No abstract

Background: Patients continue to utilize physician review websites (PRWs) to assist in their selection of a health care provider. Studies on PRWs and how they affect patient care have recently become popular in the literature. This study analyzes PRW ratings of a previously unexamined subspecialty, pediatric orthopaedic surgeons. Methods: Three hundred ninety-nine randomly selected Pediatric Orthopaedic Society of North America member's PRW ratings were examined from May 4, 2020 to July 18, 2020. Healthgrades. com, Vitals.com, RateMDs.com, and Google.com were reviewed. Number of ratings and average ratings (0 to 5.0) were recorded. Provider sex, years in practice (0 to 10, 11 to 20, and 21+), practice type (academic, private), geographic location (Northeast, Southeast, Midwest, Southwest, West), degree (Medical Doctor, Doctor of Osteopathic Medicine), and fellowship training (yes, no) were recorded. Kruskal-Wallis testing was performed to determine factors affecting positive surgeon ratings. Results: 98.5% (393) of Pediatric Orthopaedic Society of North America surgeons were rated on a PRW at least once and were highly rated with an average rating of 4.14 of 5.0. Surgeons in practice 1 to 10 years had higher ratings than those in practice 11 to 20 and 21+ years, on Healthgrades.com (P = 0.049) and RateMDs.com (P = 0.011). Academic surgeons were found to have higher ratings than those in private practice on Google.com (P = 0.007). Sex, region of practice, degree type, and fellowship training status did not have an effect on online ratings across all PRWs. Conclusions: Pediatric orthopaedic surgeons are frequently and highly rated, similar to other orthopaedic subspecialties. Surgeons in practice 1 to 10 years were found to have statistically higher ratings on some websites. Academic surgeons were found to have statistically higher ratings on some websites.

Introduction: We report the youngest documented patient (38 years old) to develop an acute popliteal artery thrombus following primary total knee arthroplasty (TKA). Patient Concerns: The patient presented for an elective TKA secondary to posttraumatic arthritis. Past medical history included a tibial plateau fracture, two knee arthroscopies and an elevated body mass index (37.53). A right TKA was performed with no intraoperative complications. Two hours postoperatively, the right foot was poikilothermic and lacking dorsalis pedal pulse. Diagnosis: Popliteal artery thrombus confirmed by angiogram and venous duplex. Interventions: Immediate vascular surgery consult and subsequent embolectomy. Outcomes: At 1 year postoperatively, the patient is doing well with no further complications. Conclusion: Due to the lack of significant past medical history putting this patient at risk, future research should focus on prior trauma, age, and BMI as risk factors, specifically in patients undergoing TKA.

The orthopedic surgical specialty is strongly tied to partnerships with industry that have fostered innovation and greatly enhanced patient care. A substantial number of orthopedic surgeons currently receive some form of industry support. These relationships are highly scrutinized because they present the possibility of both personal and financial conflicts of interest (COI). The authors examined orthopedic patients' awareness of existing regulation and perceptions of financial COI by performing a prospective survey-based study of patients seen in an academic orthopedic department. Data were collected during 1 year, in a cross-section of hospital-based and community clinical settings. The authors collected 513 surveys during a 1-year period between 4 clinical locations. Of all respondents, 55% were unconcerned regarding gifts or direct compensation their physicians received from industry, and only 16% were very or extremely concerned regarding these benefits. Patients' opinions regarding possible influence of benefits were similarly ambivalent, with 54% of patients minimally or not at all concerned regarding the potential influence of industry gifts or compensation. Seventy-six percent of patients had never heard of the Sunshine Act, and only 3% indicated that they were aware of the legislation and its intention. The income of the respondents and their level of education were positively correlated with increased concern about handling of COI, as well as knowledge regarding the Sunshine Act. These data suggest that orthopedic surgery patients are widely unconcerned regarding physician COI, but specific subsets of patients may be more likely to have concerns regarding these relationships. [ Orthopedics . 2021;44(5):e682–e686.]