{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:52:56Z","timestamp":1790373176938,"version":"4.1.0"},"reference-count":46,"publisher":"Ovid Technologies (Wolters Kluwer Health)","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n \n \n \u27a2 Medical malpractice litigation in orthopaedic surgery remains a major challenge, as the field consistently ranks among the most frequently litigated specialties. Malpractice claims in orthopaedics often involve surgical errors, misdiagnoses, delayed treatment, and inadequate postoperative care, with substantial financial and emotional consequences for health-care providers.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 Malpractice risk varies by orthopaedic subspecialty, with adult reconstruction and spine surgeons facing the highest litigation rates, often due to nerve injuries, delayed or missed diagnoses, or postoperative complications. Although defense verdicts are the most common outcome, substantial settlements and plaintiff verdicts occur in cases involving irreversible damages, inadequate informed consent, or technical errors.<\/jats:p>\n <\/jats:list-item>\n \n \u27a2 Proactive risk management and legal preparedness can help to mitigate liability and protect physicians. Preventative strategies include clear, supportive communication to build patient trust, comprehensive documentation ensuring adherence to evidence-based guidelines, and diagnostic accuracy through use of objective tools.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>","DOI":"10.2106\/jbjs.25.00394","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T16:00:07Z","timestamp":1765987207000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Medical Malpractice Litigation in Orthopaedic Surgery in the United States"],"prefix":"10.2106","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7078-9148","authenticated-orcid":false,"given":"Peter","family":"Boufadel","sequence":"first","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5894-3373","authenticated-orcid":false,"given":"Diane","family":"Ghanem","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The Johns Hopkins Hospital, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9256-9952","authenticated-orcid":false,"given":"Mohammad","family":"Daher","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4066-9783","authenticated-orcid":false,"given":"Adam","family":"Rizk","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9158-3655","authenticated-orcid":false,"given":"Joyce D.","family":"Suarez","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline B.","family":"Granruth","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Y.","family":"Fares","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0217-4752","authenticated-orcid":false,"given":"Karan","family":"Goswami","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5457-4910","authenticated-orcid":false,"given":"Daniel E.","family":"Goltz","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Orlando, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8073-0796","authenticated-orcid":false,"given":"Alexander R.","family":"Vaccaro","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph A.","family":"Abboud","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"issue":"7","key":"bib1-20260211","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1056\/NEJMsa1012370","article-title":"Malpractice risk according to physician specialty","volume":"365","author":"Jena","year":"2011","journal-title":"N Engl J Med."},{"issue":"16","key":"bib3-20260211","doi-asserted-by":"crossref","first-page":"893","DOI":"10.5435\/JAAOS-D-23-00174","article-title":"Effect of lawsuits on professional well-being and medical error rates among orthopaedic surgeons","volume":"31","author":"Adelani","year":"2023","journal-title":"J Am Acad Orthop Surg."},{"issue":"12","key":"bib4-20260211","doi-asserted-by":"crossref","first-page":"3659","DOI":"10.1007\/s00402-021-03958-1","article-title":"Litigations in orthopedics and trauma surgery: reasons, dynamics, and profiles","volume":"142","author":"Gathen","year":"2022","journal-title":"Arch Orthop Trauma Surg."},{"key":"bib5-20260211","article-title":"Data Sharing Project Highlight. 2017-2021 Healthcare Specialties","journal-title":"Inside Medical Liability Online. 2024 Winter."},{"issue":"2","key":"bib6-20260211","doi-asserted-by":"crossref","first-page":"e260","DOI":"10.3928\/01477447-20190211-01","article-title":"Trends and risk factors in orthopedic lawsuits: analysis of a national legal database","volume":"42","author":"Cichos","year":"2019","journal-title":"Orthopedics."},{"issue":"5","key":"bib7-20260211","doi-asserted-by":"crossref","first-page":"e615","DOI":"10.3928\/01477447-20180621-06","article-title":"Medical malpractice in orthopedic surgery: a Westlaw-based demographic analysis","volume":"41","author":"Rynecki","year":"2018","journal-title":"Orthopedics."},{"issue":"2","key":"bib8-20260211","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.spinee.2017.06.038","article-title":"The medicolegal landscape of spine surgery: how do surgeons fare?","volume":"18","author":"Makhni","year":"2018","journal-title":"Spine J."},{"key":"bib9-20260211","article-title":"Malpractice and medicine: who gets sued and why?","author":"Peckham","journal-title":"Medscape."},{"issue":"1","key":"bib10-20260211","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1111\/j.1748-720X.2012.00651.x","article-title":"The impact of defense expenses in medical malpractice claims","volume":"40","author":"Carroll","year":"2012","journal-title":"J Law Med Ethics."},{"issue":"2","key":"bib11-20260211","doi-asserted-by":"crossref","first-page":"353","DOI":"10.2307\/2946682","article-title":"Do doctors practice defensive medicine?","volume":"111","author":"Kessler","year":"1996","journal-title":"Quarterly Journal of Economics."},{"issue":"2","key":"bib12-20260211","first-page":"69","article-title":"Incidence and costs of defensive medicine among orthopedic surgeons in the United States: a national survey study","volume":"41","author":"Sethi","year":"2012","journal-title":"Am J Orthop (Belle Mead NJ)."},{"issue":"7","key":"bib13-20260211","doi-asserted-by":"crossref","first-page":"S443","DOI":"10.1016\/j.arth.2022.11.021","article-title":"Hip and knee are the most litigated orthopaedic cases: a nationwide 5-year analysis of medical malpractice claims","volume":"38","author":"Sauder","year":"2023","journal-title":"J Arthroplasty."},{"issue":"2","key":"bib14-20260211","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s11999-008-0581-0","article-title":"Surgeon demographics and medical malpractice in adult reconstruction","volume":"467","author":"McGrory","year":"2009","journal-title":"Clin Orthop Relat Res."},{"issue":"1","key":"bib15-20260211","first-page":"e22.00112","article-title":"Projections and epidemiology of primary hip and knee arthroplasty in Medicare patients to 2040-2060","volume":"8","author":"Shichman","year":"2023","journal-title":"JB JS Open Access."},{"issue":"3","key":"bib16-20260211","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1016\/j.arth.2024.09.020","article-title":"Medical malpractice litigation trends following primary total hip and knee joint arthroplasty: an updated nationwide analysis","volume":"40","author":"Shimizu","year":"2025","journal-title":"J Arthroplasty."},{"issue":"10","key":"bib17-20260211","doi-asserted-by":"crossref","first-page":"2958","DOI":"10.1016\/j.arth.2017.04.044","article-title":"Lawsuits after primary and revision total hip arthroplasties: a malpractice claims analysis","volume":"32","author":"Patterson","year":"2017","journal-title":"J Arthroplasty."},{"issue":"12","key":"bib18-20260211","doi-asserted-by":"crossref","first-page":"3573","DOI":"10.1016\/j.arth.2017.07.001","article-title":"Reported litigation associated with primary hip and knee arthroplasty","volume":"32","author":"Bokshan","year":"2017","journal-title":"J Arthroplasty."},{"issue":"2","key":"bib19-20260211","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1177\/09685332211054694","article-title":"Malpractice litigation following orthopaedic surgery of the hip: frequency, reasons for lawsuit, and outcomes","volume":"90","author":"Fano","year":"2022","journal-title":"Med Leg J."},{"issue":"14","key":"bib20-20260211","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1097\/BRS.0000000000002510","article-title":"Descriptive analysis of state and federal spine surgery malpractice litigation in the United States","volume":"43","author":"Agarwal","year":"2018","journal-title":"Spine (Phila Pa 1976)."},{"issue":"4","key":"bib21-20260211","doi-asserted-by":"crossref","first-page":"470","DOI":"10.3171\/2016.11.SPINE16646","article-title":"Malpractice litigation following spine surgery","volume":"27","author":"Daniels","year":"2017","journal-title":"J Neurosurg Spine."},{"issue":"6","key":"bib22-20260211","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1097\/BSD.0000000000001184","article-title":"Predictors of medical malpractice outcomes after spine surgery: a comprehensive analysis from 2010 to 2019","volume":"34","author":"Park","year":"2021","journal-title":"Clin Spine Surg."},{"key":"bib23-20260211","doi-asserted-by":"crossref","first-page":"100371","DOI":"10.1016\/j.wnsx.2024.100371","article-title":"Analysis of reasons for medical malpractice litigation due to anterior cervical discectomy and fusion","volume":"23","author":"Arif","year":"2024","journal-title":"World Neurosurg X."},{"issue":"5","key":"bib24-20260211","doi-asserted-by":"crossref","first-page":"607","DOI":"10.3171\/2023.1.SPINE221148","article-title":"Analysis of reasons for medical malpractice litigation due to laminectomy","volume":"38","author":"Bouterse","year":"2023","journal-title":"J Neurosurg Spine."},{"issue":"8","key":"bib25-20260211","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1016\/j.spinee.2022.03.015","article-title":"Malpractice litigation in elective lumbar spinal fusion: a comprehensive review of reported legal claims in the U.S. in the past 50 years","volume":"22","author":"Zhang","year":"2022","journal-title":"Spine J."},{"issue":"13","key":"bib26-20260211","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1097\/BRS.0000000000002469","article-title":"Medical malpractice claims following incidental durotomy due to spinal surgery","volume":"43","author":"Durand","year":"2018","journal-title":"Spine (Phila Pa 1976)."},{"issue":"5","key":"bib27-20260211","doi-asserted-by":"crossref","first-page":"E20","DOI":"10.3171\/2020.8.FOCUS20600","article-title":"The medicolegal impact of misplaced pedicle and lateral mass screws on spine surgery in the United States","volume":"49","author":"Sankey","year":"2020","journal-title":"Neurosurg Focus."},{"issue":"3","key":"bib30-20260211","doi-asserted-by":"crossref","first-page":"e199","DOI":"10.1097\/OI9.0000000000000199","article-title":"Malpractice lawsuits in orthopedic trauma surgery: a meta-analysis of the literature","volume":"5","author":"Thabet","year":"2022","journal-title":"OTA Int."},{"issue":"1","key":"bib31-20260211","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jse.2024.07.011","article-title":"The increasing medicolegal cost in the care of high-level athletes","volume":"34","author":"Latario","year":"2025","journal-title":"J Shoulder Elbow Surg."},{"issue":"1","key":"bib32-20260211","doi-asserted-by":"crossref","first-page":"e47","DOI":"10.3928\/01477447-20211101-06","article-title":"Analysis of medical malpractice outcomes for sports orthopedic procedures","volume":"45","author":"Gatto","year":"2022","journal-title":"Orthopedics."},{"issue":"7","key":"bib33-20260211","doi-asserted-by":"crossref","first-page":"2236","DOI":"10.1016\/j.arthro.2018.02.035","article-title":"Medical malpractice litigation following arthroscopic surgery","volume":"34","author":"Shah","year":"2018","journal-title":"Arthroscopy."},{"issue":"11","key":"bib34-20260211","doi-asserted-by":"crossref","first-page":"2325967117738957","DOI":"10.1177\/2325967117738957","article-title":"Factors associated with physician loss in anterior cruciate ligament reconstruction malpractice lawsuits","volume":"5","author":"Bokshan","year":"2017","journal-title":"Orthop J Sports Med."},{"issue":"5","key":"bib35-20260211","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1097\/CORR.0000000000003049","article-title":"Medicolegal sidebar: nuclear verdicts-should orthopaedic surgeons be concerned?","volume":"482","author":"Bal","year":"2024","journal-title":"Clin Orthop Relat Res."},{"issue":"3","key":"bib36-20260211","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.jse.2022.09.010","article-title":"Medical malpractice litigation after total shoulder arthroplasty: a comprehensive analysis based on the Westlaw legal database","volume":"32","author":"Megalla","year":"2023","journal-title":"J Shoulder Elbow Surg."},{"issue":"10","key":"bib37-20260211","doi-asserted-by":"crossref","first-page":"2196","DOI":"10.1016\/j.jse.2022.05.021","article-title":"Malpractice against shoulder surgeons: what the data say","volume":"31","author":"Lynch","year":"2022","journal-title":"J Shoulder Elbow Surg."},{"issue":"3","key":"bib38-20260211","first-page":"7703","article-title":"Assessment of malpractice claims associated with rotator cuff surgery","volume":"10","author":"Deckey","year":"2018","journal-title":"Orthop Rev (Pavia)."},{"issue":"9","key":"bib39-20260211","doi-asserted-by":"crossref","first-page":"2007","DOI":"10.1016\/j.jse.2020.12.018","article-title":"Malpractice trends in shoulder and elbow surgery","volume":"30","author":"Sharma","year":"2021","journal-title":"J Shoulder Elbow Surg."},{"issue":"4","key":"bib40-20260211","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/0363-5023(93)90290-J","article-title":"Hand surgery and the medical liability issue","volume":"18","author":"Kessler","year":"1993","journal-title":"J Hand Surg Am."},{"issue":"1","key":"bib41-20260211","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/PRS.0b013e3181fad3a7","article-title":"A single-institution experience of hand surgery litigation in a major replantation center","volume":"127","author":"Bastidas","year":"2011","journal-title":"Plast Reconstr Surg."},{"issue":"4","key":"bib42-20260211","doi-asserted-by":"crossref","first-page":"466","DOI":"10.1177\/1558944718760032","article-title":"Litigation following carpal tunnel release","volume":"14","author":"Ganesh Kumar","year":"2019","journal-title":"Hand (N Y)."},{"issue":"1","key":"bib43-20260211","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1053\/j.jfas.2021.02.016","article-title":"Medical malpractice trends in foot and ankle surgery","volume":"61","author":"Kadakia","year":"2022","journal-title":"J Foot Ankle Surg."},{"issue":"5","key":"bib44-20260211","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1053\/j.jfas.2024.05.012","article-title":"Medical malpractice litigation following hindfoot arthrodesis","volume":"63","author":"Megalla","year":"2024","journal-title":"J Foot Ankle Surg."},{"issue":"8","key":"bib45-20260211","doi-asserted-by":"crossref","first-page":"e1088","DOI":"10.1097\/PTS.0000000000000484","article-title":"Characteristics of medical professional liability claims in pediatric orthopedics","volume":"17","author":"Burns","year":"2021","journal-title":"J Patient Saf."},{"issue":"6","key":"bib46-20260211","doi-asserted-by":"crossref","first-page":"e482","DOI":"10.1097\/BPO.0000000000001348","article-title":"Medical malpractice in pediatric orthopaedics: a systematic review of US case law","volume":"39","author":"Galey","year":"2019","journal-title":"J Pediatr Orthop."},{"issue":"Suppl 11","key":"bib47-20260211","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1097\/BOT.0000000000000436","article-title":"I\u2019ve been served\u2026 now what?","volume":"29","author":"Suk","year":"2015","journal-title":"J Orthop Trauma."},{"issue":"3","key":"bib48-20260211","first-page":"242","article-title":"Difficult patient-physician relationships and the risk of medical malpractice litigation","volume":"11","author":"Schleiter","year":"2009","journal-title":"Virtual Mentor."},{"issue":"5","key":"bib49-20260211","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.2106\/00004623-200605000-00036","article-title":"Revised grades of recommendation for summaries or reviews of orthopaedic surgical studies","volume":"88","author":"Wright","year":"2006","journal-title":"J Bone Joint Surg Am."}],"container-title":["Journal of Bone and Joint Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.25.00394","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:55:15Z","timestamp":1787752515000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.25.00394"}},"subtitle":["Risk Factors, Outcomes, and Strategies for Navigating Lawsuits, Prevention, and Reform"],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":46,"URL":"https:\/\/doi.org\/10.2106\/jbjs.25.00394","relation":{},"ISSN":["0021-9355","1535-1386"],"issn-type":[{"value":"0021-9355","type":"print"},{"value":"1535-1386","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,18]]}}}