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History of the Association of Bone and Joint Surgeons

Derkash, Robert S. MD

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Clinical Orthopaedics and Related Research: April 1997 - Volume 337 - Issue - p 306-309
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In the late 1940s there were only 3 organized orthopaedic organizations. They were the American Board of Orthopaedic Surgery (ABOS), the American Academy of Orthopaedic Surgery (AAOS), and the American Orthopaedic Association (AOA). After World War II there were numerous orthopaedic surgeons who were beginning to publish. Because there was a large backlog of manuscripts, they found it frustrating that the only American orthopaedic journal was The Journal of Bone and Joint Surgery.

Because of these frustrations, Dr. Earl McBride from Oklahoma City, OK, and others thought that another organization to hold small, intimate meetings to exchange professional ideas was needed. The idea to have an organization comprised of young orthopaedic surgeons who would share innovative ideas and discuss difficult orthopaedic problems was the seed that initiated the Association of Bone and Joint Surgeons. Dr. McBride was the shepherd of the organization and he and his wife, Polly, helped to steer it down the path that led to its becoming one of the outstanding organizations in the orthopaedic world. In addition, the only recognized American orthopaedic journal was The Journal of Bone and Joint Surgery and it was thought that another orthopaedic journal was needed. The Journal of Bone and Joint Surgery was overwhelmed with clinical material and it could not possibly accommodate the vast amount of manuscripts submitted.

In 1947 the Association of Bone and Joint Surgeons (ABJS) was conceived with charter members being Drs. Earl McBride, Garrett Pipkin, Duncan McKeever, Judson Wilson, Fritz Teal, Louis Breck, Henry Louis Green, Howard Shorbe, Theodore Vinke, Paul Williams, Eugene Secord, and Frank Hand(Fig 1). An organizational meeting was held at the annual Academy meeting in Chicago in January 1949 with the first meeting of the Association of Bone and Joint Surgeons being held on April 1 and 2, 1949, in Oklahoma City. Dr. McBride was the first president and Dr. Fritz Teal was the first secretary. So that it did not conflict with the Academy meetings, it was decided to have 1 annual meeting in the spring of every year, and spouses and families were encouraged to attend the annual meetings. Social activities were arranged to promote interchanges between members. The first interim session of the Association of Bone and Joint Surgeons was held at the Waldorf Astoria Hotel in New York City on February 14, 1950.

Fig 1
Fig 1:
The first meeting of the Association of Bone and Joint Surgeons, Oklahoma City, OK, April 1-2, 1949: (top row, left to right) Judson Wilson, Howard Shorbe, Theodore Vinke, Louis Breck, Paul Williams, Eugene Secord, Frank Hand, Henry Louis Green; (bottom row, left to right) Fritz Teal, Garrett Pipkin, Earl McBride, Duncan McKeever.

Membership is by invitation only. Members must be younger than 50 years of age and must have been a member of the American Academy of Orthopaedic Surgery for 3 years. Members need to attend 1 meeting every 3 years and present an abstract every 3 years. Membership started with 50 members who became senior members when they reached the ripe old age of 50. This soon changed to age 55 as the young doctors got closer to the dreaded age. It was soon discovered that there were several other brilliant young orthopaedists knocking on the door and the membership increased to 75, and finally to 85 domestic members. In addition, there are 20 corresponding members from other countries.

The idea for a journal was conceived at the inception of the organization. At the second annual meeting in Lincoln, Nebraska on April 14, 1950, Dr. Louis Breck reported that 200 orthopaedic surgeons were surveyed and it was the consensus that another journal was needed. Dr. McBride went to Boston and sat in the office of Dr. William A. Rogers, editor of the Journal of Bone and Joint Surgeons, until Rogers gave his approval to establish another English language journal of orthopaedic surgery. It became reality in 1952 and Dr. Anthony DePalma and Dr. McBride were assigned to contact J. B. Lippincott Company about publishing a journal. Mr. Walter Kahoe of the J. B. Lippincott Company helped expedite printing of the journal. Dr. DePalma was made editor in chief, and the Association of Bone and Joint Surgeons selected Clinical Orthopaedics as the title for the journal. At the annual meeting in Minneapolis on March 29, 1959, a motion was passed that a new contract be negotiated with J. B. Lippincott Company so that the Association of Bone and Joint Surgeons retained the right of the name of Clinical Orthopaedics. Dr. DePalma discussed this with J. B. Lippincott and this was thought to be satisfactory. The first volume was published in the summer of 1953. The original format in 1953 is similar to the format today. The symposium for the first issue was entitled Children's Orthopaedics; the lead article in Section II was entitled Research in Orthopaedic Surgery, which was written by Alfred Shands several years before he founded the Orthopaedic Research Society. Volume I also included an article on physiologic basis of bone graft surgery by Marshall Urist who reviewed and solicited basic science articles. Articles were submitted and reviewed by a voluntary editorial board. Once the format was decided upon, it was sent to J. B. Lippincott Company for publication.

To start the journal, each member was assessed $100, but within 2 to 3 years the journal was self sufficient. The journal started with the idea that it would be 1 hardbound copy annually but within a year, because of the large number of submitted articles, this was soon increased. During the next several years, more and more articles were submitted on basic research related to orthopaedics, and it was thought best to change the name of the journal. In 1962 at an interim meeting in New York City, the Association of Bone and Joint Surgeons changed the name of Clinical Orthopaedics to Clinical Orthopaedics and Related Research. The thought was that the journal should be dedicated not only to clinical orthopaedics but also to orthopaedic research.

The theme of the journal has been to have a symposium on 1 topic and this has been maintained throughout the existence of the journal. The symposium is followed by numerous general articles including basic research. The basic principles of the journal have not changed. The journal has always been hardbound and there have been no advertisements within its covers. The journal was published once per year in 1952, 2 issues in 1953, 3 issues in 1959, 6 issues in 1963, 8 issues in 1971, and it now is published monthly.

The office of the journal was first housed in the orthopaedic department of Thomas Jefferson Medical School in Philadelphia under the guidance of Dr. Anthony DePalma. This was all done on a voluntary basis including the use of his office staff. In 1966 after 16 years as editor in chief, Dr. Anthony DePalma stepped down and the journal was moved to the University of California, Los Angeles under the guidance of Dr. Marshall Urist.

Dr. Urist served as deputy editor of the basic science articles from 1953 to 1966. The actual change in the journal name from Clinical Orthopaedics to Clinical Orthopaedics and Related Research was in Volume 26 in 1963 under the guidance of Dr. Urist. Dr. Edgar Bick was appointed deputy editor of a new feature on The Classics. Dr. Leonard Peltier was appointed in 1979 to succeed Dr. Bick as editor of the section on The Classics because of his interest in the history of orthopaedics. Bick's selections were often milestones rather than classic articles, but the end prospect was generally of interest to Clinical Orthopaedics and Related Research readers. After the death of Dr. Bick in 1978, the Board of Trustees appointed Dr. Leonard Peltier as editor of the section on The Classics.

Dr. Urist spent 27 years as editor in chief of Clinical Orthopaedics and Related Research. When Dr. Urist became editor in chief in 1966 there was only a Board of Associate Editors, and he helped establish a formal Board of Trustees. Under his leadership the journal flourished. Clinical Orthopaedics and Related Research is now the second largest orthopaedic journal in the world with paid subscribers. The circulation has increased to approximately 11,000 subscribers in more than 100 countries. There is now a Marshall R. Urist Young Investigator Award given annually by the Association. Dr. Carl Brighton succeeded Dr. Urist as editor in chief in 1993.

Clinical Orthopaedics and Related Research receives many good manuscripts and less than 25% of unsolicited manuscripts are published. The authors are required to compete on the basis of quality and relevance. The Editorial Board for Clinical Orthopaedics and Related Research has more than 100 authorities in all fields of bioscience. They donate their time and knowledge to make sure all manuscripts are acceptable.

Royalties from Clinical Orthopaedics and Related Research have allowed the Association of Bone and Joint Surgeons to donate money and scholarship funds for research and orthopaedic education. In 1955 the Association of Bone and Joint Surgeons was the first orthopaedic organization to contribute to the Clinical Orthopaedics Foundation. Contributions were also made to projects such as Project Hope and Medico to improve orthopaedic teaching in third world countries. To stimulate research, the Association of Bone and Joint Surgeons established the Nicolas Andry Essay Award in 1961 which carries an honorarium and is presented each year at the annual meeting. At each annual meeting there is an Earl McBride Speaker Award to acknowledge his achievements.

The official seal for the organization was created by Milton Coby who was president of the organization in 1966. The skeleton of the serpent from the staff of Aesculapius was pictured surrounding a nondeformed tree. The tree was not deformed to signify the long range objective of orthopaedic surgery. The first presidential gavel was modeled from the upper end of the femur and was designed by Theodore Vinke in 1962. A medallion of the seal of the Association was cast in gold under the direction of Dr. Earl McBride in 1963 and is worn by the president at the annual meeting.

Since its inception in 1952, the Association of Bone and Joint Surgeons has been a small, close knit group of orthopaedic surgeons who maintain a close bond professionally and personally. It is unique in that it has maintained a good balance among researchers and academicians as well as orthopaedists in private practice. The Association has developed a very strong orthopaedic journal, Clinical Orthopaedics and Related Research, which has maintained very high quality in publishing articles on clinical medicine and research throughout the years.

Clinical Orthopaedics and Related Research through its symposiums has published many new concepts in orthopaedic surgery. For example, the journal has published new and radical approaches to orthopaedic problems, such as Charnley's total hip arthroplasty, the original Kenji Takagi work on arthroscopy, Lyman Smith's percutaneous intradiscal therapy, the first and only English language papers by Ilizarov on callus extension, and the original work of F. Gunston on total knee arthroplasty.

The founders of the Association of Bone and Joint Surgeons were bold innovators in orthopaedic surgery after World War II. Hopefully surgeons of today will have an environment favorable for innovation and publication of new approaches to unsolved problems in this journal. Louis Breck, 1 of the founding members of the Association of Bone and Joint Surgeons, published 2 articles in Clinical Orthopaedics and Related Research on metal to metal total hip arthroplasty, an operation coming back into favor after 30 years of high density polyethylene liners and sockets. Louis Breck invented a data retrieval system for his patients' followup records 40 years before the advent of computers. Hopefully, this attitude will continue in the future.

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