ABSTRACT
With the ever-changing dynamics of surgical training, it is essential for the content of educational research to evolve simultaneously. This study aimed to assess the current state of scholarly work in orthopaedic training education and to identify particular educational topics that are trending in the literature. Methods: 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. Results: 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%). Conclusion: 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. Level of Evidence: III.
ABSTRACT
Background: Systematic reviews on the use of platelet-rich plasma (PRP) in orthopaedic surgery are abundant in current published literature. However, a beautification of results (referred to as spin) has been noted in abstracts across various aspects of medicine. Purpose: To determine the prevalence of spin in systematic reviews of PRP-related orthopaedic surgery abstracts. Study Design: Cross-sectional study. Methods: Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and Murad and Wang guidelines, we conducted a search in Medline, Embase, and the Cochrane Database for reviews on PRP-related orthopaedic surgery. The search included studies published from inception until June 30, 2021. Included were systematic reviews written in English that involved the use of PRP in the treatment of orthopaedic injuries in human participants. The abstracts of the included reviews were evaluated for the top 9 types of spin as described by Yavchitz et al in 2016. We determined the relationship between spin and study characteristics using odds ratios. Results: Of an initial 1560 studies, 176 were included. We found that 50 studies (28.4%) contained at least 1 form of spin. The 2 most common forms of spin found in our sample were type 5 ("Conclusion claims the beneficial effect of treatment despite high risk of bias"; n = 27 [15.3%]) and type 3 ("Selective reporting or overemphasis of efficacy in outcomes favoring beneficial effect of intervention"; n = 18 [10.2%]). No statistical significance was found between study characteristics and the presence of spin. Conclusion: Spin was present in 28% of the systematic reviews that covered PRP-related orthopaedic treatments. Spin was not associated with general study characteristics, including adherence to PRISMA guidelines or funding. Journals and authors should be aware of spin in articles and avoid its usage.
ABSTRACT
PURPOSE: To investigate whether pullout strength in the acellular dermal allograft matrix (ADM) used for superior capsule reconstruction depends on the distance from the edge of the graft. METHODS: ADM used for superior capsule reconstruction was obtained and cut into 30 squares. Two sutures were placed through the center of each graft by using a loaded Keith needle and forming a simple stitch. The grafts were divided into 3 groups of 10 grafts with a distance of 5 mm, 10 mm or 15 mm from the closest edge of the graft, respectively. The grafts were then preloaded to 5 N and pulled to failure at a rate of 12 mm/s on an MTS 858 MiniBionix servohydraulic mechanical test frame. The load to failure was recorded as well as the stiffness of each graft. RESULTS: The mean load to failure was 34.5 N (SD 7.89) for the 5 mm grafts, 31.7 N (SD 5.99) for the 10 mm grafts, and 66.2 N (SD 18.4) for the 15 mm grafts. There was a significant difference (< 0.0001) between the large grafts (15 mm) and the 2 smaller grafts (10 mm, 5 mm). There was no significant difference in stiffness between the groups of graft (P 0.40). CONCLUSION: Placing the suture at least 15 mm from the edge of the graft increases the graft's ultimate yield strength to suture pullout. CLINICAL RELEVANCE: The depths of the suture in ADM could improve pullout strength for constructs of superior capsular reconstructions.
