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O rthopaedic surgery is arguably the most successful specialty in the 20th century in terms of the amount of suffering it has relieved. The claim becomes even more legitimate if we focus on the second half of the 20th century. Total joint replacement, more-modern approaches to skeletal trauma (particularly intramedullary nailing of longbone fractures), and arthroscopic surgery all transformed not just their respective sub-subspecialties, but the lives of hundreds of millions of patients with common and disabling problems. It seems, though, that the last 30 years have been less transformative. Companies introduced ‘‘me-too’’ implants that showed only substantial equivalence to less-expensive devices, rather than superiority [8]. Surgeons deployed procedures before reasonable standards of efficacy were met [2, 9]. Physicians injected millions of patients with products that demonstrated little benefit in rigorous trials [3, 6]. All of these interventions exposed patients to risks and increased costs to healthcare systems. The fact that we need concepts like the minimum clinically important difference and the minimum detectable change to characterize our treatment outcomes are poignant signs of how little we sometimes require of novel interventions, which expose patients to risk and healthcare systems to cost. The intellectually rigorous orthopaedic surgeon must remain agnostic on the subject of computer-assisted surgery, based on the data we now have. Numerous short-term followup studies suggest navigation can improve surgical accuracy [7, 10], though not all do [5]. Improved alignment in knee arthroplasty might improve implant longevity; improved alignment in hip arthroplasty might reduce the likelihood of dislocation. Both are laudable goals, but they are as-yet unproven [1, 4] despite widespread usage and considerable expense. Prior to this month’s issue of Clinical Orthopaedics and Note from the Editor-In-Chief: In ‘‘Editor’s Spotlight,’’ one of our editors provides brief commentary on a paper we believe is especially important and worthy of general interest. Following the explanation of our choice, we present ‘‘Take Five,’’ in which the editor goes behind the discovery with a oneon-one interview with an author of the article featured in ‘‘Editor’s Spotlight.’’ The author certifies that he, or any members of his immediate family, has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. This comment refers to the article available at: DOI: 10.1007/s11999-016-4863-7. S. S. Leopold MD (&) Clinical Orthopaedics and Related Research1, 1600 Spruce Street, Philadelphia, PA 19013, USA e-mail: sleopold@clinorthop.org Editor’s Spotlight/Take 5 Published online: 9 June 2016 The Association of Bone and Joint Surgeons1 2016

Editor's Spotlight/Take 5: No Benefit After THA Performed With Computer-assisted Cup Placement: 10-year Results of a Randomized Controlled Study