Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Feb 18, 2024; 15(2): 147-155
Published online Feb 18, 2024. doi: 10.5312/wjo.v15.i2.147
Limb Lengthening and Reconstruction Society orthopedic surgeons in the United States: An analysis of geographical distribution, academic, leadership, and demographic characteristics
Amir Human Hoveidaei, Reza Niakan, Seyed Hossein Hosseini-Asl, Abijith Annasamudram, Janet D Conway
Amir Human Hoveidaei, Abijith Annasamudram, Janet D Conway, International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD 21215, United States
Reza Niakan, Student Research Committee, Shiraz University of Medical Sciences, Shiraz 73, Iran
Seyed Hossein Hosseini-Asl, Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran 1417755331, Iran
Co-corresponding authors: Amir Human Hoveidaei and Janet D Conway.
Author contributions: Hoveidaei AH and Conway JD designed the study; Hoveidaei AH, Niakan R, Hosseini-Asl SH and Annasamudram A reviewed the data; all authors drafted the primary manuscript; Hoveidaei AH and Conway JD revised the primary draft critically; all the authors read and approve the final manuscript.
Institutional review board statement: The study was done in International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland, USA. It was deemed exempt by the institutional review board (IRB), as all data utilized were publicly available.
Conflict-of-interest statement: Hoveidaei AH, Annasamudram A, and Conway JD are members of Sinai Hospital of Baltimore.
Data sharing statement: Data are available on request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Amir Human Hoveidaei, MD, MSc, Research Fellow, International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, United States. hoveidaei.a.h@gmail.com
Received: October 30, 2023
Peer-review started: October 30, 2023
First decision: December 7, 2023
Revised: December 25, 2023
Accepted: January 19, 2024
Article in press: January 19, 2024
Published online: February 18, 2024

The Limb Lengthening and Reconstruction Society (LLRS) is a premier orthopedic specialty organization that promotes limb reconstruction for all ages. LLRS membership characteristics, however, are poorly reported. This study delineates orthopedic surgeon LLRS members’ demographic traits, academic achievement, leadership attainment, and geographical distribution across the United States.


To inform aspiring orthopedic professionals, as well as to promote growth and diversity in both the LLRS organization and overarching field.


This cross-sectional study examined United States LLRS members’ academic, leadership, demographic, and geographical attributes. After reviewing the 2023 LLRS member directory, Google search results were matched to the listings and appended to the compiled data. Sex and ethnicity were evaluated visually utilizing retrieved images. The Hirsch index (H-index) of academic activity, residency and fellowship training, other graduate degrees, leadership positions, practice type (academic or non-academic), and spoken languages were categorized. LLRS members per state and capita determined geographic distribution. The Mann-Whitney U test was applied to compare H-index between males and females, as well as to assess member differences pertaining to affiliation with academic vs non-academic practice facilities.


The study included 101 orthopedic surgeons, 78 (77.23%) Caucasian and 23 (22.77%) non-Caucasian, 79 (78.22%) male and 22 (21.78%) female. Surgeons with DO degrees comprised only 3.96% (4) of the cohort, while the vast majority held MDs [96.04% (97)]. Mean H-index was 10.55, with male surgeons having a significantly higher score (P = 0.002). Most orthopedic surgeons (88.12%,) practiced in academic centers. Of those professionals who occupied leadership positions, 14% were women, while 86% were men. Additionally, 19 (37.25%) United States regions and the District of Columbia lacked an LLRS-member orthopedic surgeon. Total per capita rate across the United States was 0.30 LLRS orthopedic surgeons per 1 million people.


Over 21% of LLRS members are women, surpassing prior benchmarks noted in orthopedic faculty reporting. LLRS members’ high research productivity scores imply field dedication that can refine expertise in the limb lengthening and reconstruction space. Gender disparities in leadership remain, however, necessitating greater equity efforts. A low rate of LLRS representation per capita must be addressed geographically as well, to affect improvements in regional care access. This study can serve to support aspiring orthopedic professionals, inform diversity, leadership, and field advancement strategies, and maintain the continued goal of enhanced patient care worldwide.

Keywords: Limb lengthening and reconstruction, Orthopedic surgeon demographics, Orthopedic surgeon societal membership, Orthopedic fellowships

Core Tip: Societal membership characteristics for the Limb Lengthening and Reconstruction Society had previously been poorly reported. These attributes were analyzed comparatively with industry precedents to glean insights for aspiring orthopedic professionals, inform organizational decision-making in support of growth, diversity, and equity, as well as to uphold the foundational goal of patient care optimization.