Orthopedic Surgery

AI-assisted peer teaching improved knowledge, OSCE performance, and 3-month retention in orthopedic trainees.

In a historical cohort of Zhejiang University medical students, AI-assisted peer teaching raised postintervention knowledge scores (mean 79.69 vs 75.33; P<.001). OSCE total scores were higher with AI assistance (mean 80.95 vs 76.24; P<.001), with the largest effect on clinical reasoning. The AI group showed greater engagement and maintained superior knowledge at 3 months, though decay rates were similar. This nonrandomized cohort suggests educational benefit, but randomized trials are needed before broad curricular adoption. 1

Escalating preoperative care patterns precede total hip replacement; late strong-opioid use strongly associated with surgery.

A matched case-control study of 240,299 THR recipients in England found rising analgesic and nonpharmacologic care in the 10 years before THR. Hip injection prevalence rose to 15.1% in the 6 months before surgery. Strong opioid use in the final 6 months had the strongest association with undergoing THR (OR 5.0, 95% CI 4.7–5.2). Females had higher prescription rates; younger patients had more sick leave and less medication use. 2

New persistent opioid use after surgery in opioid-naïve US patients averages about 7%.

A meta-analysis of 43 observational US studies (n=6,507,173) estimated pooled NPOU incidence 7.15% (95% CI 6.02–8.38). Heterogeneity was very high (I2=100%) and estimates varied with NPOU definition (90–180 day window 8.29% vs strict 180-day 2.89%). Incidence did not differ significantly by surgery type, payer, or basic demographics in meta-regression analyses. Observational design and between-study heterogeneity limit precision; interpret the pooled rate as a rough but clinically important estimate. 3