Orthopedics Roundtable

Orthopedics is one of the most technologically advanced, rapidly evolving areas of medicine. It also has a major impact on people’s daily lives, affecting how people move, whether they can go up and down stairs, lift a shirt over their head, or even walk. Here, four local experts share their unique perspectives on sports medicine, pediatric orthopedics, opioid medications, and more.

Q: What new developments are you excited about in the field of orthopedics?

Joseph Lamplot: One development I’m particularly excited about is the rapid improvement in AI-assisted medical documentation. AI dictation software has become increasingly sophisticated and, when implemented well, can significantly reduce the administrative burden on physicians. This allows surgeons to spend more time interacting directly with patients rather than completing documentation after clinic hours. It can also reduce transcription errors and improve the consistency of medical records. While there is still room for improvement — particularly with customization and integration with electronic medical records — the progress over the past few years has been remarkable.

Erik King: One development I’m especially excited about is safer imaging with lower radiation exposure. In pediatrics, we follow the ALARA principle — keeping radiation “as low as reasonably achievable.” Technologies like EOS imaging provide high-quality 3D images for scoliosis and orthopedic conditions while using less radiation, and advanced surgical navigation improves precision during procedures.

Mark R. Hutchinson: I’m excited about minimal-incision surgery, particularly arthroscopic-assisted, and the potential of orthobiologics and cartilage restoration.

Q: How do you think about orthopedics differently today than when you began your career?

Anthony Romeo: Today, the combination of basic science, patient-reported outcomes, innovative techniques, and advanced technology fuels my passion for orthopedics. I feel privileged to use these advancements to significantly improve patients’ lives, far beyond what was possible early in my career.

Erik King: Over time, I’ve gained a greater appreciation for prevention and early intervention. I also think more broadly about the child within their family and support system. Understanding family structure, caregivers, and the child’s daily environment helps us deliver care that supports both recovery and long-term well-being.

Joseph Lamplot: When I began orthopedic training, I assumed I would spend my six years of training learning the techniques and principles that I would apply throughout the rest of my career. In reality, orthopedics is a constantly evolving field. Surgical techniques, rehabilitation strategies, and technology continue to advance. Very little of what I do today is exactly the same as when I completed my training. I view that as a positive development. It means we are continually improving how we care for patients. My approach today is strongly driven by evidence-based medicine and adapting my practice as new high-quality research becomes available.

What do you wish more people understood about orthopedic care?

Joseph Lamplot: Many patients come to my office assuming — or even fearing — that the surgeon will immediately recommend surgery. In reality, a good orthopedic surgeon will attempt nonoperative treatment whenever appropriate. While some problems do require surgical intervention, many musculoskeletal conditions can improve with physical therapy, medication, activity modification, or other conservative treatments. I often tell patients that their shoulder or knee will “declare itself.” If they attempt nonoperative management and continue to have significant symptoms, then surgery may become the best option to improve pain and function. Shared decision-making is critical. I rarely make the decision for the patient. Instead, it is a collaborative process between the patient, their family, and the surgeon.

Erik King: In pediatric orthopedics, growth and development matter tremendously. A condition can affect a young child, teenager, and adult very differently. Treatment must account for where a child is in their physical development, which often means using approaches that support healthy growth while addressing the underlying orthopedic issue.

Mark R. Hutchinson: Early recognition and treatment of mild injuries or complaints can minimize or postpone problems in the future.

Q: What are the biggest challenges in orthopedic care today?

Erik King: One challenge is the broader lack of investment in children’s health, education, and well-being. Families often need significant support when a child faces a medical issue. Ensuring access to high-quality care and resources is essential so children can recover fully and thrive physically and developmentally.

Joseph Lamplot: One of the biggest challenges is the combination of declining physician reimbursement and the increasing cost of delivering healthcare. Even without adjusting for inflation, physician reimbursement has generally decreased over the past decade, while operating costs — including staffing, equipment, and facility costs — have continued to rise. This often forces musculoskeletal providers to see more patients to maintain the same level of revenue.

Anthony Romeo: Integrating rapidly advancing, expensive technologies while facing pressure to cut costs can restrict access to cutting-edge care. We must focus on outcomes research to verify these innovations, ensuring they truly improve patients’ lives without sacrificing affordability. 

Mark R. Hutchinson: Access and cost. Procedures and implants are expensive, and some patient do not have timely access to care, which then makes their problems worse when left untreated over time. 

What questions should patients ask their doctor prior to joint surgery?

Erik King: Families should know there are no wrong questions to ask. It’s important to understand the goal of surgery, expected recovery, possible risks, and how the procedure will improve function. Open communication helps families feel confident in the care plan and ensures everyone shares the same expectations.

Anthony Romeo: Ask about your diagnosis, non-surgical options, and preoperative preparation. Inquire about the surgeon’s experience, personal outcomes data, how they manage complications, infection and clot prevention strategies, post-surgery activity guidelines, and implant longevity to make an informed decision.

Mark R. Hutchinson: What are my nonsurgical options? How many of these have you done before, and what have your outcomes, not just the literature outcomes, been?

Q: Considering the risks that opioid medications pose, what’s the best way for people to manage pain before and after surgery?

Anthony Romeo: Discontinue opioids before surgery. Use multimodal pain management: preoperative acetaminophen and NSAIDs, along with regional blocks. After surgery, limit opioids to no more than 15 pills, then quickly switch to acetaminophen, NSAIDs, ice therapy, and joint rest for seven to 10 days to reduce risks.

Joseph Lamplot: I am a strong proponent of opioid-sparing — and when possible, opioid-free — postoperative pain protocols. Ideally, patients should not be taking narcotic medications before surgery. Postoperatively, unless there are contraindications, I typically use a multimodal approach that includes scheduled acetaminophen (Tylenol), scheduled anti-inflammatory medications, and in many cases a brief course of oral steroids. Opioids are reserved only for breakthrough pain and are used sparingly. Advances such as long-acting peripheral nerve blocks, which temporarily numb the nerves supplying the surgical area, have significantly improved pain control while reducing opioid use. Equally important is setting expectations. I routinely tell patients that they should expect some pain after surgery. Patients who understand this tend to use fewer narcotics and recover more smoothly.

Erik King: Pain management has evolved significantly. At Lurie Children’s, we use evidence-based pathways to reduce opioid use while maintaining excellent pain control. Families should discuss expectations before surgery and combine medication with strategies like icing, rest, wound care, and reassurance to help children recover comfortably and safely.

Q: What should young athletes know about sports overuse injuries and how to treat them?

Joseph Lamplot: Young athletes should recognize that even professional athletes have an offseason. In many cases, youth athletes actually have less rest than collegiate or professional athletes because they participate in the same sport year-round. This lack of recovery time increases the risk of overuse injuries. Rest and recovery are critical. Cross-training is also important to avoid repetitive stress on the same muscle groups and joints. In addition, conditioning programs that include strength training, agility work, and proper movement mechanics are essential. These programs reduce injury risk and help athletes maintain long-term performance and longevity in their sport.

Mark R. Hutchinson: Young athletes and parents should be aware that injuries happen. Minimizing risk includes monitoring training intensity, repetition counts like pitch counts, gradual (not acute) increases in training, and early recognition of complaints which lead to reduction in intensity.

Erik King: Overuse injuries are increasingly common in young athletes. Playing through pain is not always the best strategy — rest and recovery often lead to faster healing. We also encourage kids to participate in a variety of sports rather than specializing too early, which helps promote balanced musculoskeletal development.

Anthony Romeo: Most overuse injuries heal without surgery through activity reduction over weeks to months. Treatment includes stretching, physical therapies, gradual strengthening, proper nutrition, and enough sleep. When returning, expert coaching can help refine techniques to enhance performance and prevent recurrence.

Q: Besides face-to-face conversations with orthopedic specialists, where can people find reliable orthopedic resources?

Erik King: Several trusted organizations offer reliable information for families. These include the Pediatric Orthopaedic Society of North America, the American Academy of Orthopaedic Surgeons, and the American Academy of Pediatrics. Their websites provide educational resources about orthopedic conditions and treatment options.

Anthony Romeo: Consult previous patients, primary care doctors, and physical therapists for insights. Check reputable online reviews and surgeons’ personal websites for evidence-based details on treatments and outcomes.

Joseph Lamplot: With the rapid development of artificial intelligence tools, platforms such as ChatGPT and other AI-based systems can provide efficient summaries of information drawn from across the internet and, in some cases, the medical literature. While I would never recommend that patients rely solely on AI for medical decision-making, these tools can serve as a starting point for learning about orthopedic conditions. In many cases, they may provide more organized information than a typical internet search. That said, the best source of information for a patient’s specific condition will always be a discussion with a qualified medical professional.

Q: What can providers do to ensure the best outcomes for patients?

Mark R. Hutchinson: Optimizing outcomes begins with careful selection of the right procedure or the right patient. It is followed by performing the intervention with the best quality techniques and dependable, high-quality materials. Once the technique is complete, I tell my patients that half the battle is me doing the procedure; the second half is on them to diligently follow the guided rehabilitation protocol. Not all procedures have perfect outcomes, and the patient should be well-informed regarding risks benefits and expected outcomes before consenting to proceed.

Anthony Romeo: Providers must confirm diagnoses through comprehensive history, examination, and imaging, while setting realistic expectations. Improve patient health by focusing on nutrition, eliminating smoking, and evaluating support systems. Success is seen in restored function, pain relief, and improved quality of life through motivated patient-surgeon partnerships.

Joseph Lamplot: Providers must remain committed to practicing evidence-based medicine. This requires continually reviewing the medical literature and staying current with advances in their subspecialty. When complex or unusual problems arise, physicians should also maintain strong professional networks and seek additional expert opinions when needed. Medicine is increasingly collaborative. Ultimately, success is defined by the patient’s outcome. If a patient achieves their goals — whether that means returning to sports, work, or daily activities — with improved function and reduced pain, then we have done our job well.

Originally published in the Spring/Summer 2026 print issue.