About

Matthew Beal, MD, is an orthopedic surgeon specializing in adult reconstruction procedures, including partial and total hip and knee replacements. He also cares for patients with infected hip and knee replacements and those with unsuccessful prior surgeries. His clinical expertise encompasses conditions such as osteoarthritis, rheumatoid arthritis, avascular necrosis, and degenerative hip and knee arthritis. Dr. Beal leverages over 15 years of experience to provide a personal approach, ensuring patients feel confident about their care plans by taking the time to listen and address all questions. He attended The Ohio State University College of Medicine for his medical degree and completed a residency in Orthopaedic Surgery at the University of Chicago School of Medicine. He further specialized with a fellowship in Orthopaedic Surgery at Massachusetts General Hospital. Dr. Beal is an associate professor of orthopedic surgery in the Division of Adult Reconstruction at Ohio State University, where he is actively involved in research focusing on the kinematics and development of hip and knee replacements, implant fixation, and post-surgical complications. His research aims to improve the design and outcomes of joint replacement surgeries. In addition to his clinical and research activities, Dr. Beal is dedicated to education and mentorship, guiding medical students, residents, and fellows, many of whom pursue careers in academic medicine. He is actively involved with organizations such as the American Orthopaedic Association, the American Board of Orthopaedic Surgery, and the American Hip and Knee Society. His work includes developing assessment tools for resident training and contributing to curriculum design, with the goal of advancing orthopedic education and patient care.

Research topics

• Family medicine
• Artificial Intelligence
• Medical education
• Medicine
• Surgery

Selected publications

• I Have a Patient With a Large Amount of Femoral Offset. How Do I Address This Intraoperatively?

  2024-05-30

  book-chapter1st authorCorresponding

  Femoral offset is defined as the perpendicular distance from the anatomic axis of the femur to the hip joint center of rotation. Large femoral offset is commonly encountered in male patients, large patients, patients with coxa vara, and in those patients with previous slipped capital femoral epiphysis. Failure to maintain native femoral offset in such patients undergoing total hip arthroplasty (THA) has several deleterious effects, including loss of abductor power, decreased bearing performance, and instability.

  PublisherDOI

• Is there variation in utilization of preoperative tests among patients undergoing total hip and knee replacement in the US, and does it affect outcomes? A population-based analysis

  BMC Musculoskeletal Disorders · 2022-11-10 · 6 citations

  articleOpen access

  STUDY OBJECTIVE: To describe recent practice patterns of preoperative tests and to examine their association with 90-day all-cause readmissions and length of stay. DESIGN: Retrospective cohort study using the New York Statewide Planning and Research Cooperative System (SPARCS). SETTING: SPARCS from March 1, 2016, to July 1, 2017. PARTICIPANTS: Adults undergoing Total Hip Replacement (THR) or Total Knee Replacement (TKR) had a preoperative screening outpatient visit within two months before their surgery. INTERVENTIONS: Electrocardiogram (EKG), chest X-ray, and seven preoperative laboratory tests (RBCs antibody screen, Prothrombin time (PT) and Thromboplastin time, Metabolic Panel, Complete Blood Count (CBC), Methicillin Resistance Staphylococcus Aureus (MRSA) Nasal DNA probe, Urinalysis, Urine culture) were identified. PRIMARY AND SECONDARY OUTCOME MEASURES: Regression analyses were utilized to determine the association between each preoperative test and two postoperative outcomes (90-day all-cause readmission and length of stay). Regression models adjusted for hospital-level random effects, patient demographics, insurance, hospital TKR, THR surgical volume, and comorbidities. Sensitivity analysis was conducted using the subset of patients with no comorbidities. RESULTS: Fifty-five thousand ninety-nine patients (60% Female, mean age 66.1+/- 9.8 SD) were included. The most common tests were metabolic panel (74.5%), CBC (66.8%), and RBC antibody screen (58.8%). The least common tests were MRSA Nasal DNA probe (13.0%), EKG (11.7%), urine culture (10.7%), and chest X-ray (7.9%). Carrying out MRSA testing, urine culture, and EKG was associated with a lower likelihood of 90-day all-cause readmissions. The length of hospital stay was not associated with carrying out any preoperative tests. Results were similar in the subset with no comorbidities. CONCLUSIONS: Wide variation exists in preoperative tests before THR and TKR. We identified three preoperative tests that may play a role in reducing readmissions. Further investigation is needed to evaluate these findings using more granular clinical data.

  PublisherOA PDFDOI

• Incorporating Expected Outcomes Into Clinical <scp>Decision‐Making</scp> for Total Knee Arthroplasty

  Arthritis Care & Research · 2022-05-31 · 8 citations

  articleOpen access

  OBJECTIVE: Expected outcomes (e.g., expected survivorship after a cancer treatment) have improved decision-making around treatment options in many clinical fields. Our objective was to evaluate the effect of expected values of 3 widely available total knee arthroplasty (TKA) outcomes (risk of serious complications, time to revision, and improvement in pain and function at 2 years after surgery) on clinical recommendation of TKA. METHODS: The RAND/University of California Los Angeles appropriateness criteria method was used to evaluate the role of the 3 expected outcomes in clinical recommendation of TKA. The expected outcomes were added to 5 established preoperative factors from the modified Escobar appropriateness criteria. The 8 indication factors were used to develop 279 clinical scenarios, and a panel of 9 clinicians rated the appropriateness of TKA for each scenario as inappropriate, inconclusive, and appropriate. Classification tree analysis was applied to these ratings to identify the most influential of the 8 factors in discriminating TKA appropriateness classifications. RESULTS: Ratings for the 279 appropriateness scenarios deemed 34.4% of the scenarios as appropriate, 40.1% as inconclusive, and 25.5% as inappropriate. Classification tree analyses showed that expected improvement in pain and function and expected time to revision were the most influential factors that discriminated among the TKA appropriateness classification categories. CONCLUSION: Our results showed that clinicians would use expected postoperative outcome factors in determining appropriateness for TKA. These results call for further work in this area to incorporate estimates of expected pain/function and revision outcomes into clinical practice to improve decision-making for TKA.

  PublisherDOI

• Rate of USMLE Step 2 CK Scores Included on Orthopedic Surgery Applications and Associations With Step 1 Score

  Cureus · 2021-05-13 · 2 citations

  articleOpen accessSenior author

  At present, orthopedic surgery applicants do not universally include Step 2 Clinical Knowledge (Step 2 CK) scores on their applications and current inclusion rates are not yet reported. As Step 1 transitions to pass/fail scoring, we suspect more applicants will include Step 2 CK scores. We sought to identify what percentage of applications currently include Step 2 CK, if applicants who include Step 2 CK (Step 1+CK) score lower on Step 1 than those not including Step 2 CK (Step 1-CK), and what correlations exist between Step 1 and Step 2 CK scores among those who include the scores on their applications. Methodology Applicants to one residency program over two application cycles (2019-2020) were analyzed. The percentage including Step 1 and Step 2 scores was recorded. Step 1 scores were compared between Step 1+CK and Step 1-CK applicants. Differences between Step 2 CK and Step 1 scores were stratified by Step 1 score.

  PublisherOA PDFDOI

• Intra-operative Laxity Following Total Knee Arthroplasty is Highly Variable and Different Than Osteoarthritic and Normal Knees

  medRxiv · 2020-10-14

  preprintOpen accessSenior author

  Abstract Background Achieving a stable joint is an important yet challenging part of total knee arthroplasty (TKA). Neither manual manipulation of the knee nor instrumented sensors biomechanically characterize knee laxity or objectively characterize how TKA changes the laxity of an osteoarthritic (OA) knee. Therefore, the purposes of this study were: 1) objectively characterize changes in knee laxity due to TKA, 2) objectively determine whether TKA resulted in equal amounts of varus-valgus motion under a given load (i.e., balance) and 3) determine how TKA knee laxity and balance differ from values seen in non-osteoarthritic knees. Methods Two surgeons used a custom navigation system and intra-operative device to record varus-valgus motion under quantified loads in a cohort of 31 patients (34 knees) undergoing primary TKA. Similar data previously were collected from a cohort of 42 native cadaveric knees. Results Performing a TKA resulted in a “looser knee” on average, but great variability existed within and between surgeons. Under the maximum applied moment, 20 knees were “looser” in the varus-valgus direction, while 14 were “tighter”. Surgeon 1 generally “loosened” knees (OA laxity 6.1°±2.3°, TKA laxity 10.1°±3.6°), while Surgeon 2 did not substantially alter knee laxity (OA laxity 8.2°±2.4°, TKA laxity 7.5°±3.3°). TKA resulted in balanced knees, and, while several differences in laxity were observed between OA, TKA, and cadaveric knees, balance was only different under the maximum load between OA and cadaveric knees. Conclusions Large variability exists within and between surgeons suggests in what is considered acceptable laxity and balance of the TKA knee when it is assessed by only manual manipulation of the leg. Knees were “balanced” yet displayed different amounts of motion under applied load. Clinical Relevance Our results suggest that current assessments of knee laxity may leave different patients with biomechanically different knees. Objective intra-operative measurements should inform surgical technique to ensure consistency across different patients. Level of Evidence Level II prospective observational study

  PublisherOA PDFDOI

• Factors Influencing Subspecialty Choice of Orthopedic Residents: Effect of Gender, Year in Residency, and Presumptive Subspecialty.

  2020 · 25 citations

  • Medicine
  • Family medicine
  • Medical education

  Background: Subspecialty training is a common part of orthopedic surgical training. The factors which influence resident subspecialty choice have important residency design and workforce implications. Our objective was to present survey data gathered from orthopedic residents regarding their fellowship plans and relative importance of factors which influence those plans. Methods: An anonymous online survey tool was developed and distributed to orthopedic residents through their program directors at academic institutions across the country with orthopedic surgery residency programs. Results: 227 residents completed the survey. 97% planned to pursue fellowship training after residency. The most common presumptive subspecialties were sports (29.7%), joints (17.3%) and shoulder/ elbow (12.8%). The majority of senior residents (57%) reported that their subspecialty choice had changed during residency. When making their choice of subspecialty, residents were most influenced by their experiences working on the subspecialty service in question, their experiences working with a mentor, and intellectual interest. The factors influencing their choice were affected by gender, residency year and presumptive subspecialty. Conclusions: .

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• Incorporating outcomes data from large registries and administrative databases to improve appropriateness criteria for total knee replacement

  Osteoarthritis and Cartilage · 2020-04-01

  articleOpen access
  PublisherOA PDFDOI

• Use of the Behavior Assessment Tool in 18 Pilot Residency Programs

  JBJS Open Access · 2020-01-01 · 8 citations

  reviewOpen access

  Update This article was updated on March 17, 2022, because of previous errors on pages 1, 4, 5, 6, and 7. In the Abstract, Results, and Discussion sections, the specificity of the ABOS Behavior Assessment Tool that had read “57%” and “57% (95% CI 52% to 62%)” now reads “51%” and “51% (95% CI 45% to 56%).” In the Abstract, “1,012 evaluators” now reads “1,016 evaluators” and “431 residents” now reads “428 residents.” In the Results section entitled “Evaluation Results per Resident,” the sentence that had read “The domain with the greatest number of residents exhibiting low scores was ethical behavior.” now reads “The domain with the greatest number of residents exhibiting low scores was interaction.” In the Discussion section on pages 6 and 7, the number of residents with low scores in at least one domain that had read “176” now reads “196.” In Table III, the title that had read “Behavior Evaluations Completed by Resident Year in Training Source” now reads “Behavior Evaluations Completed by Resident Year in Training.” In Table VII, the column head that had read “No. of Residents with &gt;2 Low Scores within the Same Domain” now reads “No. of Residents with ≥2 Low Scores within the Same Domain.” Also in Table VII, in columns 2 and 3, the values that had read “26 (6%), 23 (5%), 19 (4%), 18 (4%), and 20 (5%)” now read “32 (8%), 61 (14%), 63 (15%), 57 (13%), and 59 (14%).” In Table VIII, the column head that had read “No. of Baseline Professionalism PD Assessment Low Score Residents (N = 32) Also with Low Scores on the Behavior Tool by at least 2 Evaluators” now reads “No. of Baseline Professionalism PD Assessment Low Score Residents (N = 32) Also with Low Scores on the Behavior Tool.” In Table IX, the title that had read “Number of Low Domain Scores by at least 2 Evaluators for Low Baseline Professionalism PD Assessment Score Residents (n = 32)*” now reads “Number of Low Domain Scores for Low Baseline Professionalism PD Assessment Score Residents (n = 32)*”. Also, the values in the table that had read “6, 3, 2, 2, 6, 13” now read “7, 2, 1, 3, 5, 14.” In Table X, the title that had read “Specificity and Sensitivity of the ABOS Behavior Tool Compared with PD Baseline Assessment for All Participating Residents (n = 440)*” now reads “Specificity and Sensitivity of the ABOS Behavior Tool Compared with PD Baseline Assessment for All Participating Residents (n = 428)*.” Also in Table X, in the right column entitled “PD Baseline Assessment High Score (3 or 4),” the values that had read “176” and “232” now read “196” and “200,” respectively. Finally, a supplementary data file has now been included with the article that contains results that portray resident performance with at least two low scores in one domain by at least two different evaluators. An erratum has been published: JBJS Open Access. 2022 Mar 31;7(1):e20.00103ER. Background: The purpose of this study was to determine the feasibility and evaluate the effectiveness of the American Board of Orthopaedic Surgery Behavior Tool (ABOSBT) for measuring professionalism. Methods: Through collaboration between the American Board of Orthopaedic Surgery and American Orthopaedic Association's Council of Residency Directors, 18 residency programs piloted the use of the ABOSBT. Residents requested assessments from faculty at the end of their clinical rotations, and a 360° request was performed near the end of the academic year. Program Directors (PDs) rated individual resident professionalism (based on historical observation) at the outset of the study, for comparison to the ABOSBT results. Results: Nine thousand eight hundred ninety-two evaluations were completed using the ABOSBT for 449 different residents by 1,016 evaluators. 97.6% of all evaluations were scored level 4 or 5 (high levels of professional behavior) across all of the 5 domains. In total, 2.4% of all evaluations scored level 3 or below reflecting poorer performance. Of 428 residents, the ABOSBT identified 26 of 32 residents who were low performers (2 or more &lt; level 3 scores in a domain) and who also scored “below expectations” by the PD at the start of the pilot project (81% sensitivity and 51% specificity), including 13 of these residents scoring poorly in all 5 domains. Evaluators found the ABOSBT was easy to use (96%) and that it was an effective tool to assess resident professional behavior (81%). Conclusions: The ABOSBT was able to identify 2.4% low score evaluations (&lt;level 3) for all residents. The tool was concordant with the PD for 81% of the residents considered low performers or “outliers” for professional behavior. The 5-domain construct makes it an effective actionable tool that can be used to help develop performance improvement plans for residents. Level of Evidence: Level II

  PublisherDOI

• An umbrella review comparing computer-assisted and conventional total joint arthroplasty: quality assessment and summary of evidence

  BMJ Surgery Interventions & Health Technologies · 2020-01-01 · 5 citations

  reviewOpen access

  BACKGROUND: Systematic reviews (SRs) of computer-assisted (CA) total knee arthroplasty (TKA) and total hip arthroplasty (THA) report conflicting evidence on its superiority over conventional surgery. Little is known about the quality of these SRs; variability in their methodological quality may be a contributing factor. We evaluated the methodological quality of all published SRs to date, summarized and examined the consistency of the evidence generated by these SRs. METHODS: We searched four databases through December 31, 2018. A MeaSurement Tool to Assess systematic Reviews 2 (AMSTAR 2) was applied to assess the methodological quality. Evidence from included meta-analyses on functional, radiological and patient-safety outcomes was summarized. The corrected covered area was calculated to assess the overlap between SRs in including the primary studies. RESULTS: Based on AMSTAR 2, confidence was critically low in 39 of the 42 included SRs and low in 3 SRs. Low rating was mainly due to failure in developing a review protocol (90.5%); providing a list of excluded studies (81%); accounting for risk of bias when discussing the results (67%); using a comprehensive search strategy (50%); and investigating publication bias (50%). Despite inconsistency between SR findings comparing functional, radiological and patient safety outcomes for CA and conventional procedures, most TKA meta-analyses favored CA TKA, whereas most THA meta-analyses showed no difference. Moderate overlap was observed among TKA SRs and high overlap among THA SRs. CONCLUSIONS: Despite conclusions of meta-analyses favoring CA arthroplasty, decision makers adopting this technology should be aware of the low confidence in the results of the included SRs. To improve confidence in future SRs, journals should consider using a methodological assessment tool to evaluate the SRs prior to making a publication decision.

  PublisherOA PDFDOI

• Resident Selection in the Wake of United States Medical Licensing Examination Step 1 Transition to Pass/Fail Scoring

  Journal of the American Academy of Orthopaedic Surgeons · 2020 · 56 citations

  • Artificial Intelligence
  • Medicine
  • Family medicine

  INTRODUCTION: The numeric score for the United States Medical Licensing Examination Step 1 is one of the only universal, objective, scaled criteria for comparing the many students who apply to orthopaedic surgery residency. However, on February 12, 2020, it was announced that Step 1 would be transitioning to pass/fail scoring. The purpose of this study was to (1) determine the most important factors used for interview and resident selection after this change and (2) to assess how these factors have changed compared with a previous report on resident selection. METHODS: A survey was distributed to the program directors (PDs) of all 179 orthopaedic surgery programs accredited by the Accreditation Council for Graduate Medical Education. Questions focused on current resident selection practices and the impact of the Step 1 score transition on expected future practices. RESULTS: A total of 78 PDs (44%) responded to the survey. Over half of PDs (59%) responded that United States Medical Licensing Examination Step 2 clinical knowledge (CK) score is the factor that will increase most in importance after Step 1 transitions to pass/fail, and 90% will encourage applicants to include their Step 2 CK score on their applications. The factors rated most important in resident selection from zero to 10 were subinternship performance (9.05), various aspects of interview performance (7.49 to 9.01), rank in medical school (7.95), letters of recommendation (7.90), and Step 2 CK score (7.27). Compared with a 2002 report, performance on manual skills testing, subinternship performance, published research, letters of recommendations, and telephone call on applicants' behalf showed notable increases in importance. DISCUSSION: As Step 2 CK is expected to become more important in the residency application process, current applicant stress on Step 1 scores may simply move to Step 2 CK scores. Performance on subinternships will remain a critical aspect of residency application, as it was viewed as the most important resident selection factor and has grown in importance compared with a previous report.

  PublisherDOI

Frequent coauthors

• David W. Manning

  Northwestern University

  17 shared

• Robert A. Siston

  The Ohio State University

  11 shared

• Jeffrey F. Granger

  The Ohio State University Wexner Medical Center

  9 shared

• Erin E. Hutter

  National Highway Traffic Safety Administration

  7 shared

• Stephen D Bigach

  Northwestern University

  7 shared

• Joshua C. Patt

  6 shared

• Ajit M.W. Chaudhari

  The Ohio State University

  6 shared

• Gregory M Freisinger

  United States Military Academy

  5 shared