John Insall and the Evolution of Total Knee Arthroplasty

Guest podcast host, Dr. Anuj Mehta, PGY 5 chief orthopaedic surgery resident at Temple University Hospital, reviews the principles of femoral neck fracture fixation and arthroplasty for geriatric femoral neck fractures, followed by interviews with Dr. Saqib Rehman, Dr. David Galos, and Dr. Matthew Craig.

Season 7 Episide 2 is my interview with Chinenye Nwachuku, MD, Orthopaedic Trauma & Joint Replacement Surgeon. Dr. Nwachuku discusses his extensive experience working, teaching, and learning orthopaedic surgery in Ghana. They discuss the evolution from short-term “mission trips” to a sustainable model focused on reciprocal learning, cultural understanding, and empowering local surgeons. Dr. Nwachuku shares insights on daily clinical work, navigating challenges, and building a stronger orthopedic community that can thrive independently.

We’re kicking off Season 7 with my interview with some of the key leaders at SIGN Fracture Care International – Sariah Khormaee, MD, PhD (CEO), David Shearer, MD (Vice President of the Board), and Dr. Faseeh Shahab, Assistant Professor at Shahab Orthopaedic and General Hospital in Peshawar, Pakistan. SIGN Fracture Care International is doing truly inspiring work around the world. They are a US-based (in Washington state) nonprofit that partners with local surgeons in low and middle income countries to bring life-changing fracture care to patients who might otherwise never walk again. Their IM nailing system, which has a unique interlocking instrumentation that doesn’t require fluoroscopy, is provided free to their surgeons. Since 1999, SIGN has trained and equipped thousands of surgeons with implants and instruments designed for hospitals that don’t have the resources many of us take for granted—helping restore mobility, dignity, and hope to millions of people. Check them out at https://www.signfracturecare.org/ and here in my interview.

Xylazine, a veterinary sedative, has increasingly been found as an adulterant in illicit fentanyl supplies across the USA. This combination has led to severe necrotic skin wounds among users, particularly in the Philadelphia region, posing significant challenges for patients and healthcare providers. As these frequently exhibit as extremity wounds, orthopaedic surgeons are amongst those involved in their care. We discuss the recent findings from the first regional symposium on this crisis with meeting co-chairs Drs. Asif Ilyas and Katharine Woozley. Dr. Ilyas is President of the Rothman Opioid Foundation, Partner and Fellowship Director at the Rothman Institute, and Professor, Vice Chair, and Associate Dean at the Drexel School of Medicine in Philadelphia, Pennsylvania. Dr. Woozley is an Associate Professor of Orthopaedic Surgery and Division Head of Hand and Nerve Surgery at Cooper Medical School in Camden, New Jersey.

In this final installment of the Ortho Time Machine episodes (for now…) we discuss Maurice Müeller, the genesis of the AO Foundation, and its profound impact on modern fracture fixation principles.   The AO Foundation, or Arbeitsgemeinschaft für  Osteosynthesefragen, revolutionized fracture treatment by introducing principles that transformed patient outcomes worldwide. In this episode, we will explore its origins, the visionary minds behind it, and the evolution of its groundbreaking techniques.

Welcome to Ortho Time Machine episodes where we explore pivotal moments and game-changing innovations in orthopaedic surgery. In this episode, we’ll journey through the life and legacy of Dr. Paul Harrington, whose work in spinal instrumentation changed the field forever. You’ve probably heard of the Harrington Rod. It was the first widely successful spinal implant, designed to treat severe scoliosis and spinal deformities. But the story of how it came to be, and the man behind it, is as remarkable as the device itself. Before Dr. Harrington’s innovation, scoliosis was often managed with rigid body casts, prolonged bed rest, and traction. These methods were not only uncomfortable but also largely ineffective for severe cases. It was clear that a transformative solution was needed.   Enter the ingenuity and unwavering commitment of Dr. Harrington. Let’s dive in.

The Ortho Time Machine episodes continue with the remarkable journey of Total Knee Arthroplasty, or TKA—a procedure that has transformed the lives of millions suffering from debilitating knee arthritis. In this episode, we’ll focus on the significant contributions of Dr. John Insall, whose innovative designs and surgical techniques elevated TKA to the gold standard it is today. From early prosthetic designs to complex revision systems, Insall’s work revolutionized how we treat degenerative knee diseases. Join me as we unpack the fascinating evolution of knee arthroplasty, including the setbacks, breakthroughs, and the visionary leadership of Dr. Insall.

In this chapter of the Ortho Time Machine episodes, we’re focusing on a game-changing innovation that transformed the way surgeons diagnose and treat joint disorders. Masaki Watanabe and many others helped to pioneer arthroscopic surgery and gave orthopaedic surgeons a new way to see and treat inside joints without large incisions. It’s hard to imagine modern orthopaedics without arthroscopy. Whether it’s repairing a torn meniscus, reconstructing an ACL, or repairing a rotator cuff, arthroscopy has become a cornerstone of our field. But how did it all begin? Who were the pioneers that made it possible? And what were the challenges along the way? Join me as we dive into the fascinating story of arthroscopy, its early skeptics, and the visionary surgeons who saw its potential.

Welcome back to Ortho Time Machine episodes where we uncover the most transformative moments and figures in the history of orthopaedic surgery. In this episode, we’re delving into the extraordinary life and work of Gavriil Ilizarov—a man who, against all odds, revolutionized limb reconstruction and deformity correction. (Note that some of the character voices are computer-generated acting and not actual footage.)

Season 6 of the OrthoClips Podcast Series features a new mini-series entitled “Ortho Time Machine”, where we travel through the fascinating history of orthopaedic surgery, exploring the game-changing moments that shaped our field. In this first episode, we’re stepping into the operating theater of one of the most brilliant minds in orthopaedics: Sir John Charnley, the father of modern total hip arthroplasty, or THA. (Note that some of the character voices are computer-generated acting and not actual footage.)