I had the honor of traveling to Bangkok, Thailand to participate in the third annual American Academy of Orthopaedic Surgeons/Royal College of Orthopaedic Surgeons Thailand combined instructional course lecture held October 19th through 23rd of 2006. A group of eight orthopaedic surgeons from the American Academy of Orthopaedic Surgeons teamed up with their counterparts from the Royal College of Surgeons in Thailand to put on an instructional course-type meeting for 1600 surgeons from around the greater Asia area. This included surgeons from Thailand, Malaysia, Indonesia, Vietnam, the Philippines, Australia, and Singapore. The Thai hosts were very gracious and shared their experiences in orthopedics with their American counterparts. We toured several hospitals in Bangkok before proceeding to Pattaya for the conference.   

The Thai orthopaedic surgeons work long hours, spending at least 40 hours a week providing service in the government-run hospitals and then additionally have a private practice which often begins in the evening and involves evening and weekend surgery. While appointments are available, the wait times for first-time orthopaedic conditions can be quite lengthy with patients often showing up at the hospital and waiting for available time slots to open up. The level of care is quite sophisticated. Many similar techniques are used in Thailand that we use in our daily practices. 

80% of the joint replacement procedures done in Thailand are for knee arthritis. Of interest is the rarity of hip arthritis in Thailand; 20% of total hip replacements are replaced due to osteonecrosis. They have a higher incidence of osteonecrosis of the femoral head due to the over-the-counter availability of prednisone and other steroid-derived medications. These are often used in excess by patients leading to the higher incidence of osteonecrosis. The incidence of obesity is quite a bit less in Thailand then it is in the United States due in part to their diet and exercise. Overall, it was a very rewarding experience and an opportunity to share ideas and techniques from a different part of the world. 

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