Academic, leadership, and demographic characteristics of orthopaedic arthroplasty leadership: a 2022 cross-sectional study.

Background: Orthopaedic Fellowship Directors (FDs) and Division Chiefs (DCs) have a profound impact on trainee development. The purpose of this study was to identify and evaluate common demographic and academic characteristics among both FDs and DCs within orthopaedic arthroplasty divisions in the United States. Methods: Adult reconstruction fellowship and residency programs were identified through the AAHKS Fellowship Match Program list and AMA's FREIDA database. Data on FDs and DCs were collected from program websites and verified through AAHKS listings. Demographic, academic, and professional information, including sex, race/ethnicity, education, fellowship training, academic rank, leadership roles, institutional tenure, and patient satisfaction, were obtained from publicly available sources such as online curricula vitae, Doximity, and LinkedIn. Research productivity metrics, including h-index, total publications, and ResearchGate (RG) scores, were extracted from Scopus and RG databases. Results: One hundred and sixteen FDs and 77 DCs from 137 orthopaedic arthroplasty programs were included. 98.2% of surgeons were males. Racial demographics were comprised of 83.4% Caucasian, 11.2% Asian, 3.6% Hispanic, and 1.8% African Americans. The mean age was 52.7 years, with an average of 18.1 years since fellowship completion, 13.8 years at the current institution, and 9.7 years in respective leadership role. Thirty leaders (17.8%) held additional graduate degrees, and 68 (40.2%) occupied other leadership positions within their departments or hospitals. The average h-index was 16.9. In terms of academic rank, 29.9% of surgeons were Full Professors, while 26.6% and 23.1% were Associate and Assistant professors, respectively. There was a moderate positive correlation between academic rank and h-index (r=0.46). Fellowship programs that graduated the most FDs and DCs were Massachusetts General Hospital [17], Hospital for Special Surgery [17] and Mayo Clinic [13]. Conclusions: The majority of orthopaedic arthroplasty FDs and DCs are male and Caucasian, many hold additional leadership roles, and a small number of fellowship programs produce a disproportionately high number of current leaders. These findings highlight the need for targeted efforts to increase gender diversity and mentorship to strengthen the future of academic arthroplasty and improve training and patient care.