Demand for total joint arthroplasty is projected to increase in the first three decades of the twenty-first century. With increasing frequency, patients who have a hip or knee replacement expect to, and choose to, participate in athletics following rehabilitation. In general, patients who have had a hip or knee replacement decrease their participation in, and intensity of, athletic activity following the total joint arthroplasty. The orthopaedic literature on athletic activity after total joint arthroplasty is limited to small retrospective studies with short-term follow-up. Expert opinion regarding appropriate athletic activity after total joint arthroplasty is available from the Hip Society and the Knee Society. When patients who have undergone joint replacements choose to participate in athletic activity, orthopaedic surgeons should provide information with which to evaluate the risk of sports activity and recommend appropriate athletic activity.

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Background: In 2017, approximately 90% of U.S. orthopaedic residents chose to participate in orthopaedic fellowships. The process of applying and interviewing for an orthopaedic fellowship is expensive and time-consuming for both orthopaedic residents and orthopaedic residency programs. Considerable physician man-hours are allocated to fellowship interviews and the match ranking process, and there are unintended consequences of time away from work for the resident and his or her training program. To reduce time and cost allocated to fellowship interviews, we implemented videoconference interviews for our adult reconstruction fellowship. The purpose of this article was to communicate the lessons that we learned about this innovation. Methods: Candidates and faculty who participated in videoconference interviews for our adult reconstruction fellowship during 2015 through 2017 were surveyed to learn more about the utility and acceptance of videoconference interviewing. Results: Eighty-five percent of the 47 videoconference interview candidates who responded to our survey believed that the videoconference interviews gave them a satisfactory understanding of our adult reconstruction fellowship; 85% of candidates stated that the fellowship manual and the videoconference interviews gave them a satisfactory understanding of our fellowship; 89% of candidates stated that the videoconference interview met their expectations; 85% of candidates believed that the videoconference interviews allowed them to present themselves to the program to their satisfaction; and 81% of candidates were comfortable ranking our program after the videoconference interviews. Furthermore, there was universal gratitude in the subjective comments for the convenience and low cost of the videoconference interviews. However, we are concerned that 15% of the candidates did not believe that they had the opportunity to present themselves to their satisfaction with videoconference interviews; 19% of applicants were not comfortable ranking our program after a videoconference interviews; 34% of videoconference interview candidates stated that the videoconference interviews had an unfavorable impact on their ranking of our program; and 30% of candidates believed that the videoconference interview was not a good format for fellowship interviews. Conclusions: This review presents what we learned about using videoconference interviews for evaluating and selecting adult reconstruction fellows. The role of videoconference interviews for selecting adult reconstruction fellows remains to be determined.

Background Despite the importance of complications in evaluating patient outcomes after TKA, definitions of TKA complications are not standardized. Different investigators report different complications with different definitions when reporting outcomes of TKA.

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The first decade of the 21st century has been declared the "Bone and Joint Decade" by 35 nations and 44 states in the United States as of March 2001. It is not surprising that Americans are interested in musculoskeletal disease and the treatment of bone and joint disorders because our population is aging, the prevalence of arthritic joints is increasing, and senior Americans are demonstrating a strong desire to stay active in activities of daily living and athletics. One of the most successful treatments for painful arthritic joints, which limit activity, is total joint replacement, which predictably relieves pain and improves function. Much has been written about the technical aspects of total joint arthroplasty. Less has been written about safe and appropriate activities for patients who have had joint replacement operations. This article evaluates athletic activity after joint replacement by reviewing the orthopaedic literature and surveying members of The Hip Society, The Knee Society, and The American Shoulder and Elbow Surgeons Society. The authors have developed consensus recommendations for appropriate athletic activity for patients who have had joint replacement operations. This article is intended to serve as a guide for orthopaedic surgeons and primary care physicians who give patients recommendations for athletic activity after joint replacement. This article is also intended to stimulate further research in the area of athletic activity after total joint arthroplasty.

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Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.