OrthoJOE

Keeping current with orthopaedic science and research. A podcast from JBJS and OrthoEvidence, feat...more

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Latest Episodes

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March 15, 2021

Distal Radial Fractures

Welcome to the OrthoJOE podcast with Dr. Marc Swiontkowski and Dr. Mohit Bhandari. In this episode of OrthoJOE, Marc and Mo discuss the RCTs (or randomized control trials) on common injuries like distal radial fractures. There is a huge amount of work involved in these. Should our focus be elsewhere? Is there such a thing as too many RCTs on the same topic?  Marc and Mo also talk about the data and their findings in recent scientific journals, including their own JBJS and Orthoevidence articles. "Cost-effectiveness studies'' are increasingly popular, with submissions doubling every 18 months. Orthopaedic surgeons must "own the bone" when treating distal radial fractures, which should be seen as a sentinel event for investigating overall bone health.  If you have any comments, questions, or topics you would like us to cover, please feel free to reach out so we can read your messages and possibly answer your questions during the next episode of OrthoJOE. We are currently working on a better mailbag system. However, in the meantime, you can contact us through our respective websites (MyOrthoEvidence and JBJS).  Talking Points: RCTs on distal radial fractures The cost-effectiveness of certain studies Getting the appropriate dialogue going The upsides and downsides to “expertise-based trials” Novel angles for future trials The AOA’s “Own the Bone” Program and focusing on poor bone quality Resources/Links: Ludvigsen T, Matre K, Gudmundsdottir RS, Krukhaug Y, Dybvik ...

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00:18:09

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March 01, 2021

How is Data Redefining Surgery?

Welcome to the OrthoJOE podcast with Dr. Marc Swiontkowski and Dr. Mohit Bhandari. In this episode of OrthoJOE, Marc and Mo explore both the challenges and opportunities that have risen from the new abundance of online information and what this means for our pursuit of evidence-based medicine in surgery. If you have any comments, questions, or topics you would like us to cover, please feel free to reach out so we can read your messages and possibly answer your questions during the next episode of OrthoJOE. You can contact us through our respective websites (MyOrthoEvidence and JBJS). We intend on having a mailbag portion of the show where we answer questions posed by our listeners. Talking Points: Traditional textbooks and journal articles in digital form look and operate similar to the printed version Application of machine learning to scientific research and clinical practice Future scientific paper: computational notebooks creating opportunity for a "living journal” Point-of-care, data-driven tools of the future Resources/Links: OrthoEvidence, (February 19, 2021- No 42) OrthoEvidence. The Digital Enterprise: Redefining How Data is Changing Surgery. OE Insight. 2021;2(2):3. Available from: https://myorthoevidence.com/Download/9a6a3a4e-405f-4e40-8970-9ffa1f77480b JBJS, Vaid S, Cakan C, Bhandari M. Using Machine Learning to Estimate Unobserved COVID-19 Infections in North America. J Bone Joint Surg Am. 2020 Jul 1;102(13):e70. doi: 10.2106/JBJS.20.00715. PMID: 32618918; PMCID: PMC7396213. https://pubmed.ncbi.nlm.nih.gov/32618918/ Machine Learning Consortium, on behalf of the SPRINT and FLOW Investigators. A Machine Learning Algorithm to Identify Patients with Tibial Shaft Fractures at Risk for Infection After Operative Treatment. J Bone Joint Surg Am. ...

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00:17:11

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February 15, 2021

Femoral Neck Fracture Evidence

Welcome to the OrthoJOE podcast with Dr. Marc Swiontkowski and Dr. Mohit Bhandari. In this episode of OrthoJOE, Marc and Mo are talking about the choice of a unipolar or bipolar prosthesis design for displaced femoral neck fractures which are treated with hemiarthroplasty. They discuss randomized clinical trials (scientific approach to control bias) vs registry data (real world). They also have a lively discourse about revision rates. If you have any comments, questions, or topics you would like us to cover, please feel free to reach out so we can read your messages and possibly answer your questions during the next episode of OrthoJOE. Talking Points: Orthoevidence article: “Unipolar vs bipolar hemiarthroplasty similar in elderly displaced femoral neck fractures in elderly individuals” Lessons from Mo’s large random control trial concerning fractures The debate about total versus hemiarthroplasty The advantage of a total hip replacement The statistics of the trial The need for a repository of data Clinical decision-making about cementification and revision Resources/Links: Farey JE, Cuthbert AR, Adie S, Harris IA. “Revision Risk After Unipolar or Bipolar Hemiarthroplasty for Femoral Neck Fractures: An Instrumental Variable Analysis of 62,875 Procedures from the Australian Orthopaedic Association National Joint Replacement Registry.” J Bone Joint Surg Am. 2021 Feb 3;103(3):195-204. doi: 10.2106/JBJS.20.00486. PMID: 33208595. https://europepmc.org/article/med/33208595  HEALTH Investigators, Bhandari M, Einhorn TA, Guyatt G, Schemitsch EH, Zura RD, Sprague S, Frihagen F, Guerra-Farfán E, Kleinlugtenbelt YV, Poolman RW, Rangan A, Bzovsky ...

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00:14:43

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February 01, 2021

Robotics in Orthopaedics

Welcome to the OrthoJOE podcast with Dr. Marc Swiontkowski and Dr. Mohit Bhandari. In this episode of OrthoJOE, Drs. Bhandari and Swionkowski discuss the future of robotics in orthopaedic surgery. Why all of the investment? What are the costs vs. benefits? How about the marketing incentives for institutions? Is there a promise of better outcomes?  If you have any comments, questions, or topics you would like us to cover, please feel free to reach out so we can read your messages and possibly answer your questions during the next episode of OrthoJOE. Talking Points: Facts about robotics in the medical industry Why robotics? Are we fixing the problem? What is the long-term value of robotics in surgery? Expertise bias in robotics Is the initial cost going to be outweighed quickly? Two-year outcome study Quicker, less invasive surgeries? Marketing using the latest technology Robotics as an enabler technology that allows us to rethink our views on surgery What is needed in order to integrate and use robots well  Resources/Links: “Robotic-Assisted Total Hip Arthroplasty: A Meta-analysis of Randomized Controlled Trials,” OrthoEvidence  “Robotic Technology in Orthopaedic Surgery,” JBJS.org  “Robotic-Assisted Pedicle Screw Placement During Spine Surgery,” JBJS.org  The Journal of Bone and Joint Surgery Orthoevidence ...

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00:16:12

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January 25, 2021

Cov-19 Crisis and Impact on Orthopaedic Publishing

Welcome to the OrthoJOE podcast with Dr. Marc Swiontkowski and Dr. Mohit Bhandari. In this episode of OrthoJOE, we’ll be talking about the Journal of Bone and Joint Surgery (JBJS) as well as Orthoevidence, our two publications which both have the goals of synthesizing information and making it digestible for the public and professionals in the industry. Today we’re also talking about the impact of COVID-19 on orthopaedic surgery, the speed at which information was disseminated, as well as the publishing standards on this information as it was released to the public.  If you have any comments, questions, or topics you would like us to cover, please feel free to reach out so we can read your messages and possibly answer your questions during the next episode of OrthoJOE. Talking Points: The history and mission statement for Orthoevidence The early days of COVID-19 Infodemic The speed at which information was disseminated  How publishing standards have evolved  Preprint servers and associated use during crisis  Resources/Links: The Journal of Bone and Joint Surgery Orthoevidence JBJS Covid-19 Collection  The "Infodemic" of Journal Publication Associated with the Novel Coronavirus Disease ...

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00:21:11

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January 17, 2021

Sham Surgery as the Surgical “Placebo” in Orthopedic Trials

Welcome to the OrthoJOE podcast with Dr. Marc Swiontkowski and Dr. Mohit Bhandari. In this episode of OrthoJOE, we’ll be talking about sham surgeries. What is sham surgery and why do we need it? Is it morally ethical to use sham controls? We talk about avoiding bias and the feasibility of using sham controls. What are the benefits? Do they outweigh the moral ramifications? If you have any comments, questions, or topics you would like us to cover, please feel free to reach out so we can read your messages and possibly answer your questions during the next episode of OrthoJOE. Talking Points: The three things most people should remember about sham surgery Agreeing on the definition of sham surgery How do you avoid bias? Psychological state of patients and how physicians can affect that The feasibility of sham surgeries  The difference sham surgeries and a placebo trial Resources/Links: My Ortho Evidence Website: https://myorthoevidence.com/Blog/Show/106 Sham surgery resources ...

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00:17:09