{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T16:58:19Z","timestamp":1789750699793,"version":"4.0.1"},"reference-count":49,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ANZ Journal of Surgery"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Despite established ethical principles, a critical synthesis of how informed consent deficiencies, leading to costly malpractice lawsuits in elective orthopedic surgery, relate to medico\u2010legal outcomes, documentation pitfalls, and team roles is lacking. This scoping review aimed to investigate the status of obtaining informed consent by the treatment team in elective orthopedic surgeries and the related legal consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following the Arksey &amp; O'Malley framework update by Levac et\u00a0al., we conducted a comprehensive search across PubMed, Scopus, Web of Science databases, and the Google Scholar search engine. Studies focusing on informed consent, legal factors, and the treatment team in elective orthopedic procedures were included in this review. Data were charted and analyzed using thematic analysis for qualitative synthesis, supplemented by quantitative summary statistics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Qualitative analysis identified four themes: documentation patterns, legal factors, cultural considerations, and risk mitigation strategies. Findings showed frequent documentation gaps (13%\u201332% of forms lacked specific complications). Nerve injury was the most common cause of lawsuits (46%\u201356%). In lumbar fusion, 24% of claims cited failure to obtain consent. US compensation averaged $871\u2009093, vastly exceeding European figures. Patient recall of complications was poor (22.5%) but improved to 48% with written aids.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The informed consent process in elective orthopedics faces systematic challenges, including inconsistent documentation, high litigation risk, and inadequate patient understanding. To reduce legal exposure and promote safety, implementing evidence\u2010based, procedure\u2010specific consent forms, interdisciplinary team training, and culturally competent communication is recommended. Addressing these requires coordinated policy reform at institutional and educational levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ans.70728","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:26:14Z","timestamp":1780575974000},"page":"1424-1441","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Informed Consent in Elective Orthopedic Surgeries: A Scoping Review of Medico\u2010Legal Challenge and Team\u2010Based Application"],"prefix":"10.1111","volume":"96","author":[{"given":"Ramin","family":"Shiri","sequence":"first","affiliation":[{"name":"Department of Orthopedics Arak University of Medical Sciences  Arak Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6668-1270","authenticated-orcid":false,"given":"Hojjat","family":"Torkmand","sequence":"additional","affiliation":[{"name":"Department of Nursing Zanjan University of Medical Sciences  Zanjan Iran"},{"name":"Department of Medical Law, Medical Ethics and Law Research Center Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1084-2936","authenticated-orcid":false,"given":"Mohammad","family":"Abdi","sequence":"additional","affiliation":[{"name":"Department of Nursing Zanjan University of Medical Sciences  Zanjan Iran"},{"name":"Department of Medical Law, Medical Ethics and Law Research Center Shahid Beheshti University of Medical Sciences  Tehran Iran"},{"name":"Social Determinants of Health Research Center, Education Development Center (EDC) Zanjan University of Medical Sciences  Zanjan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2009.0807"},{"issue":"2","key":"e_1_2_14_3_1","first-page":"238","article-title":"Legal and Ethical Recommendations for Video Recording in the Operating Room: A Review of Literature","volume":"7","author":"Torkmandi H.","year":"2024","journal-title":"Journal of Iranian Medical Council"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13037-016-0117-6"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20475"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.23.00316"},{"key":"e_1_2_14_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-013-3013-8"},{"key":"e_1_2_14_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2021.05.029"},{"key":"e_1_2_14_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-025-07671-0"},{"key":"e_1_2_14_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-023-04695-2"},{"key":"e_1_2_14_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.17517"},{"key":"e_1_2_14_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zrac159"},{"key":"e_1_2_14_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcyt.2020.12.011"},{"key":"e_1_2_14_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-021-05150-x"},{"key":"e_1_2_14_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10728-019-00381-x"},{"key":"e_1_2_14_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.clinsp.2022.100053"},{"key":"e_1_2_14_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-5-69"},{"key":"e_1_2_14_18_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0278434"},{"key":"e_1_2_14_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000002902"},{"key":"e_1_2_14_20_1","doi-asserted-by":"publisher","DOI":"10.1108\/QRJ-08-2022-0116"},{"key":"e_1_2_14_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhsa.2013.06.021"},{"key":"e_1_2_14_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-03647-2"},{"key":"e_1_2_14_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/OI9.0000000000000199"},{"key":"e_1_2_14_24_1","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200510000-00004"},{"key":"e_1_2_14_25_1","doi-asserted-by":"publisher","DOI":"10.1615\/JLongTermEffMedImplants.2014010918"},{"key":"e_1_2_14_26_1","doi-asserted-by":"publisher","DOI":"10.1177\/230949901101900302"},{"key":"e_1_2_14_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s43465-021-00398-2"},{"key":"e_1_2_14_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40001-024-02019-8"},{"issue":"4","key":"e_1_2_14_29_1","article-title":"Standardized Informed Consent Form for Clinicians Administering Platelet\u2010Rich Plasma","volume":"16","author":"Pai S. N.","year":"2024","journal-title":"Cureus"},{"key":"e_1_2_14_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-017-1901-4"},{"key":"e_1_2_14_31_1","doi-asserted-by":"publisher","DOI":"10.3944\/AOTT.2010.2396"},{"key":"e_1_2_14_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40814-021-00843-x"},{"issue":"11","key":"e_1_2_14_33_1","first-page":"2395","article-title":"The Medical\u2010Legal Aspects of Informed Consent in Orthopaedic Surgery","volume":"87","author":"Bhattacharyya T.","year":"2005","journal-title":"Journal of Bone and Joint Surgery American Volume"},{"key":"e_1_2_14_34_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588411X587226"},{"key":"e_1_2_14_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2024.03.012"},{"key":"e_1_2_14_36_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588402760978201"},{"issue":"3","key":"e_1_2_14_37_1","first-page":"421","article-title":"Legally Sound, Evidence\u2010Based Informed Consent Form for Total Hip Arthroplasty","volume":"57","author":"Pai S. N.","year":"2023","journal-title":"Indian Journal of Orthopaedics"},{"key":"e_1_2_14_38_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0732-6124"},{"key":"e_1_2_14_39_1","doi-asserted-by":"publisher","DOI":"10.3928\/01477447-20120426-28"},{"key":"e_1_2_14_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCO.0b013e3182199357"},{"key":"e_1_2_14_41_1","first-page":"182","article-title":"Evaluation of Orthopedic Surgical Litigations Which Was Discussed in Health Council During 1995\u20102000","volume":"14","author":"T\u00fcmer A. R.","year":"2003","journal-title":"Journal of Arthroplasty Arthroscopic Surgery"},{"key":"e_1_2_14_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2022.03.015"},{"key":"e_1_2_14_43_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2017.0544"},{"key":"e_1_2_14_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000002510"},{"key":"e_1_2_14_45_1","first-page":"CD009445","article-title":"Interventions to Promote Informed Consent for Patients Undergoing Surgical and Other Invasive Healthcare Procedures","volume":"7","author":"Kinnersley P.","year":"2013","journal-title":"Cochrane Database of Systematic Reviews"},{"key":"e_1_2_14_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.282.24.2313"},{"key":"e_1_2_14_47_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0288074"},{"key":"e_1_2_14_48_1","doi-asserted-by":"publisher","DOI":"10.3171\/2020.8.FOCUS20611"},{"key":"e_1_2_14_49_1","doi-asserted-by":"publisher","DOI":"10.1628\/978-3-16-166119-8"},{"key":"e_1_2_14_50_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijmedinf.2022.104693"}],"container-title":["ANZ Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70728","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ans.70728","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ans.70728","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T18:56:48Z","timestamp":1783018608000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ans.70728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":49,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1111\/ans.70728"],"URL":"https:\/\/doi.org\/10.1111\/ans.70728","archive":["Portico"],"relation":{},"ISSN":["1445-1433","1445-2197"],"issn-type":[{"value":"1445-1433","type":"print"},{"value":"1445-2197","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-12-31","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}