Advances in Orthopedics最新文献

{"title":"Preoperative Anaemia Increases the Likelihood of 1-Year Mortality After Hip Fracture.","authors":"Helena Ferris, Gavin Sedgwick, Mitchell Marnane, Sean Clarke, Ann Dwyer, Georgia Merron, Tara Coughlan","doi":"10.1155/aort/5526883","DOIUrl":"10.1155/aort/5526883","url":null,"abstract":"<p><p><b>Background:</b> Preoperative anaemia has been shown to increase the risk of adverse outcomes following hip fracture. To date, the association between haemoglobin (Hb) on admission and longer-term outcomes has not been studied extensively in the Irish hip fracture population. This study aimed to ascertain the mean Hb on admission and investigate the relationship with 1-year mortality. <b>Methods:</b> A retrospective review of all hip fracture cases in older adults discharged from an Irish urban trauma centre over a 4-year period was conducted. Hb on admission was obtained using electronic patient records. Mortality status was obtained via the Inpatient Management System and correlated with the Irish Death Events Register. Logistic regression was performed on a range of routinely collected patient and care pathway variables. <b>Results:</b> A total of 833 patients were included. Mean Hb on admission was 12.1 g/dL (SD 1.7), with 11.4% (95/833) of patients having a Hb ≤ 10 g/dL. Within 1 year of fracture 20.5% (171/833) of patients had died. On multivariate analysis, those with a Hb ≤ 10 g/dL on admission were 76% more likely to die within one year (OR 1.76, <i>p</i> < 0.02, 95% CI 1.07-2.90) compared to those with a Hb ≥ 10.1 g/dL. Patients admitted from a nursing home were also more likely to die within 1 year (OR 2.09, <i>p</i> < 0.001, 95% CI 1.26-3.45), compared to those admitted from home. Early postoperative mobilisation (OR 0.32, <i>p</i> < 0.001, 95% CI 0.22-0.48) and female gender (OR 0.49, <i>p</i> < 0.001, 95% CI 0.34-0.71) reduced the likelihood of 1-year mortality (AUC 0.71). <b>Conclusion:</b> Anaemia is common in hip fracture patients and may be viewed as a surrogate marker of frailty. In this cohort, Hb ≤ 10 g/dL on admission was a statistically significant predictor of 1-year mortality. Recognising and managing anaemic patients preoperatively may provide an opportunity to improve longer-term outcomes in hip fracture patients.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"5526883"},"PeriodicalIF":1.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794413","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":"Minimally Invasive Surgical Technique for the Extraperitoneal Fixation of Acetabulum Fracture: Technical Feasibility Study in Cadaver.","authors":"Piia Suomalainen, Essi Honkonen, Sami Nurmi, Anu Välikoski, Antti Siiki","doi":"10.1155/aort/2914086","DOIUrl":"10.1155/aort/2914086","url":null,"abstract":"<p><p><b>Background and Objectives:</b> When operating on acetabular fractures in conventional open surgery, visualization of crucial structures can be challenging. In recent years there have been several case reports on laparoscopy-assisted acetabulum surgery in the literature. Therefore, we have developed this method further using extraperitoneal endoscopy to manage acetabulum fractures. <b>Methods:</b> Operative technique: An experienced hernia surgeon familiar with the totally extraperitoneal laparoscopic technique facilitates access to the acetabulum area so that orthopaedic surgeons can focus on fixing the area with a plate and screws through laparoscopy ports. <b>Results:</b> We developed this operative technique in a cadaver laboratory where we could easily fix and plate the acetabulum area with extraperitoneal endoscopy visualization in seven cadavers both on the left and right sides. <b>Conclusions:</b> A minimally invasive full endoscopic procedure for acetabular fractures offers significant benefits over traditional open surgery due to faster rehabilitation, potentially less blood loss, and fewer wound complications. According to our initial experiences with cadavers, this minimally invasive method appears promising in terms of superior visibility and easier access to the otherwise narrow and difficult fracture site in the pelvic region compared to open surgery. Furthermore, this minimally invasive method seems feasible for exact plate placement under combined endoscopic and fluoroscopic visual control. The usefulness of this novel method in the minimally invasive treatment of acetabular fractures in real life, especially considering the practicality of proper fracture reduction, should be confirmed in future clinical trials.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"2914086"},"PeriodicalIF":1.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771204","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":"Early Mortality Rate and Associated Risk Factor in Patients Undergoing Primary Total Hip Replacement at a Tertiary Hospital in Tanzania.","authors":"Disha Deograthias Wadosa, Violet Lupondo, Adam Hussein, Jimmy Olomi","doi":"10.1155/aort/4831975","DOIUrl":"10.1155/aort/4831975","url":null,"abstract":"<p><p><b>Background:</b> Hip joint replacement surgery or total hip arthroplasty (THA) is an effective procedure for elderly patients. It can improve their quality of life and functionality while reducing the direct costs associated with arthritis. With increased THA procedures being performed on patients of different ages, it is essential to identify factors that may affect mortality for better patient care. <b>Objective:</b> This study aimed to identify the early mortality rate and potential risk factors among patients undergoing primary total hip replacement (THR) at a tertiary hospital in Tanzania. <b>Methodology:</b> This was a retrospective cohort study conducted from January 2020 to December 2021, which involved patients who had undergone THR. <b>Result:</b> The study involved 183 participants, 53.6% of which were male with a mean age of 55.9 ± 18.4 years. Early mortality (death before 3 months) was found to be 7%. Having hypertension and being seropositive for HIV were independent prognostic factors for survival. Hypertension was associated with an increased chance of death by 4.8 times. The likelihood of death was eleven times higher among participants who were HIV+. <b>Conclusion:</b> Hypertensive patients had an increased chance of death of five times more compared to those with no hypertension. HIV+ patients had an increased chance of death, up to eleven times higher with difference in disease profiles and HIV endemicity in our settings this calls for a different approach to THR.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"4831975"},"PeriodicalIF":1.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11964719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771200","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":"Accuracy of Implant Positioning in Total Hip Arthroplasty via a Supine Direct Anterior Approach Using Fluoroscopy.","authors":"Keijiro Kanno, Shigeo Hagiwara, Yuki Shiko, Yuya Kawarai, Junichi Nakamura, Seiji Ohtori","doi":"10.1155/aort/8892577","DOIUrl":"10.1155/aort/8892577","url":null,"abstract":"<p><p><b>Background:</b> Adequate implantation is important to avoid complications following total hip arthroplasty (THA). This study aimed to evaluate the accuracy and precision of implant placement in the direct anterior approach (DAA) using fluoroscopy in comparison with the anterolateral approach in lateral decubitus position (OCM) using a single implant. <b>Methods:</b> We retrospectively compared propensity score-matched THAs in DAA with fluoroscopy and in OCM. The achievement ratio of the Lewinnek cup safe zone, absolute difference in alignment, and positioning from preoperative planning was evaluated and compared between each approach. <b>Results:</b> 33 patients in both groups were eligible for this study. Significantly more cups were inside the safe zone in the DAA group than in the OCM group (33/33 vs. 25/33, <i>p</i>=0.0048). No significant differences were found between the DAA group and OCM group regarding the discrepancy from the target cup inclination, anteversion, and three-dimensional positioning. No significant difference was noted in stem alignment; however, the equality of coronal alignment variances was smaller in the DAA group (<i>p</i>=0.0047). No significant differences were found in the clinical score and complication rate. <b>Conclusion:</b> The DAA using fluoroscopy may provide more accuracy for cup placement and precision for stem placement than OCM.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"8892577"},"PeriodicalIF":1.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661898","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":"In-Hospital Outcomes of Hip Arthroplasty for Femoral Neck Fractures in Young Adult Patients: A Nationwide Study.","authors":"Hembashima Gabriel Sambe, Urvish Patel","doi":"10.1155/aort/3328450","DOIUrl":"10.1155/aort/3328450","url":null,"abstract":"<p><p><b>Introduction:</b> Femoral neck fractures (FNFs) in young adults are relatively uncommon but pose significant clinical and surgical challenges. Hip arthroplasty is rarely used as a treatment option in this population but has seen rising use over the previous decade. This study seeks to compare hip arthroplasty outcomes among young adult patients in the United States admitted with FNF by evaluating hip hemiarthroplasty (HHA) and total hip arthroplasty (THA). <b>Materials and Methods:</b> Using the National Inpatient Sample (NIS) data, adult patients less than 50 years old who underwent HHA or THA from 2016 to 2020 were analyzed. Both groups' postoperative length of stay (pLOS), total hospital charges, and prosthesis-related complications (PRCs), including mechanical loosening (ML), prosthesis dislocation (PD), and periprosthetic fracture (PPF), were analyzed and compared. <b>Results:</b> Out of 174,776,205 hospitalizations between 2016 and 2020, 15,590 young adult patients had FNF, and 2970 patients (2.18%) underwent hip arthroplasty (1195 HHAs and 1775 THAs). After controlling for demographic, clinical and hospital characteristics, HHA was associated with a 22.4% longer pLOS compared to THA [rate ratio: 1.224, 95% CI: 1.183 to 1.266; <i>p</i> < 0.001]. Patients in the HHA group also had higher odds of PPF (aOR: 9.06, 95% CI: 4.21, 19.48; <i>p</i> < 0.001). Conversely, patients in the THA group had higher odds of PD (aOR: 6.00, 95% CI: 1.78, 20.24; <i>p</i>=0.004). There was no statistically significant difference in total hospital charges between the groups [cost ratio: 1.03, 95% CI: 0.995 to 1.075; <i>p</i>=0.092]. <b>Conclusion:</b> Among young adults with FNF undergoing hip arthroplasty, HHA is associated with a longer postoperative hospital stay and higher risk of PPF as a major early complication, while THA is associated with a higher risk of PD. Financial burden is comparable for both procedure groups. When hip arthroplasty is a preferred treatment for FNFs, individual patient factors are important considerations that should guide the choice of procedure.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"3328450"},"PeriodicalIF":1.2,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11873307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539808","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":"Distal Nerve Transfer for Opponensplasty in the Setting of High Median Nerve Injury: A Case Series.","authors":"Mohammadreza Emamhadi, Mohammad Haghani Dogahe, Amirreza Emamhadi","doi":"10.1155/aort/8481129","DOIUrl":"10.1155/aort/8481129","url":null,"abstract":"<p><p><b>Background:</b> High median nerve injury leads to an absence of thumb opposition and irreversible thenar atrophy. Currently, distal nerve transfer is a new option for opponensplasty. The superiority of nerve transfer over traditional tendon transfer is that in nerve transfer, all thenar muscles may be reinnervated and so thumb functions are fully achieved, while in tendon transfer, the goal is to reanimate the function of abductor pollicis brevis (APB). This study aims to describe the results of opponensplasty using distal nerve transfer. <b>Materials and Methods:</b> This article analyses the results of opponensplasty using the transfer of abductor digiti minimi (ADM) branch of the ulnar nerve to the recurrent branch of the median nerve. Clinical outcomes were assessed by objectively evaluating APB strength, degree of thumb opposition, and thenar muscle bulk. APB strength and degree of thumb opposition measured by Medical Research Council (MRC) and Kapandji scoring systems, respectively. <b>Results:</b> From 2016 to 2019, six patients with a mean age of 29.5 years (five males and one female) with high median nerve injury were considered for opponensplasty using nerve transfer. Clinical improvement, including APB strength regaining and thumb opposition, was achieved in all patients. Moreover, recovery of thenar atrophy was observed in five patients. <b>Conclusion:</b> In high median-nerve injury, early reconstructive intervention can prevent the thenar muscle atrophy and leads to prompt reinnervation and complete restoration of thenar function. ADM branch of the ulnar nerve is a superior donor for this purpose.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"8481129"},"PeriodicalIF":1.2,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825203/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412976","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":"Complex Limb Injuries: Limb Salvage Versus Amputation-A Mini Review and Meta-Analysis.","authors":"Athanasios Serlis, Panagiotis Sgardelis, Themistoklis Vampertzis, Konstantinos Rizavas, Panagiotis Poulios, Georgios Konstantopoulos","doi":"10.1155/aort/2884802","DOIUrl":"10.1155/aort/2884802","url":null,"abstract":"<p><p><b>Introduction:</b> The management of complex limb injuries can be very challenging, and it demands a multidisciplinary approach to treatment. Amputation and limb reconstruction are the two options that clinicians must choose. This study aims to comprehensively synthesize existing tools and resources from the literature that can assist clinicians in the decision-making process. <b>Evaluation:</b> The initial resuscitation and the prehospital care are the first important steps in the management of these injuries, while the immediate transfer to trauma centers is recommended for complex cases. After the stabilization of the patient, a thorough clinical examination of the limb is necessary with emphasis on the degree of soft tissue damage. Blunt trauma in the lower limb is associated with a higher risk of early amputation. Polytrauma patients with complex limb injuries require a holistic approach, with Damage Control Orthopedics (DCO) principles. Traumatic bleeding significantly increases mortality rates, necessitating prompt control using pressure bandages or tourniquets. Computed tomography angiography (CTA) is necessary in order to assess the viability of the limb. <b>Management:</b> Scoring systems can be used as a tool in the management of complex lower and upper limb injuries. Mangled Extremity Severity Score (MESS) calculates ischemia, shock, bone and soft tissue damage, and patient characteristics. The Narakawa Index (NISSSA score) constitutes an alteration of MESS with the implementation of a nerve injury element. The Musculoskeletal Score for Severity of Injury (MESI score) estimates the risk of limb amputation by evaluating injury, neurovascular damage, type of fracture, patient characteristics, and the period from the occurrence of trauma to the definitive treatment. Further interventions and patient preferences should be incorporated into the decision-making process. <b>Outcome:</b> The outcomes of limb salvage versus amputation for complex limb injuries encompass various factors, including patient's preinjury health status, psychological well-being, functional outcomes, and economic impact. While some studies suggest better psychological outcomes with limb reconstruction and others find similar functional outcomes between the two approaches, economic considerations play a significant role in decision-making. <b>Conclusion:</b> Managing complex limb injuries effectively necessitates a comprehensive approach involving thorough assessment, multidisciplinary collaboration, and patient-centered care. Given the diverse factors influencing management and long-term outcomes, it is crucial to integrate medical expertise with patient preferences and expectations.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"2884802"},"PeriodicalIF":1.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11824304/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412972","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":"Exploring the Impact of Preoperative Laboratory Values on Short-Term Outcomes in Complex Carpal Tunnel Decompression Surgery.","authors":"Anitesh Bajaj, Rushmin Khazanchi, Rohan M Shah, Joshua P Weissman, Nishanth S Sadagopan, Arun K Gosain","doi":"10.1155/aort/8494043","DOIUrl":"10.1155/aort/8494043","url":null,"abstract":"<p><p><b>Background:</b> The present study analyzes the effects of preoperative serum albumin, hematocrit, and creatinine on postoperative outcomes in patients undergoing carpal tunnel decompression surgery. <b>Methods:</b> The American College of Surgeons National Quality Improvement Program (NSQIP) database was queried from 2011 to 2020. Albumin, hematocrit, and creatinine were collected for each patient, alongside covariates. Outcomes included 30-day medical complications, 30-day wound complications, return to the operating room, nonhome discharge, and extended postoperative length of stay. Bivariate <i>t</i>-tests and multivariate logistic regressions were conducted. For any outcome-laboratory value pairs with significance on regression, area under the receiver operating characteristic curves (AUC) were constructed. <b>Results:</b> A total of 1440 patients with albumin, 3138 patients with hematocrit, and 3159 patients with creatinine levels were identified. Increased serum albumin was associated with lower odds of medical complications (aOR: 0.479, <i>p</i>=0.035). An overall cohort cutoff of ≤ 3.5 g/dL (AUC: 0.79, <i>p</i> < 0.001) was predictive of medical complications. On multivariate logistic regression, increased hematocrit reduced the odds of medical complications (aOR: 0.889, <i>p</i> < 0.001). Predictive hematocrit cutoffs of ≤ 39.7% (AUC: 0.77, <i>p</i> < 0.001) and ≤ 36.6% (AUC: 0.74, <i>p</i> < 0.001) were identified for medical complications amongst male and female patients, respectively. Similarly, increased serum creatinine was associated with greater odds of medical complications (aOR: 1.684, <i>p</i>=0.006). Creatinine cutoffs of ≥ 1.2 mg/dL (AUC: 0.58, <i>p</i>=0.033) and ≥ 1.0 mg/dL (AUC: 0.59, <i>p</i>=0.039) were identified for medical complications amongst male and female patients, respectively. <b>Conclusions:</b> Multiple preoperative serum values were predictive of postoperative medical complications, and laboratory value thresholds were identified in this carpal tunnel decompression cohort to aid in risk stratification.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"8494043"},"PeriodicalIF":1.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063221","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":"Impact of Weather and Holidays on Orthopedic Emergency Room Crowding, Fractures, and Polytraumas in a Third-Level Referral Trauma Center in Europe.","authors":"Lorenzo Andreani, Edoardo Ipponi, Francesco Pecchia, Giorgio Balestrieri, Edoardo Tosi, Stefano Marchetti, Paolo Domenico Parchi","doi":"10.1155/aort/2970626","DOIUrl":"10.1155/aort/2970626","url":null,"abstract":"<p><p><b>Background:</b> Orthopedic trauma is a significant component of emergency department workloads worldwide. The relationship between weather conditions and injury rates is controversial in modern literature. Even less has been written to investigate bank holidays' influence on contusions, dislocations, fractures, and even polytrauma. Our study aimed to assess whether meteorological factors and national holidays could vary the workloads in the orthopedic ER of a European third-level trauma center. <b>Materials and Methods:</b> Our study consisted of a review of all the patients who underwent orthopedic evaluations in our institution's orthopedic emergency room between 2019 and 2023. Days were divided depending on weather (cloudy or sunny vs. rainy or stormy), day type (regular working days vs. national public holidays vs. Saturdays and Sundays), and presence or absence of COVID-19 restrictions. We also recorded the temperatures of each day. Cases were subdivided into three groups: cases without significant injuries (Group A), cases with isolated bone fractures, major tears or articular dislocations (Group B1), and polytrauma (Group B2). <b>Results:</b> Higher temperatures were associated with a significant increase in overall ER visits, isolated injuries, and polytrauma. Sunny or cloudy days had a significantly higher number of patients with all injury types compared to rainy or stormy days. Weekends saw a significant decrease in overall admissions and isolated injuries but a higher rate of polytrauma compared to weekdays. National holidays had a significantly lower number of admissions for all injury types compared to weekdays. Restrictions due to the pandemic significantly reduced overall ER visits. <b>Conclusion:</b> Temperatures, meteorological factors, and national holidays could vary the workloads in the orthopedic ER of a European third-level trauma center.</p>","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"2970626"},"PeriodicalIF":1.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11772064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051353","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":"ChatGPT is an Unreliable Source of Peer-Reviewed Information for Common Total Knee and Hip Arthroplasty Patient Questions.","authors":"Jonathan D Schwartzman, M Kareem Shaath, Matthew S Kerr, Cody C Green, George J Haidukewych","doi":"10.1155/aort/5534704","DOIUrl":"10.1155/aort/5534704","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background:&lt;/b&gt; Advances in artificial intelligence (AI), machine learning, and publicly accessible language model tools such as ChatGPT-3.5 continue to shape the landscape of modern medicine and patient education. ChatGPT's open access (OA), instant, human-sounding interface capable of carrying discussion on myriad topics makes it a potentially useful resource for patients seeking medical advice. As it pertains to orthopedic surgery, ChatGPT may become a source to answer common preoperative questions regarding total knee arthroplasty (TKA) and total hip arthroplasty (THA). Since ChatGPT can utilize the peer-reviewed literature to source its responses, this study seeks to characterize the validity of its responses to common TKA and THA questions and characterize the peer-reviewed literature that it uses to formulate its responses. &lt;b&gt;Methods:&lt;/b&gt; Preoperative TKA and THA questions were formulated by fellowship-trained adult reconstruction surgeons based on common questions posed by patients in the clinical setting. Questions were inputted into ChatGPT with the initial request of using solely the peer-reviewed literature to generate its responses. The validity of each response was rated on a Likert scale by the fellowship-trained surgeons, and the sources utilized were characterized in terms of accuracy of comparison to existing publications, publication date, study design, level of evidence, journal of publication, journal impact factor based on the clarivate analytics factor tool, journal OA status, and whether the journal is based in the United States. &lt;b&gt;Results:&lt;/b&gt; A total of 109 sources were cited by ChatGPT in its answers to 17 questions regarding TKA procedures and 16 THA procedures. Thirty-nine sources (36%) were deemed accurate or able to be directly traced to an existing publication. Of these, seven (18%) were identified as duplicates, yielding a total of 32 unique sources that were identified as accurate and further characterized. The most common characteristics of these sources included dates of publication between 2011 and 2015 (10), publication in The Journal of Bone and Joint Surgery (13), journal impact factors between 5.1 and 10.0 (17), internationally based journals (17), and journals that are not OA (28). The most common study designs were retrospective cohort studies and case series (seven each). The level of evidence was broadly distributed between Levels I, III, and IV (seven each). The averages for the Likert scales for medical accuracy and completeness were 4.4/6 and 1.92/3, respectively. &lt;b&gt;Conclusions:&lt;/b&gt; Investigation into ChatGPT's response quality and use of peer-reviewed sources when prompted with archetypal pre-TKA and pre-THA questions found ChatGPT to provide mostly reliable responses based on fellowship-trained orthopedic surgeon review of 4.4/6 for accuracy and 1.92/3 for completeness despite a 64.22% rate of citing inaccurate references. This study suggests that until ChatGPT is proven to be a reliab","PeriodicalId":7358,"journal":{"name":"Advances in Orthopedics","volume":"2025 ","pages":"5534704"},"PeriodicalIF":1.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998536","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}