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With the growing popularity of artificial intelligence, more patients will begin to turn to chatbots such as ChatGPT for medical information. Recent research has shown that ChatGPT and Google can both provide accurate responses to numeric-based questions; ChatGPT bases its answers on more trustworthy, academic sources than Google, and the 2 tools have little overlap when queried to generate a list of frequently asked questions. Patients should use ChatGPT cautiously. The chatbot can struggle to generate appropriate responses to questions regarding patient-specific factors. Fortunately, many institutions offer evidence-based websites that provide quality information. However, if these sites do not address a specific patient's question, ChatGPT has the potential to be a powerful tool. Of importance, unlike Google, ChatGPT consistently provides patients with a reminder that they should follow up with a licensed medical provider to address their questions and concerns related to a topic. [ABSTRACT FROM AUTHOR]

Surgeons have dealt with the negative effects of misinformation from "Dr. Google" since patients started using search engines to seek out medical information. With the advent of natural language processing software such as Chat Generative Pre-Trained Transformer (ChatGPT), patients may have a seemingly real conversation with artificial intelligence software. However, ChatGPT provides misinformation in response to medical questions and responds at the reading level of a college freshman, whereas the U.S. National Institute of Health recommends medical information be written at a 6th-grade level. The flaw of ChatGPT is that it recycles information from the Internet. It is "artificially intelligent" because of its ability to mimic natural language, not because of its ability to understand and synthesize content. It fails to understand nuance or critically analyze new inputs. Ultimately, these skills require human intelligence, whereas ChatGPT provides responses that are exactly what you might expect—artificial. [ABSTRACT FROM AUTHOR]

Rugby is a high-impact collision sport with identical competition rules by sex. The aim of this study was to analyze the trend of rugby-related fractures by body site, sex, and age in amateur athletes from 1999 to 2018. The National Electronic Injury Surveillance System (NEISS) database was queried to characterize rugby-related injuries from 1999 to 2018 in patients aged 14–23 years old. National injury estimates were calculated using sample weights. Chi-square analysis and one-way ANOVA were performed to compare categorical variables. Out of a total of 43,722 weighted cases of rugby-related fractures over the 19-year period, 70.9% were among high school- and college-aged males and females between the ages of 14–23 years (N = 30,996). Males constituted 79.3% of cases whereas females composed 20.7% of the cases. The proportion of upper extremity fractures was similar in both males and females, yet facial fractures were significantly more common among males than females (27.9% vs. 14.6%, P < 0.001). Among facial fractures, nasal fractures represented 74.4% of the sample, yet facial fractures only resulted in hospital admittance in 1.3% of cases. Lower extremity fractures were more likely to be severe, with 11.3% of LE cases being admitted to the hospital. Rugby players in the US diagnosed in the ED with fractures consisted largely of male, high school- and college-aged athletes. Males and females experienced upper and lower-extremity fractures at comparable rates, yet lower extremity injuries were more likely to be admitted to a hospital. Men were significantly more likely to experience a facial fracture in which a majority were nasal fractures. [ABSTRACT FROM AUTHOR]

Background: As total shoulder arthroplasty has emerged as the fastest growing joint replacement performed, optimizing surgical efficiency and patient outcomes is essential. The goals of the current study were to identify trends and factors affecting the operative time of total shoulder arthroplasty over a 10-year period. Methods: The National Surgical Quality Improvement Program database was analyzed to determine the operative time and 30-day complications of total shoulder arthroplasty from 2008 to 2018. Factors affecting total shoulder arthroplasty operative time were also assessed. Multivariable linear regression was used to analyze operative time over years studied while controlling for patient demographics and comorbidities. Results: A total of 20,587 total shoulder arthroplasty cases from 2008 to 2018 were included. Mean operative time in 2008 was 139.0 min, while in 2018, mean operative time decreased to 105.6 min (P <.001). Male sex, outpatient surgery, increased body mass index, and low preoperative hematocrit were associated with longer operative times, while elevated international normalized ratio, resident involvement, and elective surgeries were associated with decreased operative duration. Discussion: Operative time for total shoulder arthroplasty has decreased from 2008 to 2018. Patient factors and comorbidities are associated with operative time, and such factors are important to consider in operative planning to ensure appropriate patient and surgeon expectations. [ABSTRACT FROM AUTHOR]

Rotator cuff repair (RCR) is a common orthopedic procedure frequently performed in the outpatient setting. Malnutrition, as assessed by preoperative serum albumin <3.5 g/dL, has been independently associated with significantly higher risks of multiple adverse outcomes in several orthopedic procedures. The effect of preoperative hypoalbuminemia on short-term outcomes of RCR was previously unknown. we hypothesized that preoperative serum albumin <3.5 g/dL would be associated with higher odds of post-operative admission and prolonged length of stay. This study represents a retrospective analysis of the American College of Surgeons National Surgical Quality Improvement Program database (NSQIP) for patients undergoing RCR between 2011 and 2015. Multivariate regression analysis adjusted for sex, ASA classification, age, BMI, and diabetes status (Table 3) showed preoperative hypoalbuminemia conferred a significantly increased adjusted odds ratio of postoperative admission (adjusted odds ratio 1.711, CI 1.134–2.583, p = 0.011) and extended length of stay (adjusted odds ratio 2.073, CI 1.073–4.003, p = 0.030). Malnutrition as assessed by preoperative serum albumin <3.5 g/dL is significantly associated with increased odds of hospital admission and extended length of stay following arthroscopic RCR. This has clinical implications in surgical patient selection and risk stratification. III, Retrospective cohort study [ABSTRACT FROM AUTHOR]

Background: Relatively little is known about the true incidence of posterior shoulder instability in the United States. Purpose/Hypothesis: The purpose of this study was to characterize the incidence of posterior shoulder instability in the US military population and to examine which characteristics place these patients at highest risk. We hypothesized that the rate of posterior instability in this cohort of patients would be higher than previously reported. Study Design: Descriptive epidemiology study. Methods: All initial cases of posterior shoulder dislocation and subluxation in the Defense Medical Epidemiology Database were screened between 2016 and 2018 using the relevant International Classification of Diseases–Tenth Revision-Clinical Modification codes. Incidences were calculated, and multivariate Poisson regression was used to calculate adjusted rate ratios for the effects of sex, race, age, military service branch, rank, and year. Results: The overall unadjusted incidence was 0.032 per 1000 person-years for posterior dislocations, 0.064 per 1000 person-years for posterior subluxations, and 0.096 per 1000 person-years for all cases of posterior shoulder instability. The total incidence of all shoulder instability was 1.84 per 1000 person-years, with posterior shoulder instability accounting for 5.2% of total cases. For posterior subluxation, significant differences between groups were found in the unadjusted and adjusted rate ratio (ARR) for sex (ARR, 3.31; 95% CI, 1.85-5.93 for men), race (ARR, 0.458; 95% CI, 0.294-0.714 for Black servicemembers and ARR, 0.632; 95% CI, 0.421-0.948 for servicemembers of other race), age (ARR, 3.69; 95% CI, 1.56-8.70 for patients aged 30-34 years), and military service branch (ARR, 0.663; 95% CI, 0.460-0.955 for Air Force servicemembers). For posterior shoulder dislocations, a significant difference was found only between men and women (ARR, 4.55; 95% CI, 1.85-11.2 for men). Conclusion: The incidence of posterior shoulder instability among US military personnel is higher than previously reported in the general US population, with a majority of cases due to subluxation. This increased incidence is likely reflective of a young and highly active population along with improvements in awareness and diagnosis of posterior instability in recent years. [ABSTRACT FROM AUTHOR]

Background: The internet and standard search engines are commonly used resources for patients seeking medical information online. With the advancement and increasing usage of artificial intelligence (AI) in health information, online AI chatbots such as ChatGPT may surpass traditional web search engines as the next go-to online resource for medical information. This study aims to assess the ability of ChatGPT to answer frequently asked questions regarding pediatric supracondylar humerus (SCH) fractures., Methods: Seven (7) frequently asked questions (FAQs) regarding SCH fractures were presented to ChatGPT. Initial responses were recorded and rated as either "excellent requiring no clarification (0 items need clarification)," "satisfactory requiring minimal clarification (1 to 2 items need clarification)," "satisfactory requiring moderate clarification (3 to 4 items need clarification)," or "unsatisfactory requiring substantial clarification (>4 items need clarification or response contains false information).", Results: While 4 responses met satisfactory ratings with either moderate (2 responses) or minimal (2 responses) clarification, 3 of the 7 FAQs yielded a response from ChatGPT that were unsatisfactory. There were no responses that required no further clarification., Conclusions: ChatGPT provided some satisfactory responses to FAQs regarding pediatric SCH fractures, but required substantial clarification about treatment algorithms, casting and return to sport timelines, and the utility of physical therapy. Therefore, ChatGPT is an unreliable resource for information on treating SCH fractures. Parents of children who experience SCH fractures should continue to communicate with their doctors for the most accurate medical information., Level of Evidence: Level V-expert opinion on ChatGPT responses., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2025 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: This study aims to analyze the ability of ChatGPT to answer frequently asked questions (FAQs) regarding FAI. We hypothesize that ChatGPT can provide accurate and thorough responses when presented with FAQs regarding FAI., Design: Ten FAQs regarding FAI were presented to ChatGPT 3.5 and initial responses were recorded and analyzed against evidence-based literature. Responses were rated as "excellent response requiring no further clarification," "satisfactory response requiring minimal clarification," "satisfactory response requiring moderate clarification," or "unsatisfactory response requiring substantial clarification.", Setting: Institutional., Independent Variables: Frequently asked questions regarding femoroacetabular impingement., Main Outcome Measures: Accuracy and thoroughness of ChatGPT responses to FAQs. Hypothesis was formulated before data collection., Results: Most responses from ChatGPT were rated as satisfactory and required only minimal clarification. Two responses received an excellent rating and required no further clarification, while only 1 response from ChatGPT was rated unsatisfactory and required substantial clarification., Conclusions: ChatGPT provided largely accurate and thorough responses to FAQs regarding FAI while appropriately reiterating the importance of always consulting a medical professional., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Introduction: Patients have long turned to the Internet for answers to common medical questions. As the ability to access information evolves beyond standard search engines, patients with adolescent idiopathic scoliosis (AIS) and their parents may use artificial intelligence chatbots such as ChatGPT as a new source of information., Methods: Ten frequently asked questions regarding AIS were posed to ChatGPT. The accuracy and adequacy of the responses were graded as excellent not requiring clarification, satisfactory requiring minimal clarification, satisfactory requiring moderate clarification, and unsatisfactory requiring substantial clarification., Results: ChatGPT gave one response that was excellent not requiring clarification, four responses that were satisfactory requiring minimal clarification, three responses that were satisfactory requiring moderate clarification, and two responses that were unsatisfactory requiring substantial clarification, with information about higher level, more complex areas of discussion such as surgical options being less accurate., Conclusion: ChatGPT provides answers to FAQs about AIS that were generally accurate, although correction was needed on specific surgical treatments. Patients may be at risk of developing a Dunning-Kruger effect by proxy from the superficial and sometimes inaccurate information provided by ChatGPT on more complex aspects of AIS., (Copyright © 2024 by the American Academy of Orthopaedic Surgeons.)

Introduction: 3D planning software for shoulder arthroplasty recently emerged for aiding in intraoperative determination of native glenoid. These protocols often require increased scan resolution, however, raising the question of an increased prevalence and clinical impact of incidental findings (IFs) from preoperative imaging., Methods: A retrospective review of preoperative shoulder CT reports was conducted for 333 consecutive patients planning anatomic or reverse total shoulder arthroplasties. Patients with thin-sliced CT scans (1.25 mm) were compared with those with standard CT scans (2.5 mm). Poisson regression was performed with baseline characteristics and potentially pathologic IFs (PPIFs)., Results: IFs were present in 131 of the 333 scans (39.3%), and 38 of the 333 scans (11.4%) included PPIFs. Only 8 of the 333 scans (2.4%) required workup, with 2 of the 333 (0.6%) leading to new cancer diagnoses. Thin-sliced CT scans detected a higher mean number of IFs (1.12 versus 0.22, P < 0.001) while the mean number of PPIFs remained similar (0.13 versus 0.10, P = 0.43)., Conclusion: IFs are frequent; however, only 0.6% scans led to new cancer diagnoses. Comparison of thin-sliced with standard CT scans revealed a higher frequency of IFs but similar PPIFs, indicating increased burden of IFs without the benefit of identifying additional malignancies. As demand rises for shoulder arthroplasties, surgeons should consider the potential hidden costs of IFs when using 3D planning programs., (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.)