Extract
Advances in medicine in general and orthopaedic surgery in particular have been largely empirical throughout history. That is, intuition has guided developments through trial and error. Until recently, science has more often explained what was already observed by clinicians rather than created new interventions. Within the last decade or two, however, therapeutic musculoskeletal interventions have been emerging from the laboratory rather than from the intuition of practitioners. Current examples include gene therapy, cyclooxygenase-2 (COX2) inhibitors, growth factors, and the new polyethylenes. As always, traditional interventions become obsolete at some point and are replaced by new treatments. The rapidity and nature of recent scientific developments have provided the potential for an astonishing array of novel advances that will supersede the old treatments, and they suggest that more interventions will come from the laboratory rather than from practitioners. In order to take full advantage of the available and emerging technologies from a wide variety of fields, we will need orthopaedists who understand the capabilities and limitations of the technologies as well as the clinical and biological realities so that the new science can be translated into real benefits for our patients.