President of the Royal College of Orthopaedic Surgeons of Thailand discusses orthopaedic practice in his country

Among the international association presidents who attended the AAOS 2025 Annual Meeting in San Diego was Keerati Chareancholvanich, MD, president of the Royal College of Orthopaedic Surgeons of Thailand. He was joined in that allegedly sunny city by about 30 Thai orthopaedic colleagues, a fairly typical number of specialists from Thailand who attend the Annual Meeting.

“We support our members to attend [the AAOS Annual Meeting] every year,” Dr. Chareancholvanich said. The almost continuous rain during the week of the meeting, unusual for San Diego, reminded those from Thailand of their home country, where such deluges are common.

There are approximately 3,200 members of the Royal College. “Next year, 2026, we will celebrate our 60-year anniversary of the Royal College,” he shared.

International knowledge exchange
Beyond attending the AAOS Annual Meeting, there is an ongoing educational exchange between Thai and American orthopaedic surgeons. Many Thai surgeons come to the United States for advanced training after becoming fully qualified in their specialty.

Dr. Chareancholvanich noted that surgeons from Thailand are particularly interested in spending time with American surgeons knowledgeable in hip and knee reconstructive surgery, pediatric orthopaedics, orthopaedic oncology, and trauma management. Dr. Chareancholvanich himself has spent time in Minneapolis learning from Ramon Gustilo, MD, creator of the widely used Gustilo-Anderson Open Fracture Classification System.

The orthopaedic landscape in Thailand
When queried about distinctive orthopaedic problems in Thailand, Dr. Chareancholvanich mentioned the rapidly increasing number of fragility fractures among the elderly, particularly fractures around the hip. Advances in public health in Thailand have led to people living longer, which has led to an unprecedented number of fragility fractures. “I think this is a situation every country confronts, because we have a lot of aging people around the world,” he acknowledged.

Furthermore, rural healthcare remains somewhat limited in Thailand. Because of this, individuals with orthopaedic pathology in rural areas often arrive for treatment at major medical centers with advanced conditions.

However, patients treated in Thailand’s modern medical centers receive advanced orthopaedic care. For example, with respect to intertrochanteric fracture, Thai surgeons prefer cephalomedullary nails rather than lateral plates and hip screws.

He noted that the general feeling is that cephalomedullary nails allow for “much earlier ambulation and much stronger biomechanical design.” For intracapsular fractures, Thai surgeons prefer Morse taper bipolar implants.

As for total joint replacement, Dr. Chareancholvanich estimated that 70% to 80% of Thai orthopaedic surgeons continue to use the posterior approach, as “most of them get training on the posterior approach from their mentors.”

However, he noted that the anterior approach is gaining momentum with younger surgeons, and that even patients have expressed interest in this technique. Robotic surgery is slowly being adapted in Thailand, with one center utilizing this technology in Bangkok.

Dr. Chareancholvanich closed by expressing hope that the Royal College can find ways to collaborate with AAOS in the future, so he and his colleagues can have the opportunity to further share orthopaedic advances from their country.

Stuart A. Green, MD, FAAOS, is cofounder and past president of the Limb Lengthening and Reconstruction Society, past president of the Association of Bone and Joint Surgeons, and an attending surgeon at the Tibor Rubin Long Beach VA Medical Center in California. He is the son, first cousin, and father of AAOS Fellows. Dr. Green is a member of the AAOS Now Editorial Board.