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Discipline: search.filters.discipline.OrthopaedicsSubject: search.filters.subject.Gender Equity

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  • Item type:Publication,
    Sex and Gender Considerations in Orthopaedic Research Open PDF 
    (Ovid Technologies (Wolters Kluwer Health), 2024-10-08)
    Bechtold, Joan E.
    ;
    Bauer, Thomas W.
    ;
    Clayton, Janine
    ;
    Foucher, Kharma C.
    ;
    Graves, Leland
    JBJS convened a symposium to discuss the reporting of sex and gender in research studies as an imperative to improve research methods and results to benefit all patients. Barriers to improved reporting include a lack of societal and cultural acceptance of its need; a lack of education regarding appropriate terminology and appropriate statistical methods and efficient study designs; a need for increased research funding to support larger group sizes; unknown concordance of cell and animal models with humans to reflect biologic variables such as sex; and a lack of understanding of key considerations of gender, race, and other social determinants of health and how these factors intersect. Attention to developing and disseminating best-practice statistical methods and to educating investigators (at all career levels), reviewers, funders, editors, and staff in their proper implementation will aid reporting. Concomitantly, well-designed studies with sufficient rigor and adequate resources are essential to enable meaningful and reproducible research. Existing recommendations, such as the Sex and Gender Equity in Research (SAGER) guidelines, provide valuable guidance that can be applied across the research ecosystem. Academic institutions and private foundations are likely groups to assist in scientific and institutional review board guidance and study recruitment and pilot funding to generate meaningful power estimates, and to serve as sources for additional funding and presentation of workshops, educational events, and seminars. All of this needs to be conducted on an ongoing basis to ensure that sex and gender are considered in scientific analyses, where relevant.
  • Item type:Publication,
    Equity in Access to Arthroplasty from a Gender Perspective: A Narrative Review Open PDF 
    (Springer Science and Business Media LLC, 2025-06-04)
    Patel, Neha
    ;
    McDougall, Catherine
    ;
    Arif, Azeta
    Objective Despite growing gender diversity in medical education, orthopaedic surgery—particularly arthroplasty—remains one of the most male-dominated subspecialties. This review critically evaluates the barriers limiting female surgeons' access to arthroplasty, including disparities in training, mentorship, professional advancement, and leadership roles. In addition it explores the implications of gender disparities on workforce diversity, patient care outcomes, and surgical innovation while identifying strategies to enhance gender equity in the field. Introduction Women remain significantly underrepresented in arthroplasty, comprising a lower percentage of trainees, faculty, and senior consultants as compared to other surgical specialties. Systemic barriers such as implicit bias, limited mentorship, work-life balance challenges, and inequitable leadership opportunities contribute to this underrepresentation. These disparities influence career trajectories, limiting diversity in surgical perspectives and innovation. Addressing these issues is critical to achieving an equitable and inclusive workforce. Methodology A structured narrative review was conducted using peer-reviewed articles, institutional reports, and orthopaedic society publications. The Data were retrieved from PubMed, Scopus, and institutional databases, focusing on gender representation in orthopaedic surgery, mentorship initiatives, workforce statistics, and leadership opportunities in arthroplasty. Comparative analysis was performed across subspecialties and institutions, and recommendations from diversity and inclusion initiatives were evaluated to highlight successful interventions. Conclusion Achieving gender equity in arthroplasty requires systemic changes, including structured mentorship programs, leadership development workshops, and institutional commitments to diversity. Addressing implicit biases, promoting flexible training pathways, and fostering sponsorship programs for female surgeons are essential. A diverse workforce in arthroplasty will not only promote professional equity but also improve patient care and surgical innovation.
  • Item type:Publication,
    The Role of Women in the Top 100 Most Influential Arthroplasty Publications: A Bibliometric Analysis Open PDF 
    (Elsevier BV, 2025-04)
    Payne, Camryn S.
    ;
    Boddu, Sayi P.
    ;
    Beckett, Nathan C.
    ;
    Cancio-Bello, Alexandra M.
    ;
    Bingham, Joshua S.
    BACKGROUND: Women account for 2% of arthroplasty surgeons in the United States. It is important to understand how women contribute to the literature in the field of arthroplasty currently. We compared the proportion of first, middle, and senior authorship by women in the top 100 most-cited hip and knee arthroplasty studies published between 2010 and 2024 to the national proportion of women hip and knee arthroplasty surgeons and evaluated the H-indices of authors by gender. METHODS: The literature search was performed on the Clarivate Analytics Web of Knowledge database. Once 100 studies met the inclusion criteria, those that did not originate from the United States or whose author first names were not included were excluded. The author's gender was determined by first name. The Scopus author database was used to determine the H-index for first and senior authors. RESULTS: There were 91 papers that met the criteria. These papers were produced by a total of 458 authors, of whom 13.7% were women. There were six (7.4%) of 81 unique first authors, 50 (15.8%) of 315 middle authors, and seven (11.3%) of 62 unique senior authors who were women. Women had lower average H-indices than men. CONCLUSIONS: Women's contributions to the most influential hip and knee arthroplasty articles are much higher than predicted given their underrepresentation in the field, indicating the substantial value they add to leading arthroplasty research. Despite this, disparities exist for women in authorship rank and H-index. These disparities may be mitigated by intentionally fostering greater support for women throughout all phases of orthopaedic surgery training to improve opportunities for impactful research and career advancement.
  • Item type:Publication,
    What Are the Rates and Trends of Women Authors in Three High-impact Orthopaedic Journals from 2006-2017? Open PDF 
    (2020)
    Hiller, Kathryn P.
    ;
    Boulos, Alexandre
    ;
    Tran, Megan M.
    ;
    Cruz, Aristides I.
    BACKGROUND: The gender gap among authors publishing research in journals is narrowing in general medicine and various medical and surgical subspecialties. However, little is known regarding the gender gap among authors publishing research in orthopaedic journals. QUESTIONS/PURPOSES: (1) What is the proportion of women first and last authors of original research articles in three high-impact orthopaedic journals from 2006 to 2017? (2) What is the proportion women first authors of original research by orthopaedic subspecialty from 2006 to 2017? METHODS: A sample of original research publications from the even numbered months of issues of Clinical Orthopaedics and Related Research® (CORR®), the Journal of Bone and Joint Surgery, American volume (JBJS), and the American Journal of Sports Medicine (AJSM) were examined from 2006 to 2017. These journals were selected because of their clinical relevance, target audience, and relatively high impact factors. Over the studied period, a single author extracted and reviewed pertinent data, including the gender of the first and last authors and the primary subspecialty of the research article. The senior author refereed disputes regarding the primary subspecialty of each included article. The proportion of women first and last authors in each journal was compared between 2006 to 2017 using chi-square analysis. The proportion of women first authors according to orthopaedic subspecialty in which an article primarily focused its study was also compared between 2006 to 2017 using chi-square analysis. RESULTS: Data were collected from 6292 articles, 13% (800) of which were first-authored by women and 10% (604) of which were last-authored by women. From 2006 to 2017, the overall percentage of women first authors in the examined journals increased (from 11% in 2006 to 17% in 2017; odds ratio 1.6563 [95 % CI 1.4945 to 1.8356]; p < 0.001). Overall across the period studied, the percentage of women first authors in JBJS was 14% while 12% of first authors in CORR and AJSM were women. Regarding subspecialty, the percentage of women first authorship ranged from 9% in the shoulder subspecialty to 21% in pediatric orthopaedics across all three journals. CONCLUSIONS: There has been an increase in the percentage of women first authors in articles published in three high-impact orthopaedic journals from 2006 to 2017. This observed increase is encouraging in terms of promoting gender diversity in orthopaedics and may be reflective of a modest increase in the number of women entering the orthopaedic workforce. CLINICAL RELEVANCE: Between 2006 and 2017, the overall number of women first authors in CORR, JBJS, and AJSM modestly increased. This may suggest a nascent narrowing of the gender gap in orthopaedics. Although this is a welcome finding in terms of promoting and encouraging gender diversity in this man-dominated field, the overall percentage of women authorship remains modest, at best. Future investigations should examine whether the modest increase in women first authorship over time found in this study translates into an increased percentage of senior/last authorship in the future, as this may have implications for women orthopaedic workforce retention.
  • Item type:Publication,
    How Well Represented Are Women Orthopaedic Surgeons and Residents on Major Orthopaedic Editorial Boards and Publications? Open PDF 
    (2020)
    Rynecki, Nicole D.
    ;
    Krell, Ethan S.
    ;
    Potter, James S.
    ;
    Ranpura, Akash
    ;
    Beebe, Kathleen S.
    BACKGROUND: Recent studies indicate that women are substantially underrepresented as orthopaedic surgeons and residents compared with other specialties in medicine and medical school. The reasons for this are multifactorial and not completely understood, but previous studies suggest that women may be attracted to fields in which they have female role models. Given that women interested in academia and research may use female editorship and authorship as a proxy for female representation in orthopaedic surgery, we wanted to examine the proportion of women represented in orthopaedic journals and determine if it reflects the distribution of women in orthopaedic surgery as a field. We further wanted to understand if this representation has changed over time in the setting of a slowly shifting gender landscape within orthopaedic surgery. QUESTIONS/PURPOSES: (1) How are women orthopaedic surgeons and residents represented in orthopaedic journals compared with men? (2) Have these proportions changed in the past two decades in light of relatively new efforts to recruit women to the field of orthopaedic surgery? METHODS: The gender composition of editorial boards and first and last authors were obtained from the 1997, 2007, and 2017 volumes of the following journals: The Journal of Bone & Joint Surgery (JBJS), the Journal of the American Academy of Orthopaedic Surgeons (JAAOS), and Clinical Orthopaedics and Related Research® (CORR®). Gender neutral names were searched to obtain a picture to ensure proper tallies. RESULTS: The total combined amount of women first and last authors increased from 88 of 1450 (6%) in 1997 to 152 of 1912 (8%) in 2007 to 723 of 5391 (13%) in 2017. Similarly, three of 113 (3%) editorial board members were women in 1997, three of 105 (3%) were women in 2007 and 10 of 107 (9%) editors were women in 2017. Of note, 0 out of 9 editors-in-chief were women. CONCLUSIONS: Based on the current percentage of women orthopaedic surgeons and residents, women are represented equally or in greater numbers as editors and authors in JAAOS, JBJS, and CORR. This may be in part due to women orthopaedic surgeons entering academic medicine at a greater rate than males. CLINICAL RELEVANCE: Orthopaedic surgeons serving as mentors to prospective female applicants can cite female representation on editorial boards and as authors as an example of gender parity in the field. Additionally, active orthopaedic surgeons who are women interested in these leadership positions should be encouraged that these opportunities exist, regardless of gender.
  • Item type:Publication,
    Despite Growing Number of Women Surgeons, Authorship Gender Disparity in Orthopaedic Literature Persists Over 30 Years Open PDF 
    (2020)
    Brown, Meghan A.
    ;
    Erdman, Mary Kate
    ;
    Munger, Alana M.
    ;
    Miller, Anna N.
    BACKGROUND: The most recent demographic data reveal that only 6.5% of practicing orthopaedic surgeons are women, and as far as we know, only two women have held chair positions in academic orthopaedic programs in the United States. Furthermore, orthopaedic surgery is the least gender-diverse speciality recognized by the Accreditation Council for Graduate Medical Education. The factors that contribute to the lack of gender diversity in orthopaedics remain ill-defined. A lag in publication productivity may be a barrier to career advancement for women orthopaedic surgeons, but this has not been well studied. QUESTIONS/PURPOSES: (1) What is the proportion of orthopaedic studies published in six major orthopaedic journals by women first or senior authors from 1987 to 2017? (2) Did men and women orthopaedic surgeons publish in equal proportions during the study period (measured in 5-year intervals)? (3) Are there differences in the characteristics (such as study type or subject focus) of orthopaedic publications authored by women and those authored by men? (4) Has the increased proportion of practicing women orthopaedic surgeons been matched by an equal increase in authorship by women orthopaedic surgeons during the study timeframe? METHODS: A cross-sectional analysis was designed to characterize trends in authorship of orthopaedic studies by women over time. All publications from the first issue of each of six major orthopaedic journals were evaluated at seven time points (1987, 1992, 1997, 2002, 2007, 2012, and 2017). Characteristics of each first and senior author (including gender, academic degree, and specialty), and study category of each publication were collected. Articles for which this information was not available were excluded (35 of 1073, or 3.3% of published studies, no difference in proportion of excluded studies between journals). The proportions of women and men authors were compared at the seven time points and for six study categories (basic science, case report/technique article, clinical medicine, economics/practice management, editorial content [including true editorials, letters to the editor, commentaries, and book reviews] and review/meta-analysis) using a Fisher's exact test or chi-squared analysis. We compared the rates of change of women authorship, practicing women orthopaedic surgeons, and women orthopaedic residents during the study period using an ANOVA and Tukey's honestly significant difference (HSD) post-hoc test with Cohen's D measure of effect size. RESULTS: From 1987 to 2017, only 1.7% (15 of 880) of senior authors and 4.4% (46 of 1038) of first authors of orthopaedic publications were women orthopaedic surgeons. Based on population proportions (that is, percent of practicing women orthopaedic surgeons compared with men), the proportion of women senior authors was less than would be expected at each time point after 1987 compared with men. There were no differences between the types of studies authored by women or men. Finally, during the study period, the rate of growth of women senior authorship was less than the rates of growth of both practicing women orthopaedic surgeons (d = 5.3, 95% CI, 4.8-5.6; p = 0.023) and women first authorship (d = -4.3, 95% CI -4.6 to -3.6, p = 0.030; estimated mean 3.3, p = 0.013). CONCLUSIONS: Women orthopaedic surgeons published a small proportion of academic orthopaedic research from 1987 to 2017, and women senior authors consistently published less than would be expected based on their population proportion compared with men orthopaedic surgeons. Furthermore, the growth of practicing women orthopaedic surgeons has not been matched by growth in senior authorship by women over the same timeframe. CLINICAL RELEVANCE: This discrepancy warrants further exploration because a low rate of publication may negatively impact the career advancement of women orthopaedic surgeons and contribute to the overall lack of gender diversity in orthopaedics. We suggest that journals and publishers review their editorial processes to ensure blinding of author names during peer review and editorial decision-making, and to disclose those review processes to authors. We also suggest that institutions encourage women trainees and junior faculty to participate in mentorship programs and specialty societies that promote academic productivity.