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Background: Dual semitendinosus allograft reconstruction of chronic Achilles tendon ruptures has several potential benefits including superior tensile strength compared with a turndown construct and avoidance of the morbidity and operative time associated with autograft augmentation. We present a series of chronic Achilles tendon ruptures reconstructed with dual semitendinosus allograft. Methods: We retrospectively reviewed the charts of patients aged 18 years and older who underwent reconstruction of chronic Achilles tendon ruptures using dual semitendinosus allograft. The primary outcome of this study was to evaluate the need for revision surgery. Secondary outcomes included patient-reported outcomes, for which Achilles Tendon Rupture Scores (ATRS) were collected at final follow-up. Nine patients with a mean age of 58.9 (range, 43-75) years met inclusion criteria. Results: Median follow-up was 66 months (range, 27-121 months). One patient (11.1%) required revision reconstruction after sustaining graft failure 9.5 years after her index procedure, and 1 patient reported a poor ATRS score at the 27-month final follow-up despite an intact surgical repair. At final follow-up, no patient required the use of an assistive device for ambulation or a walking boot. The median ATRS at final follow-up was 93 (range, 30-100). Discussion: Good clinical outcomes without rerupture were observed in 7 of 9 patients (77.8%) at short- to midterm follow-up, suggesting that dual semitendinosus allograft reconstruction is a viable option for the reconstruction of chronic Achilles tendon tears. Level of Evidence: Level IV, case series. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to analyze and compare the quality, accuracy, and readability of information regarding anatomic Total Shoulder Arthroplasty (aTSA) and reverse Total Shoulder Arthroplasty (rTSA) provided by various AI interfaces (Open AI's ChatGPT and Microsoft's Copilot)., Methods: Thirty commonly asked questions (categorized by Rothwell criteria into Fact, Policy, and Value) by patients were inputted into ChatGPT 3.5 and Copilot. Responses were assessed with the DISCERN scale, JAMA benchmark criteria, Flesch-Kincaid Reading Ease Score (FRES), and Grade Level (FKGL). The sources of citations provided by CoPilot were further analyzed., Results: Both AI interfaces generated DISCERN scores >50 (aTSA and rTSA ChatGPT 57 (Fact), 61 (Policy), 58 (Value), aTSA and rTSA Copilot 68 (Fact), 72 (Policy), 70 (Value)), demonstrating "good" quality of information provided, except for the Policy questions by CoPilot which were scored as "excellent" (>70). CoPilot's higher JAMA score (3 vs. 0) and FRES scores above 30 indicated more reliable, accessible responses, which required a minimum of 12th grade education to read the same. In comparison, the ChatGPT generated more complex texts, with the majority of the FRES scores <20, and FKGL score signifying complexity of academic level text. Finally, CoPilot provided citations and demonstrated the highest percentage of Academic sources (31.1% for rTSA and 26.7% for aTSA) suggesting reliable sources of information., Conclusion: Overall, the information provided by both AI interfaces ChatGPT and CoPilot was scored as a "good" source of information for commonly asked patient questions regarding shoulder arthroplasty. But the answers to questions pertaining to shoulder arthroplasty provided by CoPilot proved to be more reliable (p=0.0061), less complex, easier to read (p=0.0031), and referenced information from reliable resources including Academic sources, Journal articles, and Medical sites. Although answers provided by CoPilot were "easier" to read, they still required a 12th grade education, which may be too complex for most patients, posing a challenge for patient comprehension. There were a substantial amount of non-medical media sites, and Commercial sources that were cited for both aTSA and rTSA questions by CoPilot. Critically, answers from both AI interfaces should serve as supplementary resources rather than primary sources on perioperative conditions pertaining to shoulder arthroplasty., (Copyright © 2025 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.)

Introduction: International medical graduates (IMGs) continue to play an important role in the US health care system, but little is known about their trends of matching into highly competitive residencies such as orthopedic surgery. The purpose of this study was to analyze temporal trends of IMG applicants matching into US orthopedic residency programs between 2008 and 2024 and compare them with US allopathic (MD) and osteopathic (DO) graduates., Methods: Orthopedic residency specific data for years 2008 to 2024 was obtained from the National Resident Match Program and Electronic Residency Application Service. Variables collected included total number of programs, total positions offered, number of applicants (MD, DO, and IMG), positions filled, and fill rate for each group. Trends were examined using simple linear regression modeling., Results: The number of orthopedic residency programs increased from 160 (2008) to 218 (2024), with total positions increasing from 636 (2008) to 916 (2024). The IMG fill rate decreased from 2.99% in 2008 to 0.87% in 2024 ( p < 0.01 for linear trend; β -0.069). This corresponds to an absolute number decrease of 19 IMGs in 2008 to 8 in 2024. More specifically, the proportion of US IMGs decreased from 0.94% to 0.66%, and the proportion of non-US IMGs decreased from 2.04% to 0.21%. Over the 17-year study period, a total of 105 US IMGs and 110 non-US IMGs matched into orthopedic surgery. The US MD applicant fill rate decreased significantly from 96.5% to 85.0% ( p < 0.001; β -0.944). The DO applicant fill rate increased significantly from 0.31% to 13.97% ( p < 0.0001; β 0.990)., Conclusion: The declining rate of IMGs matching into orthopedic residency programs in the United States underscores the growing challenges faced by IMGs in accessing training in this competitive specialty. The notable increase in DO graduates securing orthopedic residency positions likely reflects the integration of a unified accreditation system for MD and DO residency programs established in 2020., Level of Evidence: Retrospective Cohort Study; IV., Competing Interests: Disclosure: The Disclosure of Potential Conflicts of Interest forms are provided with the online version of the article (http://links.lww.com/JBJSOA/A675)., (Copyright © 2024 The Authors. Published by The Journal of Bone and Joint Surgery, Incorporated. All rights reserved.)