JOEI The Journal

Ira H. Kirschenbaum, MD
  • 5.0 (3)
  • Medicine
  • Updated Biweekly

The Journal of Orthopaedic Experience & Innovation publishes the podcasts of its "Open Mic" Topic Sessions and 5-minute summaries of all its articles.

  1. 6h ago

    You Don't Know Until You Know: Primary to Hinge In Knee Arthroplasty

    The recording of the JOEI Zoom "Open Mic" featuring Ron Hilllock, MD, Parminder Kang, MD, & Eric Slotkin, DO.

  2. 15h ago

    5-Minute Summary: From My Perspective… Medial or Lateral? The Native Knee Pivot Controversy and Its Implant Consequences

    Dr. Stephen Howell shares his thoughts on this topic.

  3. 2d ago

    5-Minute Summary: Beyond MIC: Biofilm Eradication, MBEC, and Sustained Intra-articular Antibiotic Delivery in Periprosthetic Joint Infection

    Periprosthetic joint infection (PJI) remains a challenging complication of total joint arthroplasty, in part because biofilm-associated bacteria demonstrate substantially greater antimicrobial tolerance than planktonic organisms. Although systemic antibiotics are central to PJI treatment, concentrations achieved within the joint may exceed the minimum inhibitory concentration (MIC) yet remain insufficient to reach the minimum biofilm eradication concentration (MBEC). This pharmacokinetic mismatch represents a fundamental limitation of conventional antimicrobial therapy. This narrative review examines biofilm biology, the limitations of MIC-based treatment, and the emerging role of MBEC in understanding biofilm eradication. Current local delivery strategies, including antibiotic-loaded polymethylmethacrylate spacers and beads, intra-wound antibiotic powders, and intraoperative irrigation, are reviewed, with emphasis on their limited ability to sustain biofilm-eradicating concentrations. Intra-articular antibiotic infusion offers a potential strategy to overcome these limitations by delivering sustained, high local antibiotic concentrations while maintaining comparatively modest systemic exposure. Available clinical series report encouraging infection-control rates across DAIR, single-stage revision, and salvage procedures; however, evidence remains largely retrospective and heterogeneous. Further comparative studies are needed to define optimal patient selection, antibiotic regimens, dosing strategies, and the clinical efficacy of intra-articular therapy in PJI.

  4. 3d ago

    Are All Triple-Taper Stems The Same

    The recording of the JOEI Zoom "Open Mic" featuring Cory Calendine, MD, Elizabeth Gausen, MD, and David Rodriguez, MD.

  5. 3d ago

    5-Minute Summary: Beyond BMI: Surgical Readiness in the Age of GLP-1 Therapy

    GLP-1 receptor agonists like Ozempic and Wegovy are reshaping how healthcare systems approach preoperative optimization. Originally developed for diabetes, these therapies are now widely used for weight reduction. In orthopedics, this shift is transforming patient preparation for major surgeries like Total Knee Arthroplasty (TKA).

  6. 5d ago

    5-Minute Summary: Concordance of ChatGPT with a Fellowship-Trained Orthopaedic Surgeon in Detecting Periprosthetic Osteolysis Following Total Shoulder Arthroplasty

    This study aimed to evaluate the agreement between ChatGPT 4.0 and a fellowship-trained orthopaedic surgeon in detecting periprosthetic osteolysis on radiographs following anatomic total shoulder arthroplasty (aTSA), using the Gruen and Modified Gruen zone scoring systems. Agreement with a fellowship-trained orthopaedic surgeon was evaluated.

  7. 6d ago

    5-Minute Summary: Changes in Oral and Gut Microbiome Diversity in Patients undergoing Total Joint Arthroplasty and Receiving Perioperative Antibiotics, a Pilot Case Series

    Perioperative antibiotic prophylaxis is common practice in joint replacement surgery. Antibiotics can cause dysbiosis to the native microbiome which can negatively affect patient health and may play a role Periprosthetic Joint Infection (PJI). The purpose of this pilot feasibility study was to evaluate if (1) we can measure a change in the microbiome of patients undergoing primary hip and knee replacements who receive routine peri-operative antibiotics and (2) at what time point does a patient’s microbiome return to pre-surgery profiles?

  8. Oct 12

    5-Minute Summary: Reclaiming the Continuum of Care: A Physician-Owned Capital Platform for Aligning Care Delivery, Risk, and Financial Infrastructure

    Modern healthcare is characterized by a fundamental structural misalignment: physicians deliver care, yet do not control the financial infrastructure that determines its cost, access, or sustainability. This disconnect is particularly evident in orthopedics, where highly standardized, high-value procedures coexist with wide cost variation and administrative inefficiency. In Mid-Missouri alone, independent physicians collect roughly 29% less from Medicare and close to half the commercial rates that the local university hospital receives for identical orthopedic procedures — while the 2026 CMS fee schedule drops total hip reimbursement from $1,043 to $975.20. This paper introduces the Physicians Nexus — a physician-owned capital platform designed to align care delivery, insurance risk, and financial infrastructure under unified physician governance. At its core is a physician-owned financial institution that aggregates capital across specialties and geographies. Through this platform, physician groups participate in the health cooperative that standardizes benefit design and generates predictable utilization. This alignment enables the formation of a physician-governed captive insurance structure that captures underwriting gains and retains reserves within the system. By internalizing the economic value of care delivery and redeploying it through a coordinated financial structure, the Physicians Nexus shifts physicians from participants in fragmented systems to owners of an integrated platform. This model reduces cost, improves access, and restores physician autonomy while creating a scalable, self-reinforcing system of care and capital formation.

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About

The Journal of Orthopaedic Experience & Innovation publishes the podcasts of its "Open Mic" Topic Sessions and 5-minute summaries of all its articles.

Information

  • Creator
    Ira H. Kirschenbaum, MD
  • Years Active
    2022 - 2026
  • Episodes
    229
  • Rating
    Clean
  • Copyright
    © Ira H. Kirschenbaum, MD
  • Show Website
    JOEI The Journal

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