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The Orthopaedic Forum   |    
On Rise and Decline
Augusto Sarmiento, MD1
1 10333 S.W. 72nd Avenue, Miami, FL 33156. E-mail address: asarm@bellsouth.net
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Disclosure: The author did not receive any outside funding or grants in support of his research for or preparation of this work. Neither he nor a member of his immediate family received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2009 Nov 01;91(11):2740-2742. doi: 10.2106/JBJS.I.00830
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Extract

In 1776, the year when America declared its independence, Edward Gibbon released his book The Decline and Fall of the Roman Empire. He concluded, rightly or wrongly, that the fall of the empire was mainly due to barbarian invasions and the spread of Christianity. Since Gibbon's day, many others have observed that great nations and institutions, after reaching the pinnacle of power and success, gradually decline because of internal degradation. Arnold Toynbee, another British historian, is reported to have said, "An autopsy of history would show that all great nations commit suicide." I am using these pronouncements to create an analogy with the condition of the orthopaedic discipline. The metaphor is based on observations on the manner in which our profession appears to be showing symptoms suggestive of decline.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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