aDepartment of Orthopaedic Surgery, University of California – San Francisco, CA

bVOICES Health Policy Research Center, Department of Orthopaedic Surgery, Stanford University CA

cSt. Mary’s Medical Center, San Francisco Orthopaedic Residency Program, San Francisco, CA

Financial Disclosure: This work was supported in part by an Orthopaedic Research and Education Foundation (OREF) Mentored Clinician Scientist Grant to R.N.K. and a National Institutes of Health K23AR073307-01 to R.N.K. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. J.W.K. has received financial support for educational programs from the Integra Foundation. R.N.K. is a consultant for Restor 3D, Acumed and Triple Ring. He owns stock and is on the board of Modum Health. He has received research grants from the National Institute of Health, Orthopedic Research and Education Foundation, and Gordon and Betty Moore Foundation. L.M.S. has received research grants from the Moore Foundation and has a leadership role in Sustainable Global Surgery Group. The remaining authors declare no conflicts of interest.

Study conception and design: K.R.J., A.R., R.N.K., L.M.S.; article inclusion: K.R.J, N.M.T; data collection: K.R.J., C.L.; analysis and interpretation of results: K.R.J., N.M.T., C.L., J.W.K., R.N.K., L.M.S.; draft manuscript and preparation: K.R.J., N.M.T., L.M.S.

This article does not contain any studies with human or animal subjects performed by any of the authors.

Correspondence to Lauren M. Shapiro, MD, MS, Department of Orthopaedic Surgery, University of California – San Francisco, 1500 Owens St., San Francisco, CA 94158 e-mail: [email protected].