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  1. Article ; Online: Assessing the Finances of Applying to Surgical Residency in 2019-2020: A US Nationwide Surgical Specialties Comparison.

    Gordon, Adam M / Pulford, Christopher

    Journal of graduate medical education

    2023  Volume 15, Issue 5, Page(s) 558–563

    Abstract: ... ...

    Abstract Background
    MeSH term(s) Humans ; Internship and Residency ; Orthopedics/education ; Surgery, Plastic/education ; Urology/education ; Students, Medical
    Language English
    Publishing date 2023-08-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2578612-X
    ISSN 1949-8357 ; 1949-8357
    ISSN (online) 1949-8357
    ISSN 1949-8357
    DOI 10.4300/JGME-D-23-00274.1
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Anemia Severity and the Risks of Postoperative Complications Following Total Ankle Arthroplasty.

    Gordon, Adam M / Malik, Azeem Tariq

    Foot & ankle specialist

    2022  , Page(s) 19386400221106650

    Abstract: Background: Although studies have demonstrated the effect of anemia severity on postoperative complications after arthroplasties of the shoulder, hip, and knee, no studies have investigated the effect on total ankle arthroplasty (TAA). The objective was ...

    Abstract Background: Although studies have demonstrated the effect of anemia severity on postoperative complications after arthroplasties of the shoulder, hip, and knee, no studies have investigated the effect on total ankle arthroplasty (TAA). The objective was to determine the influence of preoperative anemia severity on complications following TAA.
    Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) was queried from 2006 to 2019 for patients undergoing TAA. Utilizing the World Health Organization (WHO) definitions of anemia, patients were stratified into 3 cohorts: nonanemia (hematocrit >36% for women, >39% for men), mild anemia (hematocrit 33%-36% for women, 33%-39% for men), and moderate to severe anemia (hematocrit <33% for both women and men). Demographics, comorbidities, length of stay, and short-term (30-day) postoperative complications were compared between groups. Bivariate analyses, including χ
    Results: After exclusion, 1490 patients (1313 nonanemia [88.1%], 154 mild anemia [10.3%], and 23 moderate/severe anemia [1.6%]) were included. Increasing severity of anemia was associated with an increased average hospital length of stay (1.84 vs 2.19 vs 2.78 days, P < .001) and rate of reoperation (0.38% vs 3.90% vs 4.35%, P < .001). There was a statistically significant increase in wound disruptions (0.15% vs 1.95% vs 4.35%, P = .001), minor complications (1.52% vs 4.55% vs 8.70%, P = .008), major complications (1.98% vs 5.84% vs 4.35%, P < .033), and any complications (3.50% vs 10.39% vs 13.04%, P = .001) between groups. Multivariate analysis identified mild and moderate/severe anemia as a predictor of reoperation and extended length of stay (P ≤ .033).
    Discussion: Preoperative anemia is a modifiable risk factor for medical and surgical complications within 30 days of TAA. Medical optimization prior to surgical intervention is necessary in patients undergoing TAA.
    Level of evidence: Level III: Retrospective comparative study.
    Language English
    Publishing date 2022-06-29
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2488579-4
    ISSN 1938-7636 ; 1938-6400
    ISSN (online) 1938-7636
    ISSN 1938-6400
    DOI 10.1177/19386400221106650
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  3. Article ; Online: The Utility of the Standardized Letter of Recommendation for Orthopedic Surgery Residency Applicants: A Systematic Review.

    Gordon, Adam M / Mont, Michael A / Choueka, Jack

    Orthopedics

    2023  Volume 47, Issue 1, Page(s) e1–e5

    Abstract: Despite widespread adoption for evaluating residency candidates, few studies have evaluated the orthopedic standardized letter of recommendation (SLOR). A systematic review using PubMed, Embase, and Web of Science was performed in June 2022. Study design ...

    Abstract Despite widespread adoption for evaluating residency candidates, few studies have evaluated the orthopedic standardized letter of recommendation (SLOR). A systematic review using PubMed, Embase, and Web of Science was performed in June 2022. Study design and results from SLOR investigations were compiled. Common outcomes studied were summative rank statement scores and SLOR individual domains. Applicants were rated ranked to match or in the top one-third of rank lists in non-normally distributed frequencies. The association of summative rank statement score with match outcome was rarely studied. Applicants' ratings skew positively, the utility is reportedly limited, and influence on match outcome has been inadequately studied. [
    MeSH term(s) Humans ; Internship and Residency ; Orthopedic Procedures/education ; Orthopedics/education ; Personnel Selection/methods
    Language English
    Publishing date 2023-09-06
    Publishing country United States
    Document type Systematic Review ; Journal Article ; Review
    ZDB-ID 424447-3
    ISSN 1938-2367 ; 0147-7447
    ISSN (online) 1938-2367
    ISSN 0147-7447
    DOI 10.3928/01477447-20230901-02
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    Zs.A 1487: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  4. Article: Total elbow arthroplasty cases involving orthopaedic residents do not affect short-term postoperative complications.

    Gordon, Adam M / Malik, Azeem Tariq

    Shoulder & elbow

    2021  Volume 15, Issue 1, Page(s) 65–73

    Abstract: Background: Impact of resident participation on short-term postoperative outcomes after total elbow arthroplasty has not been studied. The aim was to investigate whether resident participation affects postoperative complication rates, operative time, ... ...

    Abstract Background: Impact of resident participation on short-term postoperative outcomes after total elbow arthroplasty has not been studied. The aim was to investigate whether resident participation affects postoperative complication rates, operative time, and length of stay.
    Methods: The American College of Surgeons National Surgical Quality Improvement Program registry was queried from 2006 to 2012 for patients undergoing total elbow arthroplasty. A 1:1 propensity score match was performed to match resident cases to attending-only cases. Comorbidities, surgical time, and short-term (30-day) postoperative complications were compared between groups. Multivariate Poisson regression was used to compare the rates of postoperative adverse events between groups.
    Results: After propensity score match, 124 cases (50% with resident participation) were included. Adverse event rate after surgery was 18.5%. On multivariate analysis, there were no significant differences between attending-only cases and resident involved cases, with regards to short-term major complications, minor complications, or any complications (all
    Discussion: Resident participation during total elbow arthroplasty is not associated with increased risk for short-term medical or surgical postoperative complications or operative efficiency.
    Language English
    Publishing date 2021-08-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2503275-6
    ISSN 1758-5732
    ISSN 1758-5732
    DOI 10.1177/17585732211034455
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 6789: Show issues Location:
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  5. Article ; Online: Costs of U.S. Allopathic Medical Students Applying to Neurosurgery Residency: Geographic Considerations and Implications for the 2020-2021 Application Cycle.

    Gordon, Adam M / Malik, Azeem Tariq

    World neurosurgery

    2021  Volume 150, Page(s) e783–e789

    Abstract: Objective: Although studies have evaluated the economic burden to medical students desiring a neurosurgery residency broadly, a detailed breakdown of costs has not been reported. Given that the Association of American Medical Colleges and Society of ... ...

    Abstract Objective: Although studies have evaluated the economic burden to medical students desiring a neurosurgery residency broadly, a detailed breakdown of costs has not been reported. Given that the Association of American Medical Colleges and Society of Neurological Surgeons have recommended neurosurgery residency programs for the 2021 residency application cycle cancel away rotations and in-person interviews, our objective was to evaluate cost savings to medical students applying during this time and the implications.
    Methods: Using the 2019-2020 Texas STAR Dashboard database, we queried responses from neurosurgery residency applicants. We recorded application costs, away rotation costs, interview costs, and total costs for medical school seniors applying to neurosurgery residency. Demographic information for applicants was also recorded. Mean and median costs were reported with percentile distributions and geographic comparisons. A Kruskal-Wallis H test was used to determine differences in mean costs by medical school region.
    Results: Our cohort included 121 U.S. allopathic applicants to neurosurgery residency. Mean application costs were $1711, away rotation costs were $3840, interview costs were $6400, and total costs were $11,882. No significant difference was observed for mean total costs for applicants from schools in the central ($10,525/applicant), northeast ($11,311/applicant), south ($12,660/applicant) and west ($12,404/applicant) regions (P = 0.181). There was no significant difference in the mean application fees, away rotation costs, or interview costs among regions.
    Conclusions: In the COVID-19 era, neurosurgery residency applicants could save >$10,000 through the use of virtual interviews and lack of away rotations. There are potential geographic trends; however, further evaluation should be performed.
    MeSH term(s) COVID-19 ; Costs and Cost Analysis ; Cross-Sectional Studies ; Databases, Factual ; Geography ; Humans ; Internship and Residency/economics ; Neurosurgery/economics ; Pandemics ; Students, Medical ; Surveys and Questionnaires ; United States ; Young Adult
    Language English
    Publishing date 2021-04-05
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2534351-8
    ISSN 1878-8769 ; 1878-8750
    ISSN (online) 1878-8769
    ISSN 1878-8750
    DOI 10.1016/j.wneu.2021.03.149
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    Zs.A 1159: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

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  6. Article ; Online: How Does Geographic Region Affect the Total and Individual Costs for Medical Students Applying to the Competitive Surgical Residencies?

    Gordon, Adam M / Ahlering, Thomas E

    Journal of surgical education

    2021  Volume 79, Issue 1, Page(s) 147–156

    Abstract: Objective: Studies have individually assessed the expenses for medical students desiring a surgical residency in neurosurgery, orthopaedic surgery, otolaryngology, plastic surgery, and urology. A detailed comparison of expenses by geographic region have ...

    Abstract Objective: Studies have individually assessed the expenses for medical students desiring a surgical residency in neurosurgery, orthopaedic surgery, otolaryngology, plastic surgery, and urology. A detailed comparison of expenses by geographic region have not been reported. The aim was to geographically compare the expenses of United States medical students applying to the 5 most competitive surgical residencies.
    Setting/participants: Anonymous nationwide survey of plastic surgery, orthopaedic surgery, otolaryngology, urology, and neurological surgery residency applicants.
    Design: A cross sectional, retrospective analysis of the 2019-2020 Texas STAR Dashboard database, an online tool generated from a nationwide survey of students. Individual (application, away rotation, interview) and total costs for medical school seniors were recorded in addition to applicant characteristics. Mean and median costs were reported for each specialty with percentile distributions and geographic comparisons. A Kruskal-Wallis H test was performed to compare differences in costs between surgical specialties and medical school region.
    Results: In total, 1136 applicants to surgical residency were included. The number of applicants to orthopaedic surgery (OS) (n = 459), neurological surgery (NS) (n = 121), urology (UR) (n = 191), plastic surgery (PS) (n = 117), and otolaryngology (OTO) (n = 248) were reported. Mean total costs were (OS; $8,205), (NS; $11,882), (UR; $8,207), (PS; $10,845), and (OTO; $7,516) (p ≤ 0.029). Application fees were only significantly different in the northeast and southern applicants between the different specialties, notably orthopaedic surgery applicants spent the most. In all geographic regions excluding the west, neurosurgery and plastic surgery applicants spent significantly more than other specialties for interview costs and away rotation costs. In all geographic regions neurosurgery and plastic surgery applicants spent significantly more than other specialties in total costs.
    Conclusions: Orthopaedic surgery applicants spend the most on application fees in select geographic regions. Neurosurgery and plastic surgery applicants spend more on interviews, away rotations, and total costs in nearly all geographic regions.
    MeSH term(s) Cross-Sectional Studies ; Humans ; Internship and Residency ; Neurosurgery ; Retrospective Studies ; Students, Medical ; United States
    Language English
    Publishing date 2021-09-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277538-9
    ISSN 1878-7452 ; 1931-7204
    ISSN (online) 1878-7452
    ISSN 1931-7204
    DOI 10.1016/j.jsurg.2021.08.016
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    Uk I Zs.230: Show issues Location:
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    ab Jg. 2022: Lesesaal (EG)

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  7. Article ; Online: Preoperative Depression Screening for Primary Total Knee Arthroplasty: An Evaluation of Its Modifiability on Outcomes in Patients Who Have Depression.

    Gordon, Adam M / Magruder, Matthew L / Schwartz, Jake / Ng, Mitchell K / Erez, Orry / Mont, Michael A

    The Journal of arthroplasty

    2024  

    Abstract: Background: Few studies have evaluated preoperative depression screenings in patients who have depression. We studied whether depression screenings before total knee arthroplasty (TKA) were associated with lower: 1) medical complications; 2) emergency ... ...

    Abstract Background: Few studies have evaluated preoperative depression screenings in patients who have depression. We studied whether depression screenings before total knee arthroplasty (TKA) were associated with lower: 1) medical complications; 2) emergency department (ED) utilizations and readmissions; 3) implant complications; and 4) costs.
    Methods: A nationwide sample from January 1, 2010, to April 30, 2021, was collected using an insurance database. Depression patients were 1:1 propensity-score matched based on those who had (n = 29,009) and did not have (n = 29,009) preoperative depression screenings or psychotherapy visits within 3 months of TKA. A case-matched population who did not have depression was compared (n = 144,994). A 90-day period was used to compare complications and health-care utilization and 2-year follow-up for periprosthetic joint infections (PJIs) and implant survivorship. Costs were 90-day reimbursements. Logistic regression models computed odds ratios (ORs) of depression screening on dependent variables. P values less than .001 were significant.
    Results: Patients who did not receive preoperative screening were associated with higher medical complications (18.7 versus 5.2%, OR: 4.15, P < .0001) and ED utilizations (11.5 versus 3.2%, OR: 3.93, P < .0001) than depressed patients who received screening. Patients who had screening had lower medical complications (5.2 versus 5.9%, OR: 0.88, P < .0001) and ED utilizations compared to patients who did not have depression (3.2 versus 3.8%, OR: 0.87, P = .0001). Two-year PJI incidences (3.0 versus 1.3%, OR: 2.63, P < .0001) and TKA revisions (4.3 versus 2.1%, OR: 2.46, P < .0001) were greater in depression patients who were not screened preoperatively versus screened patients. Depression patients who had screening had lower PJIs (1.3 versus 1.8%, OR: 0.74, P < .0001) compared to nondepressed patients. Reimbursements ($13,949 versus $11,982; P < .0001) were higher in depression patients who did not have screening.
    Conclusions: Preoperative screening was associated with improved outcomes in depression patients.
    Level of evidence: III.
    Language English
    Publishing date 2024-02-19
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2024.02.035
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    Zs.A 2134: Show issues Location:
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    Jg. 1995 - 2021: Lesesall (1.OG)
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  8. Article ; Online: A Nationwide Analysis of the Impact of Socioeconomic Status on Complications and Healthcare Utilizations After Total Knee Arthroplasty Using the Area Deprivation Index: Consideration of the Disadvantaged Patient.

    Gordon, Adam M / Ng, Mitchell K / Elali, Faisal / Piuzzi, Nicolas S / Mont, Michael A

    The Journal of arthroplasty

    2024  

    Abstract: Introduction: Socioeconomic status (SES) has been demonstrated to be an important prognostic risk factor among patients undergoing total joint arthroplasty. We evaluated patients living near neighborhoods with higher socioeconomic risk undergoing total ... ...

    Abstract Introduction: Socioeconomic status (SES) has been demonstrated to be an important prognostic risk factor among patients undergoing total joint arthroplasty. We evaluated patients living near neighborhoods with higher socioeconomic risk undergoing total knee arthroplasty (TKA) and if they were associated with differences in: 1) medical complications; 2) emergency department (ED) utilizations; 3) readmissions; and 4) costs of care.
    Methods: A query of a national database from 2010 to 2020 was performed for primary TKAs. The Area Deprivation Index (ADI) is a weighted index comprised of 17 census-based markers of material deprivation and poverty. Higher numbers indicate a greater disadvantage. Patients undergoing TKA in zip codes associated with high ADI (90%+) were 1:1 propensity-matched to a comparison group by age, sex, and Elixhauser Comorbidity Index (ECI). This yielded 225,038 total patients, evenly matched between cohorts. Outcomes studied included complications, ED utilizations, readmission rates, and 90-day costs. Logistic regression models computed the odds ratios (OR) of ADI on the dependent variables. P-values less than 0.003 were significant.
    Results: High ADI led to higher rates and odds of any medical complications (11.7 versus 11.0%; OR: 1.05, P = 0.0006), respiratory failures (0.4 versus 0.3%; OR: 1.28, P = 0.001), and acute kidney injuries (1.7 versus 1.5%; OR: 1.15, P < 0.0001). Despite lower readmission rates (2.9 versus 3.5%), high ADI patients had greater 90-day ED visits (4.2 versus 4.0%; OR: 1.07, P = 0.0008). The 90-day expenditures ($15,066 versus $12,459; P < 0.0001) were higher in patients who have a high ADI.
    Conclusion: Socioeconomically disadvantaged patients have increased complications and ED utilizations. Neighborhood disadvantage may inform healthcare policy and improve post-discharge care. The SES metrics, including ADI (which captures community effects), should be used to adequately risk-adjust or risk-stratify patients so that access to care for deprived regions and patients is not lost.
    Language English
    Publishing date 2024-04-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2024.04.028
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    Zs.A 2134: Show issues Location:
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  9. Article ; Online: Complications in Hand Surgery During Early Independent Practice: A Single Surgeon's 5-Year Experience.

    Samade, Richard / Gordon, Adam M / Vaghani, Parth / Goyal, Kanu S

    Hand (New York, N.Y.)

    2023  , Page(s) 15589447231201875

    Abstract: Background: The objective of this study was to understand the frequency and types of complications, and the associated postoperative outcomes within the first 5 years of practice after hand and upper extremity surgery fellowship.: Methods: This was a ...

    Abstract Background: The objective of this study was to understand the frequency and types of complications, and the associated postoperative outcomes within the first 5 years of practice after hand and upper extremity surgery fellowship.
    Methods: This was a retrospective observational study of all patients seen and surgically treated by a single surgeon at a single institution from August 2014 to September 2019. This corresponded to the first 5 years of practice after fellowship. Data collected included patient demographics, perioperative data, complication type, and outcome of the complication (better/same/worse than preoperative status). Complications were classified using the Clavien-Dindo system and a unique, self-derived system.
    Results: In total, 3301 surgeries were performed during the first 5 years of practice. The overall complication rate was 7.9% (261 complications from 239 patients). The 30-day complication rate was 5.2% (171/3301). Eleven (4.2%) of the 261 complications occurred intraoperatively. The total number of complications significantly declined during the first 5 years of practice as follows: 74, 71, 46, 37, and 33 (
    Conclusion: The overall surgical complication rate for hand and upper extremity surgery was 7.9%, with a 30-day complication rate of 5.2% (171/3301). The rate of complications after fellowship declined over the first 5 years of independent practice. Superficial infections were the most common complication. More than 90% of patients ultimately improved after addressing the complication.
    Level of evidence: IV.
    Language English
    Publishing date 2023-10-03
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2277325-3
    ISSN 1558-9455 ; 1558-9447
    ISSN (online) 1558-9455
    ISSN 1558-9447
    DOI 10.1177/15589447231201875
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  10. Article ; Online: Antegrade Flexible Nailing for Pediatric Metaphyseal-diaphyseal Junction Distal Radius Fracture, is it Safe?

    Lam, Aaron / Gordon, Adam M / Thabet, Ahmed M / Abdelgawad, Amr A

    Techniques in hand & upper extremity surgery

    2023  Volume 27, Issue 3, Page(s) 161–164

    Abstract: Fractures involving the distal radius metaphyseal-diaphyseal junction (MDJ) present a unique challenge for pediatric orthopedic surgeons. These fractures are too proximal for percutaneous K -wire fixation and too distal for retrograde flexible nailing. ... ...

    Abstract Fractures involving the distal radius metaphyseal-diaphyseal junction (MDJ) present a unique challenge for pediatric orthopedic surgeons. These fractures are too proximal for percutaneous K -wire fixation and too distal for retrograde flexible nailing. The purpose of this study was to: (1) determine the safety of a described antegrade approach from the posterior interosseous nerve (PIN); (2) assess the efficacy of antegrade nailing in cases of distal MDJ fractures; and (3) describe a standardized lateral approach to the proximal radius. A cadaveric study was performed using 10 adult forearms. Anterograde flexinail was introduced at the proximal radius based on the described "safe zone". Distal MDJ fractures were created using osteotomes. We evaluated the distance between the entry point to the PIN in addition to the quality of the reduction for the fracture. The average distance between the entry point and piercing instrument to the PIN was 5.4 cm (range: 4.7 to 6.0 cm). When grouped based on sex, the average distance was significantly further for males (5.8 cm, range: 5.2 to 6.0 cm) versus females (4.9 cm, range: 4.7 to 5.2 cm), P =0.004. Fracture reduction was not maintained after the introduction of the antegrade flexible nail across the fracture site. For all specimens, >25% displacement was seen on the anterior-posterior imaging. Our modified lateral approach to the starting point in the proximal radius is safe as long as the entry point for antegrade flexible nailing stays proximal to the radial tuberosity during the lateral approach to the proximal radius while the elbow is flexed and the forearm pronated.
    MeSH term(s) Male ; Adult ; Female ; Humans ; Child ; Fracture Fixation, Intramedullary/methods ; Wrist Fractures ; Radius ; Forearm ; Fractures, Bone ; Bone Nails
    Language English
    Publishing date 2023-09-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2075789-X
    ISSN 1531-6572 ; 1089-3393
    ISSN (online) 1531-6572
    ISSN 1089-3393
    DOI 10.1097/BTH.0000000000000430
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