JOEI The Journal

The recording of The Journal of Orthopaedic Experience & Innovation "Open Mic" featuring John Sperling, MD, Tom Duquin, MD, Leesa Galatz, MD, Larry Gulotta, MD, & David Schneider, MD.

The author reviews cases and methods using knee fusion arthroplasty.

Rotator cuff tears are difficult to repair due to poor intrinsic healing ability and subsequent high retear rate. As such, patches have been developed to augment surgical repair and produce a local environment that is supportive of healing. While many have been clinically evaluated, the ideal patch has yet to be identified. Hyaluronic acid is ubiquitous in the musculoskeletal system and plays a significant role in the healing response through its cell signaling properties. The purpose of this study was to investigate the short-term clinical exam-based outcomes following rotator cuff repair utilizing a hyaluronic acid-based patch.

Stephen Howell, MD shares his perspective on an issue related to the kinematic alignment of total knee replacements.

The following cases illustrate several reconstructive options: endosteal collars as an adjunct to durable fixation; side plates and screws when only a short segment of bone remains; custom rescue sleeves; and total femoral replacement (TFR) when more limited strategies are no longer feasible.

Hand surgeons today face increasing pressures that shape both daily clinical practice and the broader delivery of musculoskeletal care. Declining reimbursement, expanding administrative burden, and restricted access to certain treatment options intersect with the inherent complexity of hand pathology and the high volume of patients requiring timely, accurate diagnosis. Fragmented care pathways—particularly when patients enter through urgent care or emergency departments—can lead to mis-triage, unnecessary imaging, and delayed treatment.

As orthopedic care continues migrating toward ambulatory surgery centers (ASCs) and office-based settings, the specialty must adopt models that enhance efficiency without compromising outcomes.

Specialist-Led Care, defined as early evaluation and triage by a subspecialty-trained surgeon supported by standardized pathways and multidisciplinary teams, offers a framework to enhance the overall patient experience while reducing overall waste to the system. When operationalized through the Longitudinal Patient Experience (LPE) model, Specialist-Led Care can streamline triage, reduce unnecessary imaging and emergency department utilization, and support safe expansion into lower-cost settings. This paper explores how these models may help hand surgeons deliver higher-value care while mitigating burnout and preserving the long-term health of the specialty.

The recording of the Journal of Orthopaedic Experience & Innovation Zoom "Open Mic" featuring Vinod Dasa, MD (Moderator), Jaso Davis, MD, Jeff Lawrence, MD, &Blake Peterson, MD.

Zero by Zero is an operating system that applies supply-chain principles to preparing patients for surgery. Every applicable requirement receives an owner, due date, acceptance authority, validity window, and recovery path. Patient on-time-in-full (OTIF) measures whether preparation is complete by the readiness-lock date and the patient arrives on Day Zero prepared and on time.

AvertD is an FDA-approved genetic test that identifies patients who may have an elevated genetic risk for developing opioid use disorder (OUD).

In our work with medical students preparing for the orthopaedic surgery residency match, we have observed a specific structural pattern affecting US citizen international medical graduates (US-IMGs) that has drawn insufficient policy attention. The share of matched US-IMG orthopaedic surgery residents has declined from 0.94% in 2008 to 0.66% in 2024, even as the US osteopathic share expanded more than fortyfold following the 2020 accreditation merger. In this clinical opinion article, the authors argue that two targeted structural reforms would meaningfully advance orthopaedic surgery’s stated commitment to workforce diversity: broadening AAMC Visiting Student Learning Opportunities (VSLO) US Network eligibility to accredited Caribbean medical schools, and disaggregating US citizen IMGs from non-US IMGs in the ERAS applicant-type field.