The AAOS Now podcast is a monthly series that spotlights hotly debated issues and controversial trends in orthopaedic surgery. Each episode presents nuanced perspectives to inspire further discourse, inform your decision-making — and maybe even change your mind. Part of The Bone Beat Orthopaedic Podcast Channel.
Brought to you by the American Academy of Orthopaedic Surgeons and the American Association of Orthopaedic Surgeons.
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The Limits of Orthopaedic Surgery: A Critique of Heroic Salvage Measures
Season 8 · Episode 7
Monday, July 27, 2026 • Duration 43:06
In this episode of the AAOS Now Podcast, host Ahmed Emara, MD, speaks with Nathan Mesko, MD, FAAOS, to explore the limits of orthopaedic surgery and the difficult decisions surrounding “heroic” measures.
Dr. Mesko draws on 13 years of experience in orthopaedic oncology and joint reconstruction to unpack what "heroic" really means in surgery. He argues that heroism has less to do with technical difficulty – ”can I perform this procedure” – and more to do with what a patient is being asked to endure to reach a surgeon's envisioned outcome.
Throughout the conversation, Dr. Mesko returns to a central idea: Surgical capability should always be outpaced by wisdom. He walks through how to recognize when the push toward a heroic operation is being driven by the surgeon rather than the patient, and he offers concrete techniques for having honest, humane conversations with patients around amputation, cancer diagnoses, and end of life. He also discusses the emotional toll of these decisions, including guilt, escalation of commitment, and how surgeons can build the humility and self-forgiveness needed for a sustainable career.
The episode closes with a personal story that illustrates why staying present with a patient and not turning away from them, even after a frustrating conversation, can matter even more than the surgery itself.
Key topics covered:
Defining "heroic" measures in orthopaedic surgery and how that threshold shifts over a surgeon's career as the surgeon matures, including the evolution from saying "yes" to every procedure to knowing when to say "no”
The challenges of actually getting informed consent for maiming or life-altering procedures, such as sacral resections and proximal femoral replacements, given the challenge of explaining to patients how much the procedure will impact their daily life
Recognizing when surgical momentum is being driven by the surgeon rather than the patient, including escalation of commitment and the sunken cost fallacy in surgical decision-making
The value of physically equalizing the conversation, such as pulling up a chair and sitting down rather than towering over the patient, to build trust and openness
The importance of listening to patients before recommending treatment options to ensure that the treatment aligns with the patient’s goals and personal wishes
Strategies for guarding against unnecessary repeat interventions, including peer consultation and pausing after setbacks
Rethinking success in orthopaedics beyond X-rays and implant longevity, including patient-reported outcomes
Managing surgeon guilt, self-forgiveness, and separating outcomes from the integrity of the decision-making process
The importance of never leaving a patient without a clear next step or follow-up plan
Listeners are encouraged to reflect not only on how they operate, but on how and why they decide to operate at all.
Host: Ahmed Emara, MD, member, AAOS Now Editorial BoardGuest: Nathan Mesko, MD, FAAOS, Vice Chair of Global Clinical Operations, Center Director for Orthopaedic Oncology, and Associate Professor, departments of Orthopaedics (Integrated Surgical Institute) and Hematology/Oncology, Cleveland Clinic
Registries: What Happens When Orthopaedic Surgeons Own the Data?
Season 8 · Episode 6
Wednesday, June 24, 2026 • Duration 40:11
In this episode of the AAOS Now Podcast, host Stuart J. Fischer, MD, FAAOS, speaks with two leaders in orthopaedic data science about how physician-controlled registries are transforming outcomes measurement, implant evaluation, and clinical decision-making. From the early vision of a national joint replacement registry to a new real-time data partnership with Epic, the conversation traces how far the registries have come and where they are headed.
Drs. James Huddleston and Steven Glassman share concrete examples of how registry data is driving practice change. They also address how the data supports Clinical Practice Guidelines and research, why surgeon and patient information is protected from outside access, and what the integration of AI and patient-reported outcomes means for the next generation of orthopaedic registries.
Key Topics Covered in This Episode:
Origins and goals of the AAOS registry portfolio: How orthopaedic surgeons built a physician-controlled data infrastructure to protect procedures and drive evidence-based care
Data sources and infrastructure: AJRR's use of hospital and ASC submissions, Medicare claims for complete follow-up on Medicare patients, and a new Epic Community Registries partnership for real-time data capture
Registry scale and participation gaps: Why AJRR has surpassed five million procedures while spine, shoulder and elbow, and musculoskeletal oncology registries are still building volume
Real-world clinical impact: How AJRR data has influenced cementless knee adoption, robotics use in unicompartmental arthroplasty, and the growth of triple-tapered femoral stems in hip replacement
Research and CPG applications: How the Registry Analytics Institute supports physician-led and industry-sponsored research, with strict controls on data dissemination
Patient-reported outcomes: The longstanding role of PROMs in spine and the challenges of scaling PROM collection for hip and knee under new government mandates
Data privacy: Why registry data remains de-identified and inaccessible to insurers and government agencies, and what individual surgeon dashboards can offer
International comparisons and ISAR: How AJRR benchmarks against registries in England, Wales, and beyond, and why U.S.-specific data remains essential
AI and the future of registries: How AJRR is piloting AI-powered EHR extraction to improve data completeness without human intervention
About Our Guests:
James Huddleston III, MD, FAAOS, is Professor of Orthopaedic Surgery at Stanford Hospital; Co-Chair of the AAOS Registry Oversight Committee; and Chair of the American Joint Replacement Registry Steering Committee
Steven D. Glassman, MD, FAAOS, is Professor of Orthopaedic Surgery at the University of Louisville School of Medicine; Medical Director at the Norton Leatherman Spine Center; Chair of the AAOS Registry Oversight Committee; and past Chair of the American Spine Registry Executive Committee
The Ortho Surgery Match Game: Signaling, Away Rotations, Research Years, and More
Season 8 · Episode 4
Friday, May 29, 2026 • Duration 40:11
In this episode of the AAOS Now Podcast, host Richard Schaefer, MD, FAAOS, sits down with two of orthopaedic surgery's most dedicated advocates for medical student mentorship, William Levine, MD, FAAOS, and Amiethab Aiyer, MD, FAAOS, for a candid conversation about the residency Match process.
The discussion tackles the nuts, bolts, and controversies of today's highly competitive application landscape, including how signaling helps students whittle down the number of programs they apply to, why away rotations may have gotten out of hand, and whether every student really needs to do a research year.
Drs. Levine and Aiyer share how their decades-long professional relationship helped shape their commitment to guiding the next generation of orthopaedic surgeons. They explain that mentorship is a bidirectional partnership in which the mentee must put forth more than just a desire to learn. They talk about the importance of building a diverse "board" of mentors across institutions. And they encourage students to seek out mentors, including near-peers, who have their “finger on the pulse” of the rapidly-evolving Match process.
The episode closes with a candid challenge to prospective applicants: Before attempting to match into orthopaedic surgery, ask yourself why you want to be an orthopaedic surgeon. According to Dr. Levine, mentors should require all of their mentees to answer that question — and if the answer is iffy, encourage them to consider a different specialty.
Key Topics Covered in this Episode
How the residency Match process works: from application to Match Day
Building a mentorship "board": why one mentor isn't enough and how to cultivate relationships across institutions
Mentorship as a bidirectional partnership: what mentees must bring to the relationship
The origin of OrthoMentor: how Drs. Levine and Aiyer began collaborating to fill a nationwide advising void and how students at institutions with limited advising resources can still access current, accurate guidance
Signaling and application caps: understanding the data behind limiting program applications (yes, 100 applications is too many)
Away rotations: how many to do and why cohort strategy matters when applying
Research years: when they help, when they don't, and what to look for in a productive year
Schools without home programs: unique challenges and where to find current guidance
Pursuing the right path: why students should reflect on their motivations before pursuing a career in orthopaedic surgery, and why where you train isn’t as important as what you do with the opportunity
About Our Guests
William N. Levine, MD, FAAOS, the Frank E. Stinchfield Professor and Chair, Department of Orthopaedic Surgery, Columbia University College of Physicians and Surgeons; Chief of the Orthopaedics Service at New York-Presbyterian/Columbia University Medical Center; and Editor-in-Chief Emeritus, Journal of the American Academy of Orthopaedic Surgeons
Amiethab Aiyer, MD, FAAOS, Division Chief of foot and ankle surgery and Associate Professor, Department of Orthopaedic Surgery, Johns Hopkins School of Medicine; Deputy Editor, Journal of the American Academy of Orthopaedic Surgeons
My Parents Survived the Khmer Rouge: Life Lessons
Wednesday, April 22, 2026 • Duration 20:55
In this deeply personal episode, Bopha Chrea, MD, shares the extraordinary story of her family's survival of Pol Pot and the Khmer Rouge regime in Cambodia, their harrowing escape from the Killing Fields across the border into Thailand, and their eventual resettlement in Canada.
Dr. Chrea, now a foot and ankle surgeon at Iowa Health Care, connects her family's journey to three core lessons she carried into her career: that opportunities are often disguised as misfortune, that growth requires getting comfortable with being uncomfortable, and that gratitude is a genuine superpower. She reflects on how her early experiences navigating the healthcare system as a young child of immigrant parents shaped her path to orthopaedics, and how she now uses those lessons to guide trainees through the challenges of residency and fellowship, as well as the transition into practice.
Key Topics Covered in This Episode
Opportunities can be disguised as misfortune — How a series of trials and tribulations, including losing his glasses and the destruction of his family’s home, miraculously ended up saving Dr. Chrea's father from execution by Pol Pot’s brutal regime. The lesson: tragedy can lead to positive outcomes and growth.
It’s important to get comfortable with being uncomfortable — How her parents’ willingness to take risks in the absence of a guaranteed path enabled the family to escape the Killing Fields and safely reach the refugee camp in Thailand, where Dr. Chrea was born. This lesson: focus on clarity of vision over certainty of path; as long as you believe in the vision, you can navigate through the uncertainty, but if you aren’t willing to try, you definitely won’t succeed.
Gratitude is a superpower — How her brother chooses to emphasize the positive aspects of the family’s time in the refugee camp, not just the horrors. The lesson: mindset matters; you can actively choose to frame experiences in a more affirming way. To this day, Dr. Chrea is intentional about expressing gratitude to the people who have supported her journey.
Mentoring is not one-size-fits-all — How meeting learners where they are helps them build confidence through small, achievable goals.
The path to orthopaedics is paved with personal experiences — How translating for her mother at medical appointments as a child sparked a lifelong commitment to providing compassionate, patient-centered care.
Guest: Bopha Chrea, MD, Assistant Professor of Orthopaedics and Rehabilitation in the Carver College of Medicine at the University of Iowa
Host: Robert M. Orfaly, MD, MBA, FAAOS, AAOS Now editorial board member
The AAOS Patient Engagement Task Force
Season 8 · Episode 2
Tuesday, March 17, 2026 • Duration 27:53
This episode spotlights the AAOS Patient Engagement Task Force and its efforts to increase patient involvement in and education about orthopaedic care. Host Stuart J. Fischer, MD, FAAOS, welcomed task force co-chairs James W. Barber, MD, FAAOS, and Monica Payares-Lizano, MD, FAAOS, to discuss the creation and structure of the task force and its focus on patient engagement as a key part of the 2024-28 strategic plan. They explain that the task force was designed to promote bi-directional communication between the AAOS Board of Directors and the AAOS councils and committees that are already involved in patient-facing work.
Highlighted task force accomplishments include a major revamp of OrthoInfo.org – AAOS’ most comprehensive patient-facing musculoskeletal health resource – to make the website more accessible and easier to navigate, as well as provide the content in multiple languages. Drs. Barber and Payares also talked about patient advocacy and the powerful impact of sharing patient stories with policymakers on Capitol Hill, about other AAOS patient education tools such as CPGs, and about the positive effect of patient engagement on PROMs. Both doctors share perspectives about how they are able to effectively inform and communicate with their unique patient populations, emphasizing the importance of placing patients at the center of orthopaedic care.
Host: Stuart J. Fischer, MD, FAAOS, member, AAOS Now Editorial Board, and former Editor-in-Chief of OrthoInfo
Guests: Monica Payares-Lizano, MD, FAAOS, pediatric orthopaedic surgeon at Phoenix Children’s; Member-at-Large, AAOS Board of Directors; co-chair, Patient Engagement Task Force
James W. Barber, MD, FAAOS, orthopaedic surgeon with Southeastern Orthopaedics and Surgery Center; Secretary, AAOS Board of Councilors; co-chair, Patient Engagement Task Force
Why Leadership Training Is Essential for Doctors
Season 8 · Episode 2
Thursday, February 19, 2026 • Duration 36:10
This episode explores the importance of leadership development in healthcare and orthopaedics, featuring insights from Duke sports medicine orthopedic surgeon and professor Dean Taylor, MD, FAAOS. Dr. Taylor, chair of the Feagin Leadership Program and a retired Army colonel, shares the origins and impact of the Feagin Leadership Program with host and West Point classmate Richard Schaefer, MD, MPH, FAAOS. Dr. Taylor highlights the program’s role in fostering patient-centered leadership not just in orthopaedics, but across the medical spectrum. He defines what healthcare leadership is and outlines the skills and traits that are essential for healthcare leaders – including emotional intelligence and self-awareness – and how these translate into clinical practice and team dynamics.
Dr. Taylor also reflects on his relationship with the late Dr. John Feagin, whose legacy inspires the multidisciplinary Feagin program, and emphasizes the value of embracing diverse perspectives to improve healthcare outcomes. Listeners gain practical advice about enhancing their leadership skills and learn about resources such as the annual leadership forum and the nonprofit Healthcare Leadership Foundation, which are aimed at advancing leadership education in medicine.
Host: Richard Schaefer, MD, MPH, FAAOS
Guest: Dean Taylor, MD, FAAOS
How AI Is Transforming Orthopaedics
Wednesday, January 28, 2026 • Duration 44:25
This episode explores the rapidly evolving role of artificial intelligence (AI) in orthopedic surgery, highlighting practical applications, current challenges, ethical considerations, and what the future holds. Dr. Peter Schilling, MD, MSc, co-founder of the Dartmouth Center for AI Research in Orthopedics, joins host Doug Lundy, MD, MBA, FAAOS, to discuss topics ranging from federated learning to the use of digital scribes in clinical practice. Dr. Schilling shares insights on how AI is shaping patient care, transforming the doctor-patient relationship, and driving research advances. The conversation also addresses common misconceptions and concerns about AI as this technology becomes increasingly integrated into everyday practice and research.
Host: Doug Lundy, MD, MBA, FAAOSGuest: Peter Schilling, MD, MSc
Innovation in Orthopaedic Surgery
Season 7 · Episode 5
Friday, December 19, 2025 • Duration 29:20
This episode explores the multifaceted nature of innovation in orthopedic surgery, from creative problem-solving in clinical practice to collaborating with industry on new device development. Dr. Robert Orfaly hosts a conversation with Dr. Amy Ladd, Chief of Stanford's Chase Hand & Upper Limb Center, a recognized leader in the field whose career includes pioneering research in thumb CMC arthritis, patents, and instrument design.
Dr. Amy Ladd shares her perspective on fostering intellectual curiosity early in one's career, the process of turning a simple idea into intellectual property, and the evolving relationship between academic institutions, industry, and orthopedic surgeons. Practical advice is given for trainees, mid-career surgeons, and anyone inspired to pursue innovation, with stories ranging from creating specialized surgical instruments to applying motion analysis technology from upper limb research to optimizing golf swings. The episode also discusses the importance of networking across disciplines and the realities of developing and commercializing new medical devices, emphasizing that creativity and collaboration are central to advancing patient care.
Host: Robert Orfaly, MD, MBA, FAAOS, Editor in Chief, AAOS Now
Guest: Amy Ladd, MD, FAAOS, Chief of Stanford's Chase Hand & Upper Limb Center; Chief of the Children’s Hand Clinic at Lucile Salter Packard Children’s Hospital at Stanfordand; and the Elsbach-Richards Professor of Surgery and Professor, by courtesy, of Medicine (Immunology & Rheumatology) and Surgery (Plastic and Reconstructive Surgery), at Stanford University Medical Center
Production and Editing: MK Quinn Media
Inside AAOS 2026: Can’t Miss Events, Education, and the Crescent City
Season 7 · Episode 4
Tuesday, November 18, 2025 • Duration 40:08
This episode provides a comprehensive preview of the 2026 AAOS Annual Meeting, set to take place in New Orleans. Special guests Dr. Matthew Provencher, Chair of the Annual Meeting Oversight Committee, and Dr. Michael Leddy, Chair of the Board of Counselors, join host Dr. Stuart Fischer to discuss the meticulous planning required for one of the world’s largest medical gatherings. They cover new data-driven changes aimed at maximizing attendee engagement, including more efficient session lengths and the elimination of ICL registration fees, making education more accessible than ever.
The episode highlights the importance of member feedback in shaping the meeting’s offerings, plans for innovative features such as an advanced navigation app, and exciting technological upgrades for hands-on learning. With expert insights and local perspective, the hosts share everything attendees can look forward to -- from educational sessions and networking opportunities, to unique New Orleans attractions and tips for making the most of time in The Big Easy.
Host: Dr. Stuart Fischer
Guests: Dr. Matthew Provencher, Chair, Annual Meeting Oversight Committee; Dr. Michael Leddy, Chair, Board of Counselors
Production and Editing: MK Quinn Media
Mastering the Art of Patient Communication
Season 7 · Episode 3
Tuesday, October 21, 2025 • Duration 27:14
This episode explores the essentials of effective doctor-patient communication in today’s rapidly changing healthcare landscape, particularly in an era influenced by “Dr. Google” and increased patient access to information. Dr. Katie Schabel, Professor of Orthopaedic Surgery at Oregon Health and Science University, draws from her experience as both a clinician and educator to discuss practical strategies for building trust, demonstrating empathy, and fostering shared decision-making with patients. Topics include the “four E's” of communication - engage, empathize, educate, and enlist - as well as tips for tackling complex conversations around surgical risks, optimization, and misinformation found online.
Host: Robert Orfaly, MD, MBA, Editor in Chief, AAOS NowGuest: Katie Schabel, MD, Professor of Orthopaedic Surgery, Oregon Health and Science University
