Leading orthopedic and spine specialists from China and the United States have issued a critical public warning: a substantial share of patients currently recommended for orthopedic surgery do not actually need invasive intervention, and overreliance on imaging alone is driving unnecessary procedures that put patients at avoidable risk.
The consensus was reached during a high-level joint forum held in Beijing on Tuesday, organized by global medical consultancy Saint Lucia Consulting, Xinhua Health, and New York’s globally ranked Hospital for Special Surgery (HSS), a leading institution for musculoskeletal care.
Todd Albert, Surgeon-in-Chief Emeritus and the Richard Rogers Chair to Advance Spine Care at HSS, shared data illustrating the scale of the issue: roughly 35 percent of patients who travel to HSS to seek a second medical opinion after being told they need surgery ultimately end up receiving effective non-surgical treatment instead.
Zhang Jianguo, chair of orthopedics at Beijing’s Peking Union Medical College Hospital, echoed this finding, noting that many patients referred to his center after a surgery recommendation from other facilities ultimately do not require any invasive procedure at all. Zhang emphasized that surgical decisions cannot be made based on imaging scans alone. “You cannot decide on surgery based solely on imaging results,” he said. “You have to look at the patient’s symptoms, physical signs, and functional limitations.”
Forum participants also highlighted the growing value of cross-border medical collaboration in reducing unnecessary procedures. Albert stressed that international cooperation is not just about encouraging patients to seek treatment abroad. Instead, the core benefit lies in streamlined preoperative assessment, secure cross-border sharing of imaging data, and collaborative expert consultations that help patients make informed choices about whether to pursue care at home or overseas. This model, Albert added, cuts down on unnecessary international referrals and wasted, costly trips for patients who do not need offshore intervention.
When it comes to complex orthopedic cases — including severe spinal deformities, age-related degenerative conditions, revision surgeries, and patients managing multiple coexisting chronic health conditions — care requires a far more comprehensive approach than just surgical skill, Zhang explained. “Complex orthopedics is not just about surgical technique anymore,” he said. “It’s a systemic project. The more complex the patient, the more you need multiple disciplines including respiratory, anesthesia, neurology and rehabilitation working together before the surgery even happens.”
To address the gap in access to high-quality expert input for uncertain orthopedic cases, Saint Lucia Consulting launched a new international orthopedic care program at the conclusion of Tuesday’s forum. The initiative is tailored specifically for patients living with complex spinal and joint conditions, and offers a full suite of services including formal international case reviews, second opinions from top global specialists, coordination for cross-border treatment when needed, rehabilitation planning support, and long-term clinical follow-up.
Cheng Xiaoyu, deputy general manager and rotating medical director of Saint Lucia Consulting, noted that the program is designed to move quickly for patients facing confusing diagnoses, conflicting medical recommendations, or poor outcomes from prior treatment. The initiative can connect patients to leading global orthopedic specialists for a formal review within 72 hours. “What complex orthopedic patients often lack, is not treatment opportunities, but the ability to make high-quality decisions at critical moments,” Cheng said.