Orthopaedic Literature Research Articles

Spin in the Abstracts of Meta-analyses and Systematic Reviews: Quadriceps Tendon Graft for Anterior Cruciate Ligament Reconstruction

Background: Spin is a reporting bias that misrepresents research. Ultimately it can affect surgeon decision making and patient care. Anterior cruciate ligament (ACL) reconstruction is common, but debate continues over optimal treatment modalities. Purpose: To identify the prevalence of spin in meta-analysis and systematic review abstracts regarding the treatment of ACL injuries with quadriceps tendon graft. Study Design: Cross-sectional study. Methods: Electronic libraries (MEDLINE, Embase, Web of Science, Google Scholar) were searched for meta-analyses and systematic reviews regarding the treatment of ACL tears with quadriceps tendon graft. The 9 most severe types of spin commonly found in abstracts were used as an evaluation tool to assess the articles. Two reviewers each performed a blinded assessment of each article for spin. A third reviewer helped after review was done to address any discrepancies between the original reviewers. Further evaluation included year of publication, number of citations, journal impact factor, and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2) score. Results: The electronic database search resulted in 986 articles, of which 13 met our inclusion criteria. After review, we found that 53.8% (7/13) of the included articles contained 1 of the 9 most severe forms of spin. Of the 13 articles, 15.4% (n = 2) contained 2 types of spin, and 38.5% (n = 5) contained 1 type of spin. No studies contained ≥3 types of spin. Of the types of spin evaluated, the most prevalent (n = 4; 30.8%) was type 3 (“selective reporting of or overemphasis on efficacy outcomes or analysis favoring the beneficial effect of the experimental intervention”). All studies, regardless of the presence of spin, were found to be low or critically low quality according to the AMSTAR-2 assessment. Conclusion: This study demonstrated the presence of spin in 53.8% of meta-analysis and systematic review abstracts pertaining to quadriceps tendon graft for ACL reconstruction. Orthopaedic surgeons should learn to recognize spin as they review articles when deciding the treatment course for ACL injuries. Additionally, strict criteria should be considered to reduce the prevalence of spin in orthopaedic literature.

Trends in Female Authorship in Orthopaedic Literature from 2002 to 2021: An Analysis of 168,451 Authors.

Significant gender disparity exists in orthopaedic surgery. While women have increasingly entered the field, we are short of the critical mass needed to drive change, including in authorship. This study aimed to characterize trends in authorship in peer-reviewed orthopaedic journals in the context of gender. This is a cross-sectional bibliometric study of orthopaedic journals in the United States. Articles that were indexed in the orthopaedic category of the Clarivate Journal Citation Report (JCR) and the Science Citation Index Expanded (SCIE) were analyzed (n = 82). Journals not originating from the U.S. (n = 43) or not considered primarily orthopaedic journals (n = 13) were excluded. The 2020 impact factors (IFs) of the remaining 26 journals were recorded. The articles underwent automated data collection from PubMed for January 2002 to December 2021 using R software to collect the title, the journal, the publication year, the first and senior author names, and the country of origin. Gender was determined by Gender API ( https://gender-api.com ). Names with <90% accuracy were excluded. Overall, 168,451 names were studied, with 85,845 and 82,606 first and senior authors, respectively. Of the first and senior authors, 13.6% and 9.9%, respectively, were female. The proportion of female first authors was significantly greater than the proportion of female senior authors. The average IF was significantly higher for male authors compared with female authors (p < 0.005). Articles with female first authors were significantly more likely to have a female senior author. Orthopaedic subspecialty journals had a smaller proportion of manuscripts authored by female first and senior authors than general journals (p < 0.0001). There were 4,451 articles written by a single author, of which 92% (4,093) were written by a man and 8% (358) were written by a woman. Over the 20-year study period, the proportion of female first authorship exhibited a significant positive trend; however, there was a non-significant increase in female senior authorship. Female representation in orthopaedics has been growing over the past decade. Increasing publication rates of female authors reveal steps toward positive gender equity in the field and present an opportunity for female leadership visibility, illustrating the capabilities of women in orthopaedics and encouraging more women to join the field.

Nonunion in Orthognathic Surgery: A Case-Series of 15 Patients

Bone nonunion is extensively studied in the orthopedic literature, but the knowledge in oral and maxillofacial surgery, specifically orthognathic surgery, is scarce. Since this complication has a significant negative impact on postoperative management of patients, more studies are needed. To report the characteristics of patients presenting with bone nonunion after orthognathic surgery. This is a retrospective case-series study on subjects who underwent orthognathic surgery between 2011 and 2021 and developed nonunion. Inclusion criteria were mobility at the site of the osteotomy and the need for a second surgical intervention. Exclusion criteria were an incomplete medical chart; the absence of nonunion upon surgical exploration, or radiological evidence of nonunion; cleft lip/palate; or syndromic patients. The outcome variable was bone healing after nonunion care. Demographics (age, sex), medical/dental comorbidities, type of surgery (type of fixation, bone grafts, Botox injection), amplitude of movements, nonunion treatment. Descriptive statistics were computed for each study variable. The sample was composed of 15 patients (11 females, mean age 40.4 years old) with nonunion (maxilla: 8 cases, mandible: 7 cases) out of 2036 patients who underwent orthognathic surgery during the period studied (incidence 0.74%). Nine (60%) were bruxers, three were smokers (20%) and one had diabetes. Mean forward movement of the maxilla was 6.55mm (4-9mm) and 7.71mm (4.8-12mm) for the mandible. All patients but one (who refused surgery) were treated by curettage of fibrous tissue and new hardware placement. In addition, 11 received a bone graft, and 4 had Botox injections. All osteotomies healed after the second surgical intervention. Curettage with or without grafting appears to be a good strategy for the cure of nonunion. Bruxism may be a risk factor (60% of patients were bruxers in this study).

How Has Statistical Testing in Orthopedics Changed Over Time? An Assessment of High Impact Journals Over 25 Years

It is important for physicians to be familiar with statistical techniques commonly used in published medical research. Statistical errors in medical literature are common, and there is a reported lack of understanding regarding statistical knowledge necessary for data interpretation and journal reading. As study design has become increasingly complex, peer-reviewed literature poorly addresses and explains the most common statistical methods utilized across leading orthopedic journals. Articles from 5 leading general and subspecialty orthopedic journals were compiled from 3 distinct time periods. After exclusions were applied, 9521 remained, and a random 5% sampling of these articles, balanced across journals and years, was conducted yielding 437 articles after additional exclusions. Information regarding the number of statistical tests used, power/sample size calculation, type of statistical tests used, level of evidence (LOE), study type, and study design was collected. The mean number of statistical tests across all 5 orthopedic journals increased from 1.39 to 2.29 by 2018 (p = 0.007). The percentage of articles that reported power/sample size analyses was not found to differ by year, but the value has increased from 2.6% in 1994 to 21.6% in 2018 (p = 0.081). The most commonly used statistical test was the t-test which was present in 20.5% of articles, followed by chi-square test (13%), Mann-Whitney analysis (12.6%) and analysis of variance (ANOVA, 9.6%). The mean number of tests was generally greater in articles from higher impact factor journals (p = 0.013). Studies with a LOE of I used the highest mean number of statistical tests (3.23) compared to studies with lower LOE ratings (range 1.66-2.69, p < 0.001). Randomized control trials used the highest mean number of statistical test (3.31), while case series used the lowest mean number of tests (1.57, p < 0.001). The mean number of statistical tests used per article has increased over the past 25 years with the t-test, chi-square test, Mann-Whitney analysis, and ANOVA being the most used statistical tests in leading orthopedic journals. Despite an increase in statistical tests it should be noted that there was a paucity in advance statistical testing within the orthopedic literature. This study displays important trends in data analysis and can serve as a guide to help clinicians and trainees better understand the statistics used in literature as well as identifying deficits within the literature that should be addressed to help progress the field of orthopedics.

Severely injured patients: modern management strategies.

Management of severely injured patients remains a challenge, characterised by a number of advances in clinical practice over the last decades. This evolution refers to all different phases of patient treatment from prehospital to the long-term rehabilitation of the survivors. The spectrum of injuries and their severity is quite extensive, which dictates a clear understanding of the existing nomenclature. What is defined nowadays as polytrauma or major trauma, together with other essential terms used in the orthopaedic trauma literature, is described in this instructional review. Furthermore, an analysis of contemporary management strategies (early total care (ETG), damage control orthopaedics (DCO), early appropriate care (EAC), safe definitive surgery (SDS), prompt individualised safe management (PRISM) and musculoskeletal temporary surgery (MuST)) advocated over the last two decades is presented. A focused description of new methods and techniques that have been introduced in clinical practice recently in all different phases of trauma management will also be presented. As the understanding of trauma pathophysiology and subsequently the clinical practice continuously evolves, as the means of scientific interaction and exchange of knowledge improves dramatically, observing different standards between different healthcare systems and geographic regions remains problematic. Positive impact on the survivorship rates and decrease in disability can only be achieved with teamwork training on technical and non-technical skills, as well as with efficient use of the available resources.

Are self-reported anthropometric data reliable enough to meet antibiotic prophylaxis guidelines in orthopedic surgery?

BackgroundSurgical site infection is a serious complication in orthopedic surgery. The use of antibiotic prophylaxis (AP) combined with other prevention strategies has been shown to reduce this risk to 1% for hip arthroplasty and 2% for knee arthroplasty. The French Society of Anesthesia and Intensive Care Medicine (SFAR) recommends doubling the dose when the patient's weight is greater than or equal to 100 kg, and the body mass index (BMI) is greater than or equal to 35 kg/m2. Similarly, patients with a BMIgreater than40 kg/m2 orlesser than18 kg/m2 are ineligible for surgery in our hospital. Self-reported anthropometric measurements are commonly used in clinical practice to calculate BMI, but their validity has not been assessed in the orthopedic literature. Therefore, we conducted a study comparing self-reported with systematically measured values and observed the impact these differences may have on perioperative AP regimens and contra-indications to surgery. HypothesisThe hypothesis of our study was that self-reported anthropometric values differed from those measured during preoperative orthopedic consultations. Materials and methodsThis single-center retrospective study with prospective data collection was conducted between October and November 2018. The patient-reported anthropometric data were first collected and then directly measured by an orthopedic nurse. Weight was measured with a precision of 500 g and height was measured with a precision of 1 cm. ResultsA total of 370 patients (259 women and 111 men) with a median age of 67 years (17–90) were enrolled. The data analysis found significant differences between the self-reported and measured height [166 cm (147–191) vs. 164 cm (141–191) (p<0.0001)], weight [72.9 kg (38–149) vs. 73.1 kg (36–140) (p<0.0005)] and BMI [26.3 (16.2–46.4) vs. 27 (16–48.2) (p<0.0001)]. Of these patients, 119 (32%) reported an accurate height, 137 (37%) an accurate weight, and 54 (15%) an accurate BMI. None of the patients had two accurate measurements. The maximum underestimation was 18 kg for weight, 9 cm for height, and 6.15 kg/m2 for BMI. The maximum overestimation was 28 kg for weight, 10 cm for height, and 7.2 kg/m2 for BMI. The verification of the anthropometric measurements identified another 17 patients who had contra-indications to surgery (12 with a BMI>40 kg/m2 and 5 with a BMI<18 kg/m2) and who would not have been detected based on the self-reported values. ConclusionsAlthough patients underestimated their weight and overestimated their height in our study, these had no impact on the perioperative AP regimens. However, this misreporting failed to detect potential contraindications to surgery. Level of evidenceIV; retrospective study with prospective data collection and no control group.

Mesenchymal Stem Cells for Enhanced Healing of the Medial Collateral Ligament of the Knee Joint.

Background and Objectives: The medial collateral ligament (MCL) is one of the major supporting ligaments of the knee joint, and MCL injuries are common where excessive valgus loading is applied to the knee joint. Although most MCL injuries can be treated conservatively, healing of the MCL can take several weeks to months. Furthermore, once injured, the biomechanical properties of the healed MCL differ from those of the native MCL, resulting in an increased risk of re-injury and chronic remnant symptoms. Mesenchymal stem cells (MSCs), owing to their therapeutic potential, have been investigated in various musculoskeletal injuries, and some preclinical studies regarding MSC-based approaches in MCL injuries have shown promising results. Despite satisfactory results in preclinical studies, there is still a lack of clinical studies in the orthopedic literature. This article describes the basic knowledge of the MCL, standard treatments for MCL injuries, and recent studies regarding the application of MSCs for enhanced healing of the MCL. MSC-based approaches are expected to be a potential therapeutic option for enhanced healing of the MCL in the future.

IS POOLING OF DATA POSSIBLE IN STUDIES EVALUATING OPEN TIBIAL SHAFT FRACTURES REQUIRING FLAP COVERAGE?

The aim of this study was to perform a systematic review of the literature on Gustilo-Anderson (GA) type IIIB open tibial shaft (AO-42) injuries to determine the consistency of reporting in the literature.A search of PubMed, EMBASE and Cochrane Central Register of Controlled Trials was performed to identify relevant studies published from January 2000 to January 2021 using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. The study was registered using the PROSPERO International prospective register of systematic reviews. Patient/injury demographics, management and outcome reporting were recorded.There were 32 studies that met the inclusion criteria with a total of 1,947 patients (70.3% male, 29.7% female). There were 6 studies (18.8%) studies that reported on comorbidities and smoking, with mechanism of injury reported in 22 (68.8%). No studies reported on all operative criteria included, with only three studies (9.4%) reporting for time to antibiotics, 14 studies (43.8%) for time from injury to debridement and nine studies (28.1%) for time to definitive fixation. All studies reported on the rate of deep infection, with a high proportion documenting union rate (26/32, 81.3%). However, only two studies reported on mortality or on other post-operative complications (2/32, 6.3%). Only 12 studies (37.5%) provided any patient reported outcomes.This study has demonstrated a deficiency and a lack of standardized variable and outcome reporting in the orthopaedic literature for Gustilo-Anderson type IIIB open tibial shaft fractures. We propose a future international collaborative Delphi process is needed to standardize.

Use of intraoperative topical antibiotics to reduce intrathecal baclofen pump surgical site infections: a single institution's experience over 24 years.

Patients requiring intrathecal baclofen (ITB) therapy are at high risk for surgical site infections (SSIs) given their poor functional status. After years of a nominal infection rate, there was an inexplicable increase in ITB pump infections at the authors' institution and multiple investigations offered no solution. Use of intraoperative topical antibiotics is well-documented in the orthopedic literature and was considered for ITB pump insertion. In this study, the authors investigated whether intraoperative vancomycin and tobramycin powder at the ITB pump site could reduce SSIs. Operative and infection data were collected and analyzed retrospectively to determine the efficacy of this change. Patients were stratified into three cohorts (1998-2009, 2010-2012, and 2013-2021) to better understand the trends before and after implementation of intraoperative topical antibiotics. Each cohort had similar demographics. One hundred fifty-four patients underwent 272 ITB pump procedures between 1998 and 2021 (131 in 1998-2009, 49 in 2010-2012, and 92 in 2013-2021) for cerebral palsy (69.5%), spastic quadriparesis due to traumatic brain injury (7.1%), anoxic brain injury (6.5%), and other causes (16.9%). Infection rates were reduced from a high of 32% in 2010-2011 to 3.8% over the last 2.5 years (p = 0.0094). There were no adverse effects from the use of topical antibiotics. In the setting of an intractable rise in ITB pump infections, the addition of intraoperative topical antibiotics significantly reduced postoperative infections in a high-risk population. One could appreciate a significant drop each year in the rate of infections after the institution of intraoperative topical antibiotics. The reduction in SSIs significantly improved the long-term outcomes for these patients.

MP62-11 IRRISEPT WASHOUT AT THE TIME OF REVISION SURGERY DECREASES TISSUE CULTURE POSITIVITY: SINGLE CENTER EXPERIENCE

You have accessJournal of UrologyCME1 Apr 2023MP62-11 IRRISEPT WASHOUT AT THE TIME OF REVISION SURGERY DECREASES TISSUE CULTURE POSITIVITY: SINGLE CENTER EXPERIENCE Alex Fuselier, Chris Smith, Ryan Griggs, Paul H. Chung, Ed Karpman, and Gerard Henry Alex FuselierAlex Fuselier More articles by this author , Chris SmithChris Smith More articles by this author , Ryan GriggsRyan Griggs More articles by this author , Paul H. ChungPaul H. Chung More articles by this author , Ed KarpmanEd Karpman More articles by this author , and Gerard HenryGerard Henry More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003320.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The presence of biofilm, which resists eradication, at the implant site during inflatable penile prosthesis (IPP) replacement surgery for infectious or non-infectious reasons appears to increase infection rates. Irrigation at the time of salvage rescue surgery has been shown to work in patients with clinically infected IPPs. Similarly, washout at the time of non-infectious revision surgery has been shown to lower subsequent infection rates. Positive cultures confirm bacterial presence on IPPs in both the clinically infected and uninfected settings. 0.05% chlorhexidine gluconate (CHG) in sterile water (Irrisept, Irrimax Corporation, Lawrenceville, GA) has been shown to reduce biofilm in the orthopedic literature. More recently, it has been shown to be highly efficacious against IPP bacteria such as E. coli and Pseudomonas that now predominate eroded and infected devices. We investigated capsule tissue cultures before and after dilute chlorhexidine irrigation in a series of patients who underwent revision surgery. METHODS: A total of 44 patients with indwelling IPPs underwent revision surgery for both infectious and noninfectious reasons between May 2021 and September 2022. A section of capsule tissue surrounding the pump sent for culture & gram staining. After implant removal, we performed a washout of all implant spaces with 0.05% chlorhexidine gluconate irrigation, 900cc for noninfectious reasons and 1800cc for infectious reasons. A second tissue culture was obtained adjacent to the prior sample post washout. No other additional antibiotic solutions were utilized for irrigation. All patients received clindamycin, gentamicin, and fluconazole for intravenous prophylaxis. RESULTS: Of the 44 patients, 4 (10%) were with infectious / erosion reasons, 40 (90%) had noninfectious etiologies. 6 (14%) of the 44 patients had evidence of positive bacterial presence prior to washout. 4 of the 4 (100%) patients for infectious / erosion reasons and 2 of the 40 (5%) of the noninfectious etiologies had evidence of bacterial presence prior to washout. All 44 (100%) of these patients had negative cultures after dilute chlorhexidine washout. CONCLUSIONS: Early results of revision washout with 0.05% chlorhexidine gluconate in sterile water solution appears to decrease the bacterial load and potentially sterilize the implant capsule at revision surgery of inflatable penile prostheses for both infectious and noninfectious reasons. Consequently, this may lead to future reduction in postoperative infection rates after IPP revision surgery. Source of Funding: Coloplast © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e865 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Alex Fuselier More articles by this author Chris Smith More articles by this author Ryan Griggs More articles by this author Paul H. Chung More articles by this author Ed Karpman More articles by this author Gerard Henry More articles by this author Expand All Advertisement PDF downloadLoading ...

The Importance of Pragmatic Study Design to the Scholarly Influence of Surgical Hip Fracture Randomized Controlled Trials

Surgical randomized controlled trials (RCTs) have potential drawbacks, leading some to question their role in filling the information gap in orthopaedic surgery. Pragmatism in study design was introduced to increase the clinical applicability of study results. The purpose of this study was to examine how pragmatism affects the scholarly influence of surgical RCTs. A search for surgical hip fracture-related RCTs published between 1995 and 2015 was done. Journal impact factor, citation number, research question, significance and type of outcome, number of centers involved, and the Pragmatic-Explanatory Continuum Indicator Summary-2 level of pragmatism score were recorded for each study. Scholarly influence was estimated by a study's inclusion into orthopaedic literature or guidelines or through the study's average yearly citation rate. One hundred sixty RCTs were included in the final analysis. A multivariate logistic regression identified large study sample size as the only predictor of an RCT being used in clinical guidance texts. Large sample size and multicenter RCTs were predictors of high yearly citation rates. The level of pragmatism in study design did not predict scholarly influence. Pragmatic design is not independently associated with increased scholarly influence; however, large study sample size was the most important study characteristic affecting scholarly influence.

The impact of Canadian-produced research on the global orthopedic literature: a bibliometric analysis.

Little is known about the quality and impact of Canadian-produced research relative to that of other developed nations. The purpose of this study was to determine the contribution of Canadian authors to the orthopedic literature globally and nationally as well as Canada's research productivity in orthopedics. We hypothesized that Canada ranks among the most impactful countries in terms of orthopedic research productivity. We performed a bibliometric analysis to identify articles published between 2001 and 2020 in the category of orthopedics. We identified Canada's global rank in terms of overall productivity and assessed the contributions of individual Canadian authors. We also examined the quality of publications as determined by category normalized citation impact (CNCI) and publication in the top quartile of journals (%Q1) in terms of impact factor. In addition, we calculated the percentage of Canadian publications that were in orthopedics. We identified 10 821 orthopedic publications from 2001 to 2020. Canada placed sixth globally in terms of productivity in orthopedic research. The annual productivity of Canadian orthopedic researchers increased over the study period by a factor of 3.2. In terms of research quality, with a %Q1 of 36.5% and a CNCI of 1.22, Canada outperformed Asian countries and the United States; the latter country had a %Q1 of 35.3% and a CNCI of 1.14 over the study period. The body of Canadian orthopedic literature has grown consistently over the past 20 years. Despite the overall leadership of the United States and other developed nations such as China and Japan, Canada ranks among the most influential countries in terms of the quality and quantity of orthopedic research.

Evaluation of Low- and Middle-Income Country Authorship in the Global Orthopaedic Literature.

Extensive research collaborations exist between high-income countries and low- and middle-income countries (LMICs), although prior work has raised concerns regarding equitable representation among LMIC authors. The goal of this bibliometric analysis was to characterize LMIC authorship among indexed orthopaedic journals and identify factors contributing to disparities in representation. We identified all articles appearing in orthopaedic journals indexed in MEDLINE and Journal Citation Reports with a focus on LMICs or cohorts between 2009 and 2018. All articles describing research conducted in LMICs or research focused on applications to cohorts in LMIC(s) were included. Author affiliation, article characteristics, and impact factor were assessed for 1,573 articles. Logistic regression models created to identify predictors of LMIC authorship. We identified few studies published in indexed journals focused exclusively on LICs. Funded studies were less likely to have LMIC last authors. Compared with articles published in lower impact factor journals, those in journals with a higher impact factor were less likely to have a LMIC first or last author. The greater the number of countries represented per study, the less likely it had a LMIC first or last author. Our study highlights persistent disparities in authorship from LMICs in indexed orthopaedic journals.

Artificial intelligence and machine learning as a viable solution for hip implant failure diagnosis-Review of literature and in vitro case study.

The digital health industry is experiencing fast-paced research which can provide digital care programs and technologies to enhance the competence of healthcare delivery. Orthopedic literature also confirms the applicability of artificial intelligence (AI) and machine learning (ML) models to medical diagnosis and clinical decision-making. However, implant monitoring after primary surgery often happens with a wellness visit or when a patient complains about it. Neglecting implant design and other technical errors in this scenario, unmonitored circumstances, and lack of post-surgery monitoring may ultimately lead to the implant system's failure and leave us with the only option of high-risk revision surgery. Preventive maintenance seems to be a good choice to identify the onset of an irreversible prosthesis failure. Considering all these aspects for hip implant monitoring, this paper explores existing studies linking ML models and intelligent systems for hip implant diagnosis. This paper explores the feasibility of an alternative continuous monitoring technique for post-surgery implant monitoring backed by an in vitro ML case study. Tribocorrosion and acoustic emission (AE) data are considered based on their efficacy in determining irreversible alteration of implant material to prevent total failures. This study also facilitates the relevance of developing an artificially intelligent implant monitoring methodology that can function with daily patient activities and how it can influence the digital orthopedic diagnosis. AI-based non-invasive hip implant monitoring system enabling point-of-care testing.

Education Research in Orthopaedic Surgery: A 6-Year Analysis.

A PubMed search string was used to identify literature on orthopaedic surgery education from 2016 to 2021. Publications on orthopaedic surgery education were divided into 8 education-based categories: (1) operative training and simulation, (2) curriculum and career development, (3) diversity, (4) wellness and burnout, (5) program evaluation and match data, (6) trainee assessments, (7) social media, and (8) other. Univariate analysis and linear regression were used to determine trends. A total of 383 orthopaedic surgery education publications met inclusion criteria. Orthopaedic surgery education publications accounted for 0.47% of the total publications from all 54 journals. Fifteen journals provided 85% of all orthopaedic education publications (N = 325). The Journal of Bone and Joint Surgery produced the most orthopaedic surgery education publications (76, 20%), followed by the Journal of Surgical Education (62, 16%) and the Journal of the American Academy of Orthopaedic Surgeons (58, 15%). Publications on curriculum and career development were the most common (21.9%). The following most frequent topics were program evaluation and match data (20.9%) and operative training and simulation (18%), respectively. Over the study period, the total amount of orthopaedic surgery education articles increased significantly (R2 = 0.86, p = 0.008). Articles included all levels of training, with resident education accounting for the majority, with 269 articles (70.2%). Recent trends in orthopaedic literature indicate an increased emphasis on education as the number of publications has increased, but are still sparse in orthopaedic literature. As the field of orthopaedics continues to advance, we recommend that academic institutions and organizations continue to evaluate and promote evidence-based educational research to ensure that orthopaedic education meets the ever-increasing demands that residents and practicing surgeons will face in the present and future. III.

Bone names and “ization” in orthopedics

Various terms in orthopedics are formed using or incorporating the name of native bones and these terms then describe a clinical entity or a procedure. The term thus created, however, may or may not be directly related to the bone associated. There are a few interesting examples of such terms that are encountered in the orthopedic literature. A short recollection of those few notable terms that have the name of a known bone within their terminology is described here for general reading and knowledge.

Authorship Patterns in the Orthopaedic Journals of Low-Income and Lower-Middle-Income Countries.

Extensive research collaborations exist between researchers from high-income countries (HICs) and those from low-income countries (LICs) and lower-middle-income countries (LMICs). Previous research has suggested that authors from LICs and LMICs are underrepresented as first and last authors in the orthopaedic literature on local populations, particularly in LICs. We present a bibliometric analysis of authorship solely in studies published in orthopaedic journals that are based in LICs and LMICs. The Global Index Medicus was queried, and all articles published from January 1, 2010, to December 31, 2021, in journals with a focus on orthopaedic surgery that were based in an LIC or an LMIC were included. Logistic regressions were calculated to assess the predictors of local authorship. Over 92% of studies included in our analysis had first or last authors from LICs or LMICs. In terms of study type, the majority (89%) of studies were clinical, although largely of low-level evidence (78% of clinical studies were case reports, case series, or descriptive studies). None received funding. LIC or LMIC first authorship and last authorship were less likely for most types of nonclinical studies. LIC or LMIC first authorship was more likely when there were more study authors. LIC or LMIC first authorship and last authorship were less likely when there were more countries affiliated with the study authors. Finally, when compared with studies with only LIC or LMIC authors, those with a combination of HIC and LIC or LMIC authors had significantly lower rates of LIC or LMIC first authorship (93.3% versus 62.5%) and last authorship (97.7% versus 70.8%). Our study presents one of the first analyses to assess authorship patterns in the orthopaedic literature of locally published journals in LICs and LMICs. Future studies are needed to contextualize our findings within a broader bibliometric landscape in order to better address the ongoing challenges to building research capacity in LICs and LMICs. Our study highlights important observations regarding authorship in international, collaborative research in orthopaedics.

Utilizing mesenchymal stem cells to improve the healing process of the medial collateral ligament in the knee

The healing process of the medial collateral ligament (MCL) in the knee is often slow, resulting in adverse outcomes such as scar tissue formation, joint instability, limited range of motion, and an increased risk of re-injury. Consequently, novel therapeutic strategies are imperative to enhance MCL healing. Mesenchymal stem cells (MSCs) have emerged as a promising treatment modality due to their robust proliferative ability, reparative potential, and ability to differentiate into various cell types. Although preclinical studies have shown encouraging results for MSC-based approaches in MCL injuries, clinical studies in the orthopedic literature remain scarce. This review provides an overview of the MCL, conventional treatments for MCL injuries, and recent advances in MSC research for augmenting MCL healing. MSC-based approaches hold promise as a future therapeutic option to improve MCL healing. Nonetheless, further research is warranted to establish the effective ness and safety of this emerging treatment modality.

Medical conferences and medical practice

Medical conferences and medical practice

ORTHO AI : The Dawn Of A New Era: Artificial Intelligence In Orthopaedics

ORTHO AI : The Dawn Of A New Era: Artificial Intelligence In Orthopaedics