Current Trends and Common Themes in Publications Concerning Private Equity Investment Into Orthopaedic Surgery...

Area of Science:

• Healthcare Management
• Orthopaedic Surgery
• Financial Markets

Background:

• Private equity (PE) investment in healthcare has surged over 250% from 2010 to 2020.
• This trend is reflected in a growing body of medical literature.
• Publications discussing PE in orthopaedic surgery practices and potential biases require examination.

Purpose of the Study:

• To identify and characterize trends in publications about PE investment in orthopaedic surgery.
• To analyze key themes and potential biases within this literature.
• To evaluate the sentiment and conflicts of interest in published research on PE in orthopaedics.

Main Methods:

• A systematic literature search was conducted for articles published between 2003 and June 2024.
• Inclusion criteria required the terms "orthopaedic surgery" or "orthopedics" and "PE" or "PE investment."
• Fifteen articles were analyzed for themes, author affiliations, and disclosed conflicts of interest.

Main Results:

• A plurality of articles (46.7%) expressed negative views on PE ownership in orthopaedic practices.
• Four articles (26.7%) had authors with undisclosed conflicts of interest (employment/ownership in PE-acquired practices).
• The most cited reasons for PE interest were ancillary service revenue; the most cited upside was economies of scale, and the primary downside was misaligned incentives.

Conclusions:

• The majority of reviewed literature holds a negative view of PE transactions in orthopaedics.
• Undisclosed conflicts of interest were present in over a quarter of the studies.
• Orthopaedic surgeons should critically assess PE literature and be aware of potential incentive misalignments.