Robotic-assisted total joint arthroplasty (rTJA) has growing interest among patients and surgeons. However, patient interest in and perceptions of rTJA have not been well explored. We sought to investigate the influence of patient demographics on interest in rTJA and patient perceptions regarding rTJA. Patients presenting for their initial adult reconstruction consultation received an optional anonymous survey prior to seeing the provider. Patient sociodemographic parameters were recorded. Additional questions assessed interest in and perceptions surrounding rTJA. Results were analyzed to determine whether patient factors correlated with survey responses. A total of 360 patients participated. Analysis of responses revealed 77.8% of patients were interested in rTJA. Interest level positively correlated with patient age (R_s = 0.139, P = .010), education level (R_s = 0.168, P = .002), household income (R_s = 0.274, P < .001), and White race (F = 4.157, P = .016). At least 100 patients believed rTJA was easier and more accurate, but more expensive and had a significant learning curve for the surgeon. Over 100 patients believed robots were capable of independently performing most or all of the rTJA operation. Patient interest in rTJA varies between patients. Many patients have an incomplete understanding of rTJA, and orthopaedic surgeons should address patient perceptions during surgical consultation. IV, Cross-sectional study.

There are few large studies evaluating total knee arthroplasty (TKA) in young patients. Therefore, we sought to evaluate patients aged 45 years or younger undergoing a primary TKA. This was a retrospective, single-institution study, from 2003 to 2018, evaluating primary TKA in patients aged 45 years or younger. We identified 162 TKAs with a minimum follow-up duration of 2 years. Common surgical indications were degenerative joint disease (50%), post-traumatic arthritis (21%), and inflammatory arthritis (20%). Forty-nine knees had a prior significant knee surgery. We evaluated survivorship free of revision for any reason and aseptic revision. In addition, we characterized complication rates and risk factors for failure. The mean age was 39 years, 70% were female, and the mean clinical follow-up duration was 7 years. At 8 years, survivorship free of revision for any reason was 82%, and survivorship free of aseptic revision was 87%. Fifty-five knees experienced at least 1 complication, with an overall complication rate of 34%. There were 6 (4%) periprosthetic joint infections (PJIs), and 24 (15%) knees of patients underwent manipulation under anesthesia with or without arthroscopic lysis of adhesions. There were no specific risk factors for revisions identified. Age less than 40 years was associated with PJI (P = .031), and marital status at the time of TKA was associated with arthrofibrosis requiring an intervention (P = .045). TKAs in patients aged 45 years or younger are associated with acceptable survivorship at a mean follow-up duration of 7 years. Patients should be counseled about the elevated risk of complications, specifically PJI and arthrofibrosis.

Background: Historically, orthopaedic surgery has had low female representation, with <6% of practicing surgeons identifying as female. Although prior literature has illustrated gender disparities in first and last authorship as well as changes in gender representation over time, less attention has been paid to middle authorship. We hypothesized that trends in female authorship would reflect increasing female participation in orthopaedic surgery and orthopaedic subspecialties coinciding with an overall increase in female authorship. Methods: Bibliometric information from articles published between 2011 and 2021 in 6 orthopaedic journals was extracted with use of the Web of Science. Collected data included author order, author names, affiliation, and corresponding author address. A gender was assigned with the use of Genderize.io, which is validated software, on the basis of author first name. Statistical analysis was performed with use of an analysis of variance for each journal, and linear regression was performed to determine trends, controlling for year. Results: Among all included orthopaedic journals, female middle authorship increased by 5 percentage points, female first authorship increased by 4 percentage points, and female last authorship increased by 1 percentage point. Over the study period, the highest rate of female middle authorship (28%) was seen in the Journal of Pediatric Orthopaedics, whereas the lowest rate (16%) was seen in The Journal of Arthroplasty. We found that the 5 highest-producing female last authors were, on average, cited significantly less per publication than their male counterparts in all but 2 journals. Conclusions: Gender gaps exist within orthopaedic surgery as well as within its body of literature. Although this study highlights areas of growth, it also promotes further inquiry into research productivity and the availability of opportunity within orthopaedic surgery as a whole. The increase in female middle authorship overall and in each journal demonstrates momentum for future growth for women in the field of orthopaedic surgery.