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  • 1
    Online Resource
    Online Resource
    Return to Play and Performance After Anterior Cruciate Ligament Reconstruction in National Football League Players
    SAGE Publications ; 2022
    In:  Orthopaedic Journal of Sports Medicine Vol. 10, No. 3 ( 2022-03-01), p. 232596712210796-
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 10, No. 3 ( 2022-03-01), p. 232596712210796-
    Abstract: Considerable variability exists in return-to-play rates after anterior cruciate ligament (ACL) injury and reconstruction (ACLR) among National Football League (NFL) players of different positions. Purpose/Hypothesis: The purpose of this study was to compare return-to-play and performance levels by position in NFL players after ACLR. It was hypothesized that (1) ACL injuries have significant effects on the careers of NFL players, including return to play and performance, and (2) players of certain positions that involve relatively less pivoting and cutting perform better after ACLR. Study Design: Descriptive epidemiology study. Methods: All NFL players who underwent ACLR between 2013 and 2018 were identified using the FantasyData injury database. Player characteristics, snap count, games played, games started, and performance metrics were collected for 3 years before and after injury using the Pro Football Reference database. Performance was measured using an approximate value (AV) algorithm to compare performance across positions and over time. Nonparametric tests were used to compare the pre- and postinjury data and the percentage change in performance between different positions. Results: Overall, 312 NFL players were included in this study, and 174 (55.8%) returned to play. Of the eligible players, only 28.5% (n = 59/207) remained in the league 3 years postinjury. Within the first 3 years postinjury, players played in fewer games (8.7 vs 13.7; P 〈 .0001), started in fewer games (3.0 vs 8.3; P 〈 .0001), had lower AVs (1.5 vs 4.3; P 〈 .0001), and had decreased snap counts (259.0 vs 619.0; P 〈 .0001) compared with preinjury. Quarterbacks were most likely to return to play (92.9% vs 53.7%; P = .0040) and to return to performance (2% vs 50% decrease in AV; P = .0165) compared with the other positions. Running backs had the largest decrease in AV (90.5%), followed by defensive linemen (76.2%) and linebackers (62.5%). Conclusion: The study findings indicated that NFL players are severely affected by ACL injury, with only 28.5% still active in the league 3 years after the injury. Running backs, defensive linemen, and linebackers performed the worst after injury. Quarterbacks were most likely to return to play and had superior postinjury performance compared with the other positions.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/23259671221079637
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2022
    detail.hit.zdb_id: 2706251-X
    SSG: 31
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  • 2
    Online Resource
    Online Resource
    Medical Student Mentorship in Orthopaedic Surgery
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Journal of the American Academy of Orthopaedic Surgeons Vol. 29, No. 16 ( 2021-08-15), p. 681-690
    Details
    In: Journal of the American Academy of Orthopaedic Surgeons, Ovid Technologies (Wolters Kluwer Health), Vol. 29, No. 16 ( 2021-08-15), p. 681-690
    Abstract: Mentorship is a key aspect of medical education, but the availability and quality of mentorship varies considerably between institutions. The lack of standardization results in information asymmetry and creates notable inequities. This disparity is particularly important for students interested in pursuing competitive specialties, such as orthopaedic surgery. The purpose of this study was to (1) demonstrate the importance of mentorship in orthopaedics, (2) provide a framework for orthopaedic surgeon mentors, and (3) guide medical students interested in activating and expanding their networks.
    Type of Medium: Online Resource
    ISSN: 1067-151X , 1940-5480
    URL: Article
    DOI: 10.5435/JAAOS-D-20-01274
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 3
    Online Resource
    Online Resource
    Team Physicians in Men’s and Women’s Professional Sports Leagues: Gender Representation and Career Path Analysis
    SAGE Publications ; 2023
    In:  Orthopaedic Journal of Sports Medicine Vol. 11, No. 7 ( 2023-07-01)
    Details
    In: Orthopaedic Journal of Sports Medicine, SAGE Publications, Vol. 11, No. 7 ( 2023-07-01)
    Abstract: The most common orthopaedic fellowship is for sports medicine, but few fellowship-trained orthopaedic surgeons fill roles as team physicians. Gender disparities within the field of orthopaedics, coupled with male-dominated professional sports leagues in the United States, may lead to lower representation of women as professional team physicians. Purpose: To (1) determine the career path trajectories of current head team physicians in professional sports, (2) quantify gender disparities across team physician representation, and (3) further characterize professional profiles of team physicians appointed to women’s and men’s professional sports leagues in the United States. Study Design: Cross-sectional study. Methods: This is a cross-sectional study of professional sports head team physicians in 8 major American sports leagues: American football (National Football League), baseball (Major League Baseball), basketball (National Basketball Association and Women’s National Basketball Association), hockey (National Hockey League and National Women’s Hockey League), and soccer (Major League Soccer and National Women’s Soccer League). Online searches were used to compile information on gender, specialty, medical school, residency, fellowship, years in practice, clinical practice type, practice setting, and research productivity. Differences according to league type (men’s vs women’s leagues) were analyzed with the chi-square test for categorical variables, t test for continuous variables, and Mann-Whitney U test for nonparametric means. Bonferroni correction was applied for multiple comparisons. Results: Within the 172 professional sports teams, 183 head team physicians were identified, including 170 men (92.9%) and 13 women (7.1%). Team physicians in both men’s and women’s sports leagues were predominantly men. Overall, 96.7% of team physicians in men’s leagues were men, and 73.3% of team physicians in women’s leagues were men ( P 〈 .001). The most common physician specialties were orthopaedic surgery (70.0%) and family medicine (19.1%). Compared with team physicians in women’s leagues, those in men’s leagues were more likely to be orthopaedic surgeons (40.0% vs 71.9%, respectively; P = .001) and to have more experience (15.9 vs 22.4 years, respectively; P 〈 .001). Conclusion: Study findings indicated disparities in gender, practice experience, and physician specialty representation among team physicians in men’s versus women’s professional sports leagues.
    Type of Medium: Online Resource
    ISSN: 2325-9671 , 2325-9671
    URL: Article
    DOI: 10.1177/23259671231182991
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2706251-X
    SSG: 31
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  • 4
    Online Resource
    Online Resource
    Trends in Industry Payments to Orthopedic Foot and Ankle Surgeons from 2014 to 2018
    SAGE Publications ; 2020
    In:  Foot & Ankle Orthopaedics Vol. 5, No. 4 ( 2020-10-01), p. 2473011420S0035-
    Details
    In: Foot & Ankle Orthopaedics, SAGE Publications, Vol. 5, No. 4 ( 2020-10-01), p. 2473011420S0035-
    Abstract: Other Introduction/Purpose: The establishment of the Open Payments Database (OPD) in 2014 made public all financial payments to physicians and hospitals by pharmaceutical and medical device companies. Since then, numerous studies have analyzed industry payment data to elucidate any correlations and trends. The purpose of this study is to examine trends in industry payments to orthopedic foot and ankle surgeons from 2014 to 2018. Methods: The Open Payments Database (OPD) was queried to collect information regarding industry payments to orthopedic foot and ankle surgeons and all orthopedic surgeons from 2014 to 2018. Information was collected on physician education, regional distribution of physicians paid, number of physicians paid, median payment amount, and payment type. Further analyses were conducted on the median payment amount to the top 5% of earners and the other 95%. Median amounts were analyzed using Mann-Whitney U non-parametric tests. Results: Of the 1,416 physicians classified as orthopedic foot and ankle surgeons, Doctors of Osteopathy and Medical Doctors received significantly higher payments than Doctors of Podiatric Medicine (597 vs. 35, P=9x10-113). Only osteopathic and allopathic physicians were included in the main analyses. No significant difference was reported from 2014 to 2018 in the median payments to orthopedic foot and ankle surgeons overall ($616 vs. $810; P=0.13), in the top 5% ($148,864 vs. $158,349; P=0.53), and other 95% ($542 vs. $730; P=0.10). There was no significant difference in payments related to consulting fees, entertainment, food and beverages, gifts, grants, honoraria, royalty and licensing fees, speaker and faculty fees, and travel and lodging. There was a significant increase in industry payments related to education ($750 vs. $1370; P=0.002). Conclusion: Following the establishment of the Open Payments Database in 2014, it was expected that industry payments would decrease significantly. However, no change was seen in payments to orthopedic foot and ankle surgeons and there remains a very large distribution in surgeon compensation. In fact, the top 5% of surgeons compensated account for over 99% of the total industry payments. While there are many factors that could account for this, foot and ankle surgeons should use data extracted from the OPD as a guide to ensure fair and equitable compensation for their work in industry.
    Type of Medium: Online Resource
    ISSN: 2473-0114 , 2473-0114
    URL: Article
    DOI: 10.1177/2473011420S00359
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2020
    detail.hit.zdb_id: 2874570-X
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  • 5
    Online Resource
    Online Resource
    Effect of Gender Differences on Patient-Reported Outcomes and Complications in Total Ankle Replacement
    SAGE Publications ; 2021
    In:  Foot & Ankle International Vol. 42, No. 6 ( 2021-06), p. 776-787
    Details
    In: Foot & Ankle International, SAGE Publications, Vol. 42, No. 6 ( 2021-06), p. 776-787
    Abstract: The purpose of this study was to evaluate gender differences in patient outcomes and complications following total ankle replacement (TAR). Methods: Consecutive patients who underwent primary TAR from July 2007 through May 2016 were prospectively followed and retrospectively reviewed. Demographic, operative, patient-reported outcomes (PROs), and complication data were collected and analyzed. PROs included the visual analog scale (VAS), 36-Item Short-Form Health Survey (SF-36), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot scale, and Short Musculoskeletal Function Assessment (SMFA). A total of 475 patients were evaluated, including 248 males (52.2%) and 227 females (47.8%) with an average of 56.8 months follow-up. Results: Women were more likely to have inflammatory arthritis (13.7% vs 2.8%; P 〈 .01) and significantly worse preoperative SF-36 total, SF-36 mental health component, AOFAS total, AOFAS pain, SMFA function, and SMFA bother scores (all P 〈 .05). Both genders demonstrated significant improvement in PROs at 1, 2, and 5 years. The magnitude of improvement was similar between genders for all PROs (all P 〈 .05) with the exception of SF-36 physical function, which was greater in men. Females underwent more nonrevision reoperations (32.2% vs 22.6%; P = .0191), but there was no significant difference in failure rates (male 7.3% vs female 3.5%; P = .07). The reoperation and failure rates at 2 years postoperation were 10.1% and 1.6% for men and 18.5% and 0.9% for women, respectively. Conclusion: Women undergoing TAR were more likely to have worse preoperative PROs and higher rates of nonrevision reoperations, which remains true when controlling for their increased incidence of inflammatory arthritis. However, women reported similar improvements in PROs and had similar prosthetic survival rates as men. Increased understanding of these disparities, combined with gender-based interventions, may further advance patient outcomes. Level of Evidence: Level III, therapeutic, retrospective comparative series
    Type of Medium: Online Resource
    ISSN: 1071-1007 , 1944-7876
    URL: Article
    DOI: 10.1177/1071100720985292
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2129503-7
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  • 6
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    Are primary and revision shoulder arthroplasty appropriately reimbursed based on relative value units?
    Elsevier BV ; 2022
    In:  Seminars in Arthroplasty: JSES Vol. 32, No. 1 ( 2022-03), p. 1-7
    Details
    In: Seminars in Arthroplasty: JSES, Elsevier BV, Vol. 32, No. 1 ( 2022-03), p. 1-7
    Type of Medium: Online Resource
    ISSN: 1045-4527
    URL: Article
    DOI: 10.1053/j.sart.2021.06.001
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2260910-6
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  • 7
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    Online Resource
    Pediatric Cervical Spine Clearance: A Consensus Statement and Algorithm from the Pediatric Cervical Spine Clearance Working Group
    American Academy of Pediatrics (AAP) ; 2019
    In:  Pediatrics Vol. 144, No. 2_MeetingAbstract ( 2019-08-01), p. 732-732
    Details
    In: Pediatrics, American Academy of Pediatrics (AAP), Vol. 144, No. 2_MeetingAbstract ( 2019-08-01), p. 732-732
    Type of Medium: Online Resource
    ISSN: 0031-4005 , 1098-4275
    URL: Article
    DOI: 10.1542/peds.144.2MA8.732
    Language: English
    Publisher: American Academy of Pediatrics (AAP)
    Publication Date: 2019
    detail.hit.zdb_id: 1477004-0
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  • 8
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    Online Resource
    The Health & Economic Disparities of Congenital Musculoskeletal Disease Worldwide: An Analysis of 25 Years (1992-2017)
    SAGE Publications ; 2021
    In:  Global Pediatric Health Vol. 8 ( 2021-01), p. 2333794X2199499-
    Details
    In: Global Pediatric Health, SAGE Publications, Vol. 8 ( 2021-01), p. 2333794X2199499-
    Abstract: Background: Large disparities exist in congenital musculoskeletal disease burden worldwide. The purpose of this study is to examine and quantify the health and economic disparities of congenital musculoskeletal disease by country income level from 1992 to 2017. Methods: The Global Burden of Disease database was queried for information on disease burden attributed to “congenital musculoskeletal and limb anomalies” from 1992 to 2017. Gross national income per capita was extracted from the World Bank website. Nonparametric Kruskal–Wallis tests were used to compare morbidity and mortality across years and income levels. The number of avertable DALYs was converted to an economic disparity using the human-capital and value of a statistical life approach. Results: From 1992 to 2017, a significant decrease in deaths/100 000 was observed only in upper-middle and high income countries. Northern Africa, the Middle East, and Eastern Europe were disproportionately affected. If the burden of disease in low- and middle- income countries (LMICs) was equivalent to that in high income countries (HICs), 10% of all DALYs and 70% of all deaths attributable to congenital musculoskeletal disease in LMICs could be averted. This equates to an economic disparity of about $2 billion to $3 billion (in 2020 $USD). Conclusion: Considerable inequity exists in the burden of congenital musculoskeletal disease worldwide and there has been no change over the last 25 years in total disease burden and geographical distribution. By reducing the disease burden in LMICs to rates found in HICs, a large proportion of the health and economic consequences could be averted.
    Type of Medium: Online Resource
    ISSN: 2333-794X , 2333-794X
    URL: Article
    DOI: 10.1177/2333794X21994998
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2021
    detail.hit.zdb_id: 2785531-4
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  • 9
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    Radiation safety education as a component of orthopedic training
    Open Medical Publishing ; 2019
    In:  Orthopedic Reviews Vol. 11, No. 1 ( 2019-03-27)
    Details
    In: Orthopedic Reviews, Open Medical Publishing, Vol. 11, No. 1 ( 2019-03-27)
    Abstract: Fluoroscopy poses an occupational hazard to orthopedic surgeons. The purpose of this study was to examine resident and faculty understanding of radiation safety and to determine whether or not a radiation safety intervention would improve radiation safety knowledge. An anonymous survey was developed to assess attitudes and knowledge regarding radiation safety and exposure. It was distributed to faculty and residents at an academic orthopedic program before and after a radiation safety lecture. Pre- and post-lecture survey results were compared. 19 residents and 22 faculty members completed the pre-lecture survey while 11 residents and 17 faculty members completed the post-lecture survey. Pre-lecture survey scores were 48.3% for residents and 49.5% for faculty; post-lecture survey scores were 52.7% and 46.1% respectively. Differences between pre and post-survey scores were not significant. This study revealed low baseline radiation safety knowledge scores for both orthopedic residents and faculty. As evidence by our results, a single radiation safety information lecture did not significantly impact radiation knowledge. Radiation safety training should have a formal role in orthopedic surgery academic curricula.
    Type of Medium: Online Resource
    ISSN: 2035-8164 , 2035-8237
    URL: Article
    DOI: 10.4081/or.2019.7883
    Language: Unknown
    Publisher: Open Medical Publishing
    Publication Date: 2019
    detail.hit.zdb_id: 2508171-8
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  • 10
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    Orthopedic Master’s in Business Administration: A career path analysis
    Open Medical Publishing ; 2019
    In:  Orthopedic Reviews Vol. 11, No. 4 ( 2019-12-05)
    Details
    In: Orthopedic Reviews, Open Medical Publishing, Vol. 11, No. 4 ( 2019-12-05)
    Abstract: In recent years, it has become increasingly important for physicians to understand the healthcare system holistically. Thus, some physicians have sought formal education in business through a Master’s in Business Administration (MBA). In this study, we looked specifically at orthopedic MD-MBAs and their career trajectories. We conducted a cross-sectional study of 127 orthopedic surgeons who have both MD and MBA degrees. Through online searches and phone calls, we compiled information regarding years in practice, fellowship training, practice type, non-clinical roles, and business school education. Almost all (96.85%) orthopedic MD-MBAs identified are still practicing clinically. The most common nonclinical roles are administration (38.58%), industry consulting (20.47%), and entrepreneurship (11.02%). Most (65.35%) pursued MBAs after medical school, but dual-degree programs are increasing in popularity. Almost all (88.57%) graduates of such programs have been practicing for less than 15 years. Orthopedic surgeons participate in a variety of nonclinical roles including administration, consulting, and entrepreneurship. For those currently in training, it is important to recognize the many opportunities that exist and the potential paths to pursuing them.
    Type of Medium: Online Resource
    ISSN: 2035-8164 , 2035-8237
    URL: Article
    DOI: 10.4081/or.2019.8360
    Language: Unknown
    Publisher: Open Medical Publishing
    Publication Date: 2019
    detail.hit.zdb_id: 2508171-8
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