By: Sophie Eydis

6 hours ago

Orthopedic departments are being challenged to move beyond treating injuries toward preventing them altogether. Here, ten industry leaders share how they’re reimagining musculoskeletal care — from integrating technology to implementing new care models — to keep patients healthier for longer.

Question: Orthopedics has long focused on repairing damage — what will it take to truly make prevention the next frontier?

Editor’s note: These responses have been lightly edited for clarity and length.

**R. Carter Cassidy, MD. Chair of Orthopedic Surgery and Sports Medicine at UK HealthCare (Lexington, Ky.): **At UK, we’re proud to shift from treatment to prevention. By embedding athletic trainers within local tactical units — police, fire and EMS — we proactively address musculoskeletal injury risks before they lead to downtime or disability. This initiative has proven highly effective in maintaining peak performance and strengthening community partnerships. It’s a strong example of how orthopedics can enhance resilience and readiness beyond the clinic.

**Douglas Dirschl, MD. Professor and Chair of the Department of Orthopedic Surgery at Baylor College of Medicine (Houston): **Prevention requires alignment among patients, providers and insurers. If any one of the three isn’t on board, progress stalls. For example, we’ve shown that any osteoporosis treatment reduces fracture risk over five years by 40%, yet prevention remains underused. Until patients seek evaluation, surgeons embrace proactive care and payers reimburse prevention, fragility fractures — and similar challenges — will persist.

**David Kalainov, MD. Medical Director of Orthopedics at Northwestern Memorial Hospital (Chicago): **To make prevention work on a large scale, both patients and providers must be adequately incentivized. Aligning motivation and reimbursement toward preventive measures is key to changing long-standing care patterns.

**C. Benjamin Ma, MD. Chair of Orthopedic Surgery at University of California San Francisco: **Orthopedics has long focused on treatment after injury, but the future lies in preparation and prevention. At UCSF, 35% of our faculty are now nonoperative clinicians focused on bone health and preventive care. Our Bone Health Clinic identifies and treats osteoporosis early — before the next fracture occurs. This proactive approach reflects the evolution our field needs.

**Elizabeth Matzkin, MD. Chief of the Women’s Sports Medicine Program at Brigham and Women’s Hospital and Assistant Professor of Orthopedic Surgery at Harvard Medical School (Boston): **Prevention can become the new standard through data-driven, evidence-based programs. Neuromuscular training — combining plyometrics, strength and movement feedback — can reduce ACL injury risk by up to 70%, especially for female athletes. Embedding these programs in youth sports and emphasizing consistency could shift orthopedics from reconstructing ligaments to truly preventing injury.

**Douglas Padgett, MD. Surgeon-in-Chief and Chair of Orthopedics at Hospital for Special Surgery (New York City): **The future of orthopedics lies in injury prevention and early recognition of osteoarthritis. For decades, we’ve excelled at reconstructing and replacing — now we must identify at-risk populations and intervene earlier. As patients live longer and stay active, community-based prevention and early detection will become essential.

**Selene Parekh, MD. Professor and Orthopaedic Surgeon at Rothman Orthopaedic Institute (Philadelphia): **To shift from repair to prevention, orthopedics must embrace predictive analytics, wearable technology and AI-driven musculoskeletal tracking. Continuous data — from gait to bone density — can flag risks before injury occurs. Equally important is a cultural shift: redefining success by the injuries we prevent, not just the surgeries we perform. Collaboration across technology, sports medicine and population health will drive that transformation.

**Thomas Vail, MD. Professor and Chair Emeritus in the Department of Orthopedic Surgery at University of California San Francisco: **Musculoskeletal health is inseparable from general health. A deeper understanding of how bone, cartilage, muscle and ligaments interact at the cellular level will shape the next era of prevention. Advances in pharmaceuticals, biologics and patient-specific repair strategies could one day halt or reverse joint degeneration — bridging the gap to a future where cartilage aging can be prevented entirely.

**Brian Waterman, MD. Chief and Fellowship Director of Sports Medicine and Professor of Orthopaedic Surgery at Wake Forest University School of Medicine (Winston-Salem, N.C.): **Most patients arrive with advanced damage — rotator cuff tears, arthritis and more. To “flip the script,” we need shared incentives between patients and providers focused on musculoskeletal wellness. Much like gainsharing in surgery centers, new models must reward proactive prevention. Whether through incentives or penalties, we need mechanisms that make prevention economically and clinically viable.

**Joseph Zuckerman, MD. Chair of Orthopedic Surgery at NYU Langone Health (New York City): **To move from repair to prevention, orthopedic clinicians must partner closely with basic scientists. This “dyad” model — clinicians working alongside researchers — is essential to developing preventive treatments that can alter disease trajectories. Building this infrastructure will take time and commitment, but it’s the only way to create sustainable breakthroughs in musculoskeletal prevention.

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