Military Orthopaedic Surgeons Research Articles

Gender Disparities Within US Army Orthopedic Surgery: A Preliminary Report.

Women account for approximately 15% of the active duty US Army, and studies show that women may be at an increased risk of musculoskeletal injury during sport and military training. Nationally, the field of orthopedic surgery comprises 14% women, lagging behind other surgical fields. Demographics for US Military orthopedic surgeons are not readily available. Similarly, demographic data of graduating medical students entering Military Medicine are not reported. We hypothesize that a gender disparity within military orthopedics will be apparent. We will compare the demographic profile of providers to our patients and hypothesize that the two groups are dissimilar. Secondarily, we examine the demographics of military medical students potentially entering orthopedics from the Uniformed Services University of the Health Sciences (USUHS) or the Health Professions Scholarship Program. A census was formed of all US Army active duty orthopedic surgeons to include staff surgeons and residents, as well as US Army medical student graduates and orthopedic patients. There are 252 Army orthopedic surgeons and trainees; 26 (10.3%) are women and 226 (89.7%) are men. There were no significant demographic differences between residents and staff. Between 2014 and 2017, the 672 members of the USUHS graduating classes included 246 Army graduates. Of those, 62 (25%) were female. Army Health Professions Scholarship Program graduated 1,072 medical students, with women comprising 300 (28%) of the group. No statistical trends were seen over the 4 yr at USUHS or in Health Professions Scholarship Program. In total, 2,993 orthopedic clinic visits during the study period were by Army service members, 23.6% were women. There exists a gender disparity among US Army orthopedic surgeons, similar to that seen in civilian orthopedics. Gender equity is also lacking among medical students who feed into Army graduate medical education programs. The gender profile of our patient population is not reflected by that of providers. Because patients prefer providers of the same gender, this is a limitation to patient satisfaction and access to care for musculoskeletal injuries. Further study is underway to identify perceptions and potential causes of these disparities, including the critical perspective of our patients. In addition to the inherent benefits offered by diversity (e.g., expanding the talent pool and more perspectives for decision-making), ultimately it affords a greater ability to maintain a fit and ready force.

Publication Rate and Impact Factor for Society of Military Orthopedic Surgeons. Annual Meeting Presentations, 2009-2013.

The Society of Military Orthopaedic Surgeons (SOMOS) is a robust academic organization with more than 1,000 members and has held annual academic scientific meetings since 1958. Currently, there is a paucity of data regarding the volume and quality of orthopaedic surgery presentations accepted for peer-reviewed publication. The purpose of this study was to answer the following questions: (1) What is the publication acceptance rate for abstract presented at SOMOS meetings? (2) What is the distribution by orthopaedic subspecialty for SOMOS presentations accepted for publication? (3) What is the overall quality of these publications? Abstracts of podium presentations at SOMOS were reviewed from 2009 to 2013. Author institutional information was obtained. Abstracts were then queried in PubMed to obtain publication status, time to publication, and impact factor of the journal in which the manuscript was successfully published. From 2009 to 2013, 592 abstracts were presented at the SOMOS conference. Overall, 59% of abstracts went on to publication at a mean of 18.1 months. Published manuscripts appeared in 59 journals with a mean impact factor of 2.6. The subspecialties of spine (67%) and basic science (66%) achieved the highest abstract publication rate while sports had the highest mean impact factor (3.3). The annual SOMOS meeting is a productive academic event, producing quality presentations resulting in a high manuscript publication rate in every orthopaedic surgery subspecialty. This is the first series to demonstrate overall productivity of a general orthopaedic surgery scientific meeting as well as the subspecialty-specific impact factors of published investigations.

Assessment Measures for Evaluation of Outcomes in Transtibial Amputees resulting from Trauma: A Systematic Review

ABSTRACT Introduction Amputations secondary to high-energy open fractures and blast, ballistic, and crush injuries to the lower extremity are common challenges faced by military and civilian orthopaedic surgeons. A lack of consensus on domains to be measured and quality of prosthetic rendering pose methodological challenges to researchers and clinicians alike. We conducted a systematic review of the literature to summarize which domains of health, prosthetic fit, and prosthetic alignment are used to describe outcomes for lower extremity amputees secondary to trauma. Materials and methods A search of PubMed, Cochrane, and Embase was conducted including the keywords: Amputation, traumatic, transtibial, survey, and metric. Articles were selected based on whether the study assessed clinical outcomes following transtibial amputation following trauma. Experimental and observational comparative studies and case series were included. Study characteristics and results were extracted using standardized data forms. The number of unique measures recorded, the frequency of measure use, and the number outcome measures were validated and were compiled. Results Literature search ultimately resulted in 273 articles being included. A conceptual model was constructed to capture and organize the causal and temporal relationships between fit, alignment, and outcome. Of the 68 articles that used questionnaires to assess prosthetic fit, 37 used a questionnaire designed specifically for the study as opposed to a published or validated tool. Four validated tools were commonly used to capture patient satisfaction with a prosthesis: The OPUS, PEQ, TAPES, and the Socket Comfort Fit Score. Prosthetic alignment was assessed in 19 of 273 articles. One article validated the use of an alignment jig for quantification and prescription of prostheses. Totally, 8 of 19 articles assessing alignment used gait analysis and ground reaction forces to capture differences due to alterations in alignment. Discussion Choice of an appropriate outcome measure is critical in generating evidence to support treatment decisions for patients undergoing transtibial amputation after trauma. We found a large number of different tools being used across studies, making results difficult to compare. Prosthetic fit and comfort of the residual limb in the socket and the alignment of the socket and the shank of the prosthesis make up the foundation for the proposed conceptual model. In order to distinguish effects attributable to an intervention of interest vs the impact of the quality of the socket fitting, validation of a clinically objective scoring system to assess socket fit is necessary. Conclusion A large number of different tools are currently being used across studies to assess outcomes for transtibial amputees resulting from trauma, and there is a need for development and validation of a clinically objective scoring system to assess socket fit. Baumgartner R, Morshed S. Assessment Measures for Evaluation of Outcomes in Transtibial Amputees resulting from Trauma: A Systematic Review. The Duke Orthop J 2017;7(1):23-29.

Extremity War Injuries X: Return to Health and Function.

The symposium Extremity War Injuries X: Return to Health and Function, presented by the American Academy of Orthopaedic Surgeons, the Orthopaedic Trauma Association, the Society of Military Orthopaedic Surgeons, and the Orthopaedic Research Society, was held in Washington, DC, on January 27 and 28, 2015. Course chairs Marc F. Swiontkowski, MD, and COL Jeffrey N. Davila, MD, presided over 2 days of general session lectures focusing on war/trauma-related musculoskeletal injuries resulting in service member disability, followed by small group discussions, with a goal of identifying knowledge gaps in the treatment of these injuries. Recognized civilian and military clinicians and researchers summarized the current state of knowledge in their topic areas and led these discussion groups with meeting participants. Musculoskeletal conditions discussed included posttraumatic osteoarthritis of the knee, foot, and ankle and their relationship to chronic ligament injuries; back disability; peripheral nerve injury; hand transplantation updates; the role of biologics; and prosthetic acceptance and function. A scientific program highlighting research presented by 12 investigators was led by COL (Ret) Romney C. Andersen, MD. Keynote speaker LT GEN Douglas J. Robb, MD, discussed the future of military research funding and the anticipated consolidation of medical care among the three military branches. Additional presentations referencing the impact of military medical care and the government's continued commitment to funding medical research occurred throughout the symposium and were given by five congressional representatives.

Burnout in U.S. Military Orthopaedic Residents and Staff Physicians.

The purpose of this study was to measure the prevalence of burnout among military orthopaedic residents and staff surgeons at the U.S. Army Medical Center. 37 residents and 21 staff surgeons of a military orthopaedic residency program were asked to voluntarily complete an anonymous electronic survey. The survey consisted of two parts: first, a demographic section including questions about relationship status, work hours, deployment history, medical education debt, mentorship, and job satisfaction and second, the Maslach Burnout Inventory. 27 residents and 11 staff completed the survey for a 67% response rate. The rate of burnout among military orthopaedic surgeons in our study was 7.7% (3.7% of residents and 16.7% of staff surgeons). In addition, 25.6% of surgeons (33% of residents and 8.3% of staff) were found to be at risk of burnout. Future studies should focus on causal relationships among specific aspects of the work environment and possible preventive or protective measures. Expanding future studies to include multiple study sites would improve the quality and generalizability of the results.

The American Academy of Orthopaedic Surgeons Evidence-Based Clinical Practice Guideline on Surgical Management of Osteoarthritis of the Knee.

This article was updated on May 4, 2016, because of a previous error. On page 689, under the “DELAY TKA” heading, the text had previously read “Moderate evidence supports that a 5-month delay to total knee arthroplasty (TKA) does not worsen outcomes.” The text now reads “Moderate evidence supports that an 8-month delay to total knee arthroplasty (TKA) does not worsen outcomes.” An erratum has been published: J Bone Joint Surg Am. 2016 June 15;98(12):e53. The AAOS Evidence-Based Guideline on Surgical Management of Osteoarthritis of the Knee includes both diagnosis and treatment. This clinical practice guideline has been endorsed by the Arthroscopy Association of North America (AANA) and the Society of Military Orthopaedic Surgeons (SOMOS). This brief summary of the AAOS Clinical Practice Guideline contains a list of the recommendations and the rating of strength based on the quality of the supporting evidence. Discussion of how each recommendation was developed and the complete evidence report are contained in the full guideline at http://www.aaos.org/Quality/Clinical\_Practice\_Guidelines/Clinical\_Practice\_Guidelines/. ### BMI AS A RISK FACTOR Strong evidence supports that obese patients have less improvement in outcomes with total knee arthroplasty (TKA). Strength of Recommendation: Strong ★★★★ ### DIABETES AS A RISK FACTOR Moderate evidence supports that patients with diabetes are at higher risk for complications with total knee arthroplasty (TKA). Strength of Recommendation: Moderate ★★★☆ ### CHRONIC PAIN AS A RISK FACTOR Moderate evidence supports that patients with select chronic pain conditions have less improvement in patient reported outcomes with TKA. Strength of Recommendation: Moderate ★★★☆ ### DEPRESSION/ANXIETY AS A RISK FACTOR Limited evidence supports that patients with depression and/or anxiety symptoms have less improvement in patient reported outcomes with total knee arthroplasty (TKA). Strength of Recommendation: Limited ★★☆☆ ### CIRRHOSIS/HEPATITIS C AS A RISK FACTOR Limited evidence supports that patients with cirrhosis …

Addressing the Global Disparities in the Delivery of Pediatric Orthopaedic Services: Opportunities for COUR and POSNA.

The burden of musculoskeletal conditions, especially injuries, is increasing in low-income and middle-income countries. Road traffic injuries have become epidemic. There are multiple barriers to accessing surgical services at both the individual (utilization) and the health system (availability) levels, and deficiencies in education and training of health providers. Specialty societies such as the Pediatric Orthopaedic Society of North America (POSNA) have an opportunity to play an important role through teaching and training. The POSNA Children's Orthopedics in Underserved Regions (COUR) committee has supported the Visiting Scholars Program, which invites surgeons from the developing world to attend a scientific meeting and facilitates the scholar's visit to North American pediatric orthopaedic centers. POSNA members have held global educational courses that support an educational exchange between lecturers and attendees. The COUR web site allows for submission of trip reports that document successes and obstacles experienced by members performing overseas clinical care and teaching. The web site also provides educational resources relevant to providing care in these environments. POSNA collaborates with other societies, such as the American Academy of Orthopaedic Surgeons and the Society of Military Orthopaedic Surgeons, to provide education in disaster management. In addition to increasing member involvement, specialty societies have the opportunity for continued data collection from overseas care, application of US registry data to disease processes in the developing world, and further collaboration with one another.

Analysis of Orthopaedic Research Produced During the Wars in Iraq and Afghanistan.

Military orthopaedic surgeons have published a substantial amount of original research based on our care of combat-wounded service members and related studies during the wars in Iraq and Afghanistan. However, to our knowledge, the influence of this body of work has not been evaluated bibliometrically, and doing so is important to determine the modern impact of combat casualty research in the wider medical community. We sought to identify the 20 most commonly cited works from military surgeons published during the Iraq and Afghanistan conflicts and analyze them to answer the following questions: (1) What were the subject areas of these 20 articles and what was the 2013 Impact Factor of each journal that published them? (2) How many citations did they receive and what were the characteristics of the journals that cited them? (3) Do the citation analysis results obtained from Google Scholar mirror the results obtained from Thompson-Reuters' Web of Science? We searched the Web of Science Citation Index Expanded for relevant original research performed by US military orthopaedic surgeons related to Operation Iraqi Freedom and Operation Enduring Freedom between 2001 and 2014. Articles citing these studies were reviewed using both Web of Science and Google Scholar data. The 20 most cited articles meeting inclusion criteria were identified and analyzed by content domain, frequency of citation, and sources in which they were cited. Nine of these studies examined the epidemiology and outcome of combat injury. Six studies dealt with wound management, wound dehiscence, and formation of heterotopic ossification. Five studies examined infectious complications of combat trauma. The median number of citations garnered by these 20 articles was 41 (range, 28-264) in Web of Science. Other research citing these studies has appeared in 279 different journals, covering 26 different medical and surgical subspecialties, from authors in 31 different countries. Google Scholar contained 97% of the Web of Science citations, but also had 31 duplicate entries and 29 citations with defective links. Modern combat casualty research by military orthopaedic surgeons is widely cited by researchers in a diverse range of subspecialties and geographic locales. This suggests that the military continues to be a source of innovation that is broadly applicable to civilian medical and surgical practice and should encourage expansion of military-civilian collaboration to maximize the utility of the knowledge gained in the treatment of war trauma. Level IV, therapeutic study.

High seas to high explosives: the evolution of calcaneus fracture management in the military.

Calcaneus fractures typically occur as a consequence of axial load. In the civilian population, this is most often because of motor vehicle accidents or falls from height. Early management of these injuries in the military population largely mirrored that of civilian surgeons. However, calcaneus fractures secondary to underfoot blasts became a significant source of morbidity and mortality in World War II. First described in the aftermath of large-scale naval battles between metal-deck ships, this "deck-slap" phenomenon is associated with high rates of concomitant injuries, infection, and amputation. We review the historical and contemporary management of calcaneus fractures by military orthopedic surgeons, as well as detailing the unique challenges faced in managing the soft-tissue component and associated injuries commonly observed in this population. Combat-related calcaneus fractures are associated with very high rates of concomitant injuries and extensive soft-tissue wounds. Despite significant research and technological advances, functional outcomes following these devastating injuries have remained unsatisfying.

French surgical experience in the Role 3 Medical Treatment Facility of KaIA (Kabul International Airport, Afghanistan): The place of the orthopedic surgery

IntroductionIn 2009, the French took command of the Medical Hospital (MH) or Role 3 Hospital at KaIA (Kabul International Airport) within the framework of its role in the military mission Operation Pamir in Afghanistan. The goal of this study was to analyze the volume of orthopedic surgical activity for the last four years, to identify its specificities and to improve training of military orthopedic surgeons. HypothesisOrthopedic surgery is the most important activity in the field and surgeons must adapt to situations and injuries that are different from those encountered in France. Patients and methodsAll patients operated on between July 2009 and June 2013 were prospectively included in an electronic database. The analysis included the number of surgical acts and patients, the types of injuries and the surgical procedures. ResultsForty-three percent (n=1875) of 4318 procedures involved orthopedic surgery. Half of these were emergencies. French military personnel represented 17% of the patients, local civilians 47% and children 17%. Half of the procedures involved the soft tissues, 20% were for bone fixation and 10% for surgery of the hand. The rate of amputation was 6%. The diversity of the surgical acts was high ranging from emergency surgery to surgical reconstruction. DiscussionThe activity of this Role 3 facility is comparable to that of other Role 3 facilities in Afghanistan, with an important percentage of acts involving medical assistance to the local population and scheduled surgeries as well as primary and/or secondary management of the wounded. The diversity of surgical acts confirms the challenge of training military orthopedic surgeons within the context of the hyperspecialization of the civilian sector. Specific training has been organized in France by the École du Val de Grâce. Specific continuing education is also necessary. Level of evidenceIV (retrospective review).

Implications of humanitarian orthopaedic surgery in a combat zone: Operation Enduring Freedom and Iraqi Freedom experience.

The primary mission of deployed military orthopaedic surgeons in a combat zone is to treat musculoskeletal battlefield trauma and associated wartime injuries. The role of humanitarian surgical care during combat operations has not been defined. An anonymous online survey was sent to databases containing all U.S. military active-duty orthopaedic surgeons as well as to members of the Society of Military Orthopaedic Surgeons. Inclusion criteria for the study were defined as at least one deployment to Iraq (Operation Iraqi Freedom, OIF) or Afghanistan (Operation Enduring Freedom, OEF). Three hundred fifty-six invitations were sent with 107 orthopaedic surgeons completing the survey. Respondents reported approximately 3,000 humanitarian surgeries performed in the combat zone, with 70% to 80% involving chronic deformity and nonunion surgeries. Seventy-nine percent of the respondents believed that humanitarian surgery was a key component of the mission, improved skills (73%), benefited population (76%), and improved security (61%). A significant amount of humanitarian surgery in the combat zone has been performed in OEF/OIF.

Evidence-based medicine in military orthopaedics: are we doing our part?

The clinical application of evidence-based medicine is influenced by the quality of the published literature. Journals assign objective levels of evidence to articles to describe the quality and reliability of individual articles. Studies assigned levels I to III are considered higher quality studies. This study reviewed 60 continuous years of the American edition of the Journal of Bone and Joint Surgery to analyze trends in the quality of research published by U.S. military orthopaedic surgeons. Three hundred and six of 371 identified articles were assigned a level of evidence from I to V. These were then analyzed to determine if military orthopaedic surgeons were producing higher quality studies over time. Over time, the total number of articles published decreased. However, the number of higher quality studies and average level of evidence per decade improved over time. This trend toward publishing higher quality studies is consistent with the general orthopaedic community and highlights the need for continued work by the military orthopaedic community to conduct higher quality studies.

ACL Reconstruction in a Deployed Environment in Support of Operation Enduring Freedom: A Surgical Technique

Military orthopaedic surgeons in deployed environments along with orthopaedic surgeons working in more austere environments often find themselves without surgical equipment that they are normally accustomed to having in the operative suite. Today's U.S. Army Combat Support Hospital is appropriately focused on being prepared for modern battlefield trauma but lacks the resources for advanced sports medicine surgery to include arthroscopic equipment and implants. In this report, we describe an autograft anterior cruciate ligament reconstruction procedure using a combined mini-open extra-articular/intra-articular technique. This method could serve as a model for orthopaedic surgeons operating in more austere environments without modern sports medicine equipment and when working with the local national population who do not have access to modern health care facilities.

Short-Term Physical and Mental Health Outcomes for Combat Amputee and Nonamputee Extremity Injury Patients

The present study: (1) reports the early physical health complications, mental health outcomes, and outpatient health care utilization of patients with serious extremity injuries sustained during the Iraq or Afghanistan wars and (2) compares clinical outcomes between amputee and nonamputee extremity injury groups. This was a retrospective review of clinical records in military health databases for patients injured in the Iraq and Afghanistan wars. Health outcomes of amputee (n = 382, injured 2001-2005) and nonamputee patients (n = 274, injured 2001-2007) with serious extremity injuries (abbreviated injury score ≥ 3) were followed up to 24 months post injury. This study was performed at Naval Health Research Center, San Diego. Amputee and nonamputee groups had similar injury severity scores. Amputees had nearly double the risk of certain adverse complications (infections, anemia, septicemia, and thromboembolic disease), but other complications (osteomyelitis and nonhealing wound) were similar between the 2 groups. Amputees had significantly greater odds of certain mental health disorders including mood, sleep, pain, and postconcussion syndrome. However, amputees had significantly reduced odds of posttraumatic stress disorder compared with nonamputees. Amputees used various outpatient clinics significantly more than nonamputees. Patients with serious combat extremity injuries showed high rates of adverse health outcomes in the short term. Amputees had higher rates of many but not all clinically important physical and mental health outcomes compared to nonamputees. These results are important for military orthopaedic surgeons and allied providers who care for and counsel these patients and clinicians and researchers who seek to understand and improve health outcomes in patients with extremity war injuries. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Evolution of Acute Orthopaedic Care

Current combat battlefield injuries are among the most complex and challenging orthopaedic cases. These injuries carry high risks for exsanguination and global contamination of extensive soft-tissue and complicated bony injuries. Military orthopaedic surgeons must employ the latest advances in acute combat casualty care to achieve favorable outcomes. Adaptive changes over the past 10 years of war have given today's surgeons the armamentarium to optimize patient care. Innovative methods of damage control resuscitation and surgery have led to increased survival. However, the fundamentals of surgical hemostasis and decontamination remain critical to successful management. The acute treatment of combat casualties involves a continuum of care from the point of injury through transport out of theater. Future research and education are paramount to better prepare military orthopaedic surgeons to further increase survivability and enhance the outcomes of service members with complex wounds.

Moderatorsʼ Summary

Major limb trauma sustained in combat results in significant long-term disability.1 Opportunity exists to integrate the experience accumulated by hundreds of military orthopaedic surgeons during a decade of conflict in Iraq and Afghanistan with the scientific knowledge held by industry in order to reduce the burden of the often devastating spinal and extremity injuries sustained by the warfighter. Collaboration between healthcare providers who manage explosive high-energy injuries and agencies such as the Defense Advanced Research Projects Agency could prove to be beneficial in protecting persons who are exposed to such injuries. The body armor currently worn by soldiers, sailors, marines, and airmen in the Middle East and Southwest Asia has saved innumerable lives. This armor consists of a helmet as well as chest and back protectors. However, the extremities remain vulnerable to blast injury, resulting in a disproportionate number of leg and arm injuries and amputations sustained during Operation Iraqi Freedom and Operation Enduring Freedom.2,3 There is a recognized need for improved groin and perineal protection, as well. An operational personnel protective system must provide adequate protection while allowing sufficient mobility. This balance between weight (ie, load) and maneuverability in challenging mountainous terrain, confined urban spaces, and blisteringly hot temperatures must be considered and analyzed if an effective exoskeleton personnel protective system is to be fielded. Some munitions are so massive as to produce injuries that are not survivable. Therefore, the financial cost of developing and deploying personnel protective systems must be weighed against the progressively less measurable benefit returned by wearing them. Potential solutions to the problem of level of protection versus mobility include the development of modular components that can be added or removed depending on the climate, terrain, threat, and mission. The capability to transition rapidly between levels of protection could reduce the warrior's load while increasing survivability in the face of multiple ballistic hazards. With modular components, commanders could modify the exoskeleton body armor based on multiple variables. However, the development and fielding of an effective exoskeleton body armor system is difficult and remains elusive. Anthropometric modeling, that is, the use of blast-test dummies, may prove to be useful in determining current deficiencies. The US Department of Defense (DoD) recognizes the need to improve management of extremity injuries and to continue to work toward injury prevention. As a result, the DoD Office of Health Affairs has established the Defense Medical Research and Development Program as a core recurring program in the DoD annual budget. Six Joint Program Committees were established to prioritize and manage medical research, including a Combat Casualty Care committee.4 Fiscal year 2010 research awards were made in the areas of coagulopathy and blood products, diagnosis and treatment of brain injury, prehospital care, advanced monitoring, en-route care, combat dentistry, extremity trauma, burns, forward surgical care, and photomedicine.5–7 The DoD has specifically targeted surgical/intensive critical care and extremity trauma/wound care as principal areas for increased funding in the future.

Publication Rate of Presentations at an Annual Military Orthopaedic Meeting

Many research abstracts presented at orthopaedic conferences do not undergo a formal editorial, or peer-review process; however, abstracts are frequently referenced in textbooks and influence clinical practice. The purpose of this study was to determine the publication rate of abstracts formally presented at the Society of Military Orthopaedic Surgeons (SOMOS) annual meetings from 1998 to 2006 that went to full-text publication. Using Google Scholar and PubMed, a literature search was performed for each abstract presented at the annual SOMOS meeting in the years 1998-2006, to calculate the overall full-text publication rate, the average duration from presentation to publication, and the distribution of publications in the various journals. A total of 770 abstracts were presented at the annual SOMOS meetings. The overall full-text publication rate at a minimum of 3 years was 45.7% (352 publications). The average time from presentation to publication was 2.7 years. The published articles appeared in 65 peer-reviewed journals, with notable distribution in Spine (10.0%), The American Journal of Sports Medicine (9.4%), and The Journal of Bone and Joint Surgery (9.4%). The full-text publication rate of abstracts presented at the annual SOMOS meetings compares favorably with that of other major orthopaedic conferences in the United States. Nonetheless, more than half of abstracts presented at the SOMOS meetings remain unpublished.

Publication Rates of Abstracts Presented at the Annual Meeting of the Society of Military Orthopaedic Surgeons

Previous studies have reported publication rates of abstracts presented at orthopaedic meetings from 22 to 68 percent. The objective of this study was to determine the publication rate of papers presented at the Society of Military Orthopaedic Surgeons (SOMOS) meetings from 1999 to 2003. A database was created including all abstracts presented at SOMOS meetings from 1999 to 2003 as listed in official program books. To assess whether each abstract resulted in publication in a peer-reviewed journal, a computerized PubMed search of the presenting author and appropriate keywords from the title was conducted. Overall, 191 of the 435 abstracts presented at SOMOS from 1999 to 2003 were published in a peer-reviewed journal, giving a publication rate of 44%. The publication rate of abstract presentations at annual SOMOS meetings compares favorably with the rates for other orthopaedic meetings. However, less than 50% result in peer-reviewed publication.

An Observational Study into the Levels of Evidence Presented at the Combined Services Orthopaedic Society Annual Meeting

ObjectivesThe role of Evidence Based Medicine in clinical care is to provide a framework for the integration of expertise, current evidence and the needs of the individual patient. Research presented...

Complex Knee Problems in a Young, Active Duty Military Population. Part II: Posterolateral Corner, Meniscus, and Cartilage Injuries

The following set of articles is part II of II in a series of comprehensive reviews, clinical approaches, and descriptions of surgical techniques from members of the Society of Military Orthopaedic Surgeons (SOMOS). These articles include review articles for the treatment of posterolateral corner injuries and articular cartilage lesions, as well as surgical technique reviews for posterolateral corner injuries and meniscal injuries.