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Received : 01-06-2021

Accepted : 10-06-2021

Available online : 11-08-2021

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Chellamuthu, Muthu, Jeyaraman, and Khanna: When surgeons wanted to go beyond their scalpels! – The philosophy of orthopaedic rheumatology

2021 marks the start of a new decade - the second one for IORA after a prosperous first decade. This year also marks the completion of 5 years of the International Journal of Orthopaedic Rheumatology (IJOR). At this juncture, we would like to look back and reflect upon the intentions and the fundamental values of this association

Periprosthetic Joint Infection in a Rheumatoid knee”,

“Failed primary replacement in a young patient with inflammatory arthritis”,

“Vocational rehabilitation for young patients with deformities”

– How many of us would have sighed in these situations – feeling pathetic for the patients?

Thank goodness, situations like these created a deep churning on the possible early interventions in such conditions in “Some”. That was the time when the scope of Orthobiologics in joint preservation surgeries was being explored. With the conglomeration of “some” like-minded friends and a divine blessing, the Indian Association of Orthopaedic Rheumatology was formed in 2009 to forge a new era of early intervention, joint preservation, and holistic care in rheumatological conditions.

There were Orthobiologics by then - most of them in the labs. There were questions on who will, how-to, and when to use them in the timeline of rheumatic diseases. And most of the Orthopaedic programs in India lacked formal rheumatological training for Orthopaedicians. There was an accord among the Orthopaedicians that holistic care of rheumatic patients is missing. This vacuity became the scope of the Indian Orthopaedic Rheumatology Association. The founding members wanted the future Orthopods to go beyond the knife to treat the rheumatic patients as a whole and preserve the native joints. Holistic care and early intervention with joint preservation, embracing biological advancements at all levels became the goals of this association.

Rheumatologists initiate the treatment and play a vital role in the management of rheumatic patients. IORA highly rates and respects their knowledge and role in the overall management of such patients. At the same time, IORA altruistically embraces the fact that Orthopaedicians, by and large, should be held responsible for severely deranged rheumatic joints and unsightly post-rheumatic deformities. We should never merely be deformity correcting surgeons but be primarily deformity preventing clinicians.

From being a novel initiative with commendable goals, over years IORA has transformed into a national organization extending its frontiers from guidance, training, and education of young Orthopaedicians to beginning to be an authority in the field. Workshops, Continuing Medical Education, Guidelines for clinical practice, and annual national conferences are a routine now. It has been nothing but a pleasure for IORA to be a center of confluence for enthusiastic minds of different specialties – Orthopaedics, Rheumatology, Regenerative medicine, and Genetics, enabling a cross-disciplinary collaboration at the national and international level. Research has been a leading front for IORA. Step by step guidance by the IORA Research Committee, regular publication of the IJOR, the official peer-reviewed journal, partnership with various national and international universities, and associations like the Indian Stem Cell Study Group and the Orthopaedic Research Group has boosted the members of IORA to design and conduct research studies in various capacities which range from molecular level studies to clinical outcome studies.

FEIORA (Fellowship in Orthopaedic Rheumatology), the new pet project of IORA was flagged off successfully as per schedule in 2020 notwithstanding the pandemic. It is an initiation of young Orthopaedicians into the field of Orthopaedic Rheumatology opening up arenas like Orthobiologic therapies, advanced Rheumatological surgeries, Medical Ethics, and Research to young surgeons.

 With many more ambitious projects in hand, the IORA foresees a more positive future in Orthopaedic Rheumatology. We wish the good work of IORA continues to better the knowledge of Orthopaedicians in the years to come, eventually improving the care for rheumatic patients.

Long live IORA.

Conflict of Interest



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