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Background: Scientists, surgeons, and trainees are increasingly taking an active role on Twitter to find, disseminate, and exchange knowledge. The purpose of this study was to determine if peer-reviewed journal articles shared on Twitter using visual abstracts (VAs) improve user engagement compared with plain-text tweets. Methods: A two-arm randomized controlled trial with crossover was performed. Manuscripts from the Journal of Arthroplasty were allocated to one of two arms and disseminated via the journal Twitter account (@JArthroplasty) as either a text-based tweet or a VA. The primary outcome was online engagement (a composite of retweets, replies, and likes) at 7 and 30 days after posting. Univariate analysis for nonparametric and parametric data was performed using Mann-Whitney test or Student t-tests, respectively; alpha was set at 0.05. Results: 20 in-press manuscripts were randomized to standard tweets (10) or VAs (10) the same day of online publication. The mean number of engagements was higher in the VA group at seven (412 ± 216 vs 195 ± 133; P ¼ .016) and 30 days (495 ± 204 vs 244 ± 162; P ¼ .007). After the crossover, similar results were reported. Overall, VAs attracted a significantly greater number of engagements than standard tweets. Most engagement for both plain-text tweets and VAs occurred shortly after the tweet is posted. Conclusion: Online, public engagement with orthopedic research is generally low. However, when VAs are used to communicate research through social media outlets such as Twitter, the overall research engagement significantly increases compared with plain-text tweets.

Total knee arthroplasty is a successful surgery for the majority of patients with osteoarthrosis of the knee. Approximately 5% of patients undergoing total knee arthroplasty experience loss of motion or arthrofibrosis. Manipulation under anesthesia (MUA) is generally indicated for patients who do not achieve >90° of flexion by 6-12 weeks postoperatively. Complications from MUA are rare but can be devastating. We describe a novel technique for MUA with no reported major complications in our review of 78 patients. The average flexion improved from 80.0 (±3.8) before manipulation to 115.4 (±2.1) after manipulation. There were no major complications including fracture or extensor mechanism injury.

Purpose of ReviewThe surgical community is constantly working to improve accuracy and reproducibility in patient care, with the goal to improve patient outcomes and efficiency. One area of growing interest with potential to meet these goals is in the use of augmented reality (AR) in surgery. There is still a paucity of published research on the clinical benefits of AR over traditional techniques, but this article aims to present an update on the current state of AR within orthopaedics over the past 5 years. Recent Findings AR systems are being developed and studied for use in all areas of orthopaedics. Most recently published research has focused on the areas of fracture care, adult reconstruction, orthopaedic oncology, spine, and resident education. These studies have shown some promising results, particularly in surgical accuracy, decreased surgical time, and less radiation exposure. However, the majority of recently published research is still in the pre-clinical setting, with very few studies using living patients. Summary AR supplementation in orthopaedic surgery has shown promising results in pre-clinical settings, with improvements in surgical accuracy and reproducibility, decreased operating times, and less radiation exposure. Most AR systems, however, are still not approved for clinical use. Further research is needed to validate the benefits of AR use in orthopaedic surgery before it is widely adopted into practice.