. A displaced midshaft clavicle fracture was fixed operatively using a precountered low-profile 2.7/3.5 mm locking plate applied in the superior position. Data were analyzed to evaluate time to union, final shoulder range of motion, incidence of hardware removal, and rate of postoperative complications. The cohort was 66.2% male with an average age at initial injury of 36.5 ± 14.1 years. At a mean of 3.6 ± 1.9 months, 99% of patients had united their fracture. At an average of 7.37-month follow-up, mean range of motion was 174° forward elevation, 173° abduction, 82° external rotation, and internal rotation to T7. Using the short musculoskeletal functional assessment (SMFA), the mean functional outcome index score was 4.12, bothersome index was 1.94, activity index was 1.55, emotion index was 2.51, arm and hand index was 1.14, mobility index was 0.68, and total index was 1.56. Ninety-two percent of patients had retained their hardware. There was 1 incidence of each of the following complications: infection, nonunion, hardware failure, and deep vein thrombosis.</p><p><strong>Conclusion: </strong>Superior clavicle plating using precontoured low-profile locking plates is an acceptable treatment modality for displaced MCF. This method yields excellent results regarding time to union, shoulder range of motion, incidence of hardware removal, and the rate of postoperative complications. Patients considering operative fixation of displaced MCF should be counseled accordingly.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"146-149"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121282","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 COVID rebound effect: Incidence of tendon rupture surgeries in the peripandemic COVID era in a single tertiary academic institution.","authors":"Andrew S Bi, Nina D Fisher, Charles C Lin, Guillem Gonzalez-Lomas, Eric J Strauss, Michael J Alaia, Laith M Jazrawi","doi":"10.1097/bh9.0000000000000029","DOIUrl":"10.1097/bh9.0000000000000029","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to increased sedentary behavior and body mass index during 2020, which may decondition musculotendinous units and lead to increased risk for injury. As patients return to pre-COVID levels of activity, we hypothesize that there will be a resultant rebound increase in tendon ruptures.</p><p><strong>Level of evidence: </strong>III, descriptive epidemiology study.</p><p><strong>Methods: </strong>The electronic medical record was queried for current procedural terminology codes for tendon ruptures (Achilles, patella, quadriceps, hamstring, distal biceps, triceps, and pectoralis major) from January 2017 to December 2021 at a single academic urban center. Data were reviewed to ensure only acute tendon rupture repairs were included. The years 2017-2019 were used as a proxy for pre-COVID rates, 2020 as a proxy for the COVID quarantine, and 2021 as a proxy for \"post-COVID\" activity. Univariate analysis was performed for comparative data.</p><p><strong>Results: </strong>A total of 1,879 patients (82.8% male, mean age 47.8 years) who sustained tendon injuries and underwent surgical repair were identified. There were 589 (31.3%) Achilles tendon repairs, 181 (9.6%) patella tendon repairs, 414 (22.0%) quadriceps tendon repairs, 100 (5.3%) hamstring tendon repairs, 397 (21.1%) distal biceps repairs, 105 (5.6%) triceps repairs, and 93 (4.9%) pectoralis tendon repairs. The total number of tendon injuries per year was 2017-357 (19.0%), 2018-380 (20.2%), 2019-380 (20.2%), 2020-308 (16.4%), and 2021-454 (24.2%). The rates in 2017, 2018, and 2019 were within 1% of each other, but there were a 3.8% decrease in rate of tendon injuries from 2019 to 2020 and a 7.8% increase in rate of tendon injuries from 2020 to 2021. When analyzed by quarter, a linear regression model demonstrated a statistically significant increase in case counts over the period from Q2 2020 to Q2 2021 (β = 21.20; 95% confidence interval = 13.62-28.78, P-value < .01).</p><p><strong>Conclusions: </strong>A \"COVID rebound\" of tendon rupture repairs in 2021 from a prolonged period of inactivity during 2020 occurred at a single academic center. As patients return to pre-COVID levels of activity that may be unsuitable to their deconditioned state, healthcare providers should counsel patients appropriately on return to activity or sport following long periods of induced inactivity.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"166-171"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121441","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":"Scapholunate ligament injuries in the nonarthritic wrist.","authors":"Matthew V Abola, Michele Cerasani, Omri Ayalon, Jacques H Hacquebord","doi":"10.1097/bh9.0000000000000002","DOIUrl":"10.1097/bh9.0000000000000002","url":null,"abstract":"<p><strong>Abstract: </strong>The scapholunate ligament (SLL) is a critical stabilizer of the wrist joint. Disruption of the SLL leads to altered wrist kinematics, including scaphoid flexion, lunate extension, and increased stress on surrounding cartilage and ligaments, which can progress to dorsal intercalated segment instability and scapholunate advanced collapse. Despite predictable biomechanical changes, clinical outcomes vary widely because some patients develop significant functional limitations, whereas others remain asymptomatic. Nonoperative management, including immobilization, therapy, and bracing, remains the first-line treatment for partial tears or stable injuries. Surgical intervention, such as SLL repair with capsulodesis or reconstruction, is indicated for cases with persistent pain, instability, or functional deficits. Capsulodesis is a commonly used adjunct to SLL repair. Multiple surgical techniques exist for SLL repair in the acute setting and for reconstruction in the chronic setting when SLL is deemed irreparable. Although several surgical techniques are available for chronic injuries, a gold standard has not yet been established.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"7-14"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-based differences in outcomes after surgical management of patellar instability.","authors":"Danielle H Markus, Eoghan T Hurley, Andrew S Bi, Edward S Mojica, Kirk A Campbell, Eric J Strauss","doi":"10.1097/bh9.0000000000000021","DOIUrl":"10.1097/bh9.0000000000000021","url":null,"abstract":"<p><strong>Background: </strong>The purpose was to investigate whether pain, function, satisfaction, or return to play (RTP) differs between sexes postoperatively in those undergoing medial patellofemoral ligament (MPFL) reconstruction for patellar instability.</p><p><strong>Methods: </strong>A review of patients who underwent an MPFL reconstruction for patellar instability was performed. Kujala score, visual analogue scale (VAS), patient satisfaction, willingness to undergo surgery again, revisions, RTP, and MPFL-return to sport after injury (MPFL-RSI) score were evaluated. Clinical outcomes were compared between sexes.</p><p><strong>Results: </strong>Our study included 141 knees that underwent MPFL reconstruction, and the population was 69.5% female. Postoperatively, the mean VAS score at rest was 1.0 ± 1.7 in male patients and 1.6 ± 2.1 in female patients (P = .0963). The mean Kujala score was 88.8 ± 13.3 and 83.5 ± 16.1 for male and female patients, respectively (P = .1062). Overall, there was a significant difference in RTP, with male patients returning at higher rates (58.1 vs. 33.3%, P = .0479). The mean VAS score during activity was significantly lower in male patients at 1.8 compared with female patients at 3 (P = .016). The MPFL-RSI score was also significantly worse in female patients (69.5 vs. 55.6, P = .0098). Although female patients had slightly higher rates of recurrent subjective instability (14.3 vs. 11.7%) and re-dislocation (2 vs. 0%), the difference was not statistically significant (P > .05).</p><p><strong>Conclusion: </strong>Female patients had worse clinical outcomes than male patients undergoing MPFL reconstruction for patellar instability, with significantly lower rates of RTP, VAS score during sport, and MPFL-RSI scores with a trend toward lower Kujala score and VAS score.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"135-138"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121288","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":"Readability analysis of AAOS and ASSH shoulder and elbow patient education online content: A 9-year follow-up study.","authors":"Connor Parry, Teresa Veselack, Matthew Doscher, Bryan G Beutel","doi":"10.1097/bh9.0000000000000030","DOIUrl":"10.1097/bh9.0000000000000030","url":null,"abstract":"<p><strong>Abstract: </strong>Given the progressive spread of medical misinformation, access to understandable educational content from trusted sources has become increasingly more crucial for patients. Online patient education materials, particularly from specialty organizations, have been criticized for being too complex for the average reader. It is advised that this information be at or below the 6th-grade reading level. This study is a 9-year follow-up to an analysis conducted in 2013 which evaluated the overall readability of educational articles from the American Academy of Orthopaedic Surgeons (AAOS) and American Society for Surgery of the Hand (ASSH) websites related to shoulder and elbow conditions. In the current investigation, 74 shoulder and elbow articles were assessed using the same methodology, which included analyzing the number of years since their last update, word count, percentage of passive sentences, Flesch Reading Ease score, Flesch-Kincaid grade level, Simple Measure of Gobbledygook (SMOG) grade, and New Dale-Chall grade level. No articles from either site were at or below the recommended 6th-grade reading level. Those from the AAOS were longer than those from the ASSH (P < .001). The articles had a mean Flesch Reading Ease score of 53.8 vs. 58 (P = .01), Flesch-Kincaid grade level of 9.6 vs. 9.4, SMOG grade of 8.9 vs. 8.6, and New Dale-Chall grade of 10.5 vs. 10.1 for the AAOS and ASSH sites, respectively. Although no significant differences in the readability measures were noted between the 2013 and current AAOS articles, the current ASSH content had a significantly higher Flesch Reading Ease score (P = .01) and significantly lower Flesch-Kincaid (P = .04), SMOG (P = .03), and New Dale-Chall (P = .03) grade levels, than their 2013 counterparts. Although improvements have been made in the shoulder and elbow articles from the ASSH, there remains a need to further improve the readability of AAOS and ASSH online materials to better ensure adequate patient education.</p>","PeriodicalId":72481,"journal":{"name":"Bulletin of the Hospital for Joint Disease (2013)","volume":"83 1","pages":"172-178"},"PeriodicalIF":0.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146121292","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}