Seth S. Leopold, M.D.
Editor-in-Chief, Clinical Orthopaedics and Related Research
My approach to treating patients
In 2021, after 20 years of operating on patients who have hip and knee problems, I stopped doing surgery. Most of my time now is spent as the editor-in-chief of a large international scientific journal (Clinical Orthopaedics and Related Research). My enthusiasm for working with patients whose lives are affected by joint pain remains as great as ever, though going forward, I’ll do it without a scalpel.
This process focuses the emphasis where it needs to go: On the whole person, rather than on the painful or stiff joint. The consults I now offer focus on helping patients make complicated decisions in ways that put their values and interests front-and-center. Since I will not myself perform the operation if surgery turns out to be the patient’s choice, I believe patients can trust the advice I give. As someone who has practiced in Seattle for about 20 years, I also can help patients find the best surgeon for the job, should a patient want my thoughts on that matter. The most-common questions I try to help patients answer include things like:
- Is joint replacement right for me?
- How do the risks balance out against the rewards of joint replacement surgery?
- Have I overlooked potentially useful nonsurgical approaches or ways to adapt to my condition that can help me avoid the risk and time off associated with surgery?
- My joint replacement has not worked out as well as I’d hoped (it’s painful, it’s stiff, it dislocates or feels unstable, it’s infected, etc.); should I have another operation on it to try to make it better?
As the editor-in-chief of a leading international journal, I am up to date on the best-available evidence, which I’ll use to try to help patients arrive at choices that are consistent with their values.
I’ve spent a career helping patients with my hands. I’m enjoying spending time now helping patients with my head and my heart.
If you have questions about your arthritic hip or knee, or if you have a joint replacement that is bothering you and would like a second opinion about whether surgery would likely improve on what you’ve got, I’m happy to try to help.
There is no cookbook approach; while my role is important, it is primarily supportive. My goal, with every patient, is to strike the balance of education, empathy, and partnership that will best serve each individual whose life I am privileged to touch. A few articles about how I try to achieve this are mentioned in links below.
It’s my honor to walk alongside patients and help them make decisions in ways that bring them peace. My goal is to listen actively, and share what I know about contemporary treatments, including alternatives to surgery, ways to adapt to painful conditions, and surgical options when appropriate. As the editor-in-chief of a large, international surgical journal, I’ve had the opportunity to share my thoughts about what surgeons do; some of those touch on my patient-care philosophies. A few examples are listed below; although these were intended primarily for an audience of surgeons, I believe some patients may enjoy reading them, as well:
- Editorial: What Do You Say When a Patient Says Thank You?
- Editorial: Words Hurt – Avoiding Dehumanizing Language in Orthopaedic Research and Practice
- Editorial: How the Words We Use Affect the Care We Deliver
- Editorial: The Sacredness of Surgery
- Editorial: What Makes Young Surgeons Tick (or Cut)?
- Editorial: Are We All Better-than-Average Drivers, and Better-than-Average Kissers? Outwitting the Kruger–Dunning Effect in Clinical Practice and Research
- Editorial: What is Narrative Medicine, and Why Should We Use it in Orthopaedic Practice?
Dr. Leopold's clinical interests include less invasive surgical treatments for arthritis, non-surgical treatments for arthritis, and management of failed joint replacements.
Dr. Leopold is an avid sea kayaker, an aerobatic pilot, an ex-boxer, and a terrible jazz piano player. He enjoys reading good fiction. He has two college-age daughters; he married his high-school sweetheart and feels lucky that she still puts up with him some 30 years later.
Make an Appointment
As mentioned, Dr. Leopold no longer operates, but rather consults with patients about whether surgery is right for them. Patients considering (or who have been recommended to have) any of the following procedures to discuss those options—and others—with him in an office visit.
- Minimally invasive (quadriceps-sparing) total knee replacement
- Total knee replacement
- Minimally-invasive partial knee replacement (unicompartmental)
- Knee osteotomy
- Total hip replacement
- Mini-incision total hip replacement
- Hemiresurfacing arthroplasty of the hip (partial hip replacement)
- Hemiarthroplasty for hip fracture
- Open reduction internal fixation (repair) of hip fractures
- Knee arthroscopy
- Osteoarthritis (hip/knee)
- Rheumatoid arthritis (hip/knee
- Avascular necrosis (osteonecrosis of the femoral head)
- Developmental dysplasia of the hip
- Metastatic disease to the hip/pelvis/knee
- Hip fracture
- Meniscus tears in the knee
- Squyer, E.; Stamper, D.L.; Hamilton, D.T.; Sabin, J.A.; Leopold, S.S.: Unloader Braces for Osteoarthritis: Do Patients Actually Wear Them? Clin Orthop 471: 1982-1991, 2013.
- Zeltser, D.W.; Leopold, S.S.: Classifications in Brief: Schatzker classification of tibial plateau fractures. Clin Orthop 471: 371-374, 2013.
- Amman S, Cizik A, Leopold SS, Manner PA. Two-Incision Minimally Invasive vs. Standard Total Hip Arthroplasty: Comparison of Component Position and Hospital Costs. J Arthroplasty 27: 1569-1574, 2012.
- Lohse, G.R.; Leopold, S.S.; Theiler S.; Sayre C.; Cizik, A.; Lee, M.J.: Systems-based safety intervention: Reducing falls with injury and total falls on an orthopaedic ward. J Bone Joint Surg Am 94:1217-1222, 2012.
- Carofino, B.C.; Leopold, S.S.: Classifications in Brief – The Neer classification for proximal humerus fractures. Clin Orthop 471: 39-43, 2013.
- Kim, P.K.; Leopold, S.S.: Classifications in Brief: The Gustilo-Anderson classification for open fractures. Clin Orthop 470: 3270-3274, 2012.
- Hacquebord, J.; Leopold, S.S.: Classifications in Brief: The Risser Classification — A classic tool for the clinician treating adolescent idiopathic scoliosis. Clin Orthop470: 2335-2338, 2012.
- Iannuzzi, N.P.; Leopold, S.S.: Classifications in Brief: The Mason classification for radial head fractures. Clin Orthop 470: 1799-1802, 2012.
- King JC, Manner PA, Stamper DL, Schaad DC, Leopold SS.:Is Minimally Invasive Total Knee Arthroplasty Associated with Lower Costs Than Traditional TKA?. Clin Orthop Relat Res. 2010 Dec 16. [Epub ahead of print]
- Wolf, C.F.; Gu, N.Y.; Doctor, J.; Manner, P.A.; Leopold, S.S.: Comparison of direct-exchange vs. two-stage revision for the infected THA: A Markov expected-value decision analysis. In press. J Bone Joint Surg Am, 2010.
- King, J.C.; Manner, P.A.; Stamper, D.L.; Schaad, D.C.; Leopold, S.S.: Economic analysis of minimally invasive versus traditional total knee arthroplasty. In press. Clin Orthop, 2010.
- Emerson, W.; Brand, R.A.; Heckman, J.D.; Warme, W.J.; Wolf, F.M.; Leopold, S.S.:Testing for the presence of positive-outcome bias in peer review: A randomized controlled trial. Arch Intern Med, 170 (21): 1934-1939, 2010
- Leopold, S.S.: Minimally invasive total knee arthroplasty for osteoarthtitis. N Engl J Med 360:17;1749-1758, 2009.
- Gu, N.; Doctor, J.; Wolf, C.; Manner, P.A.; Leopold, S.S.: A comparison of physician and patient time tradeoffs for postoperative hip outcomes. Value Health 12(4): 618-20, 2009.
- King, J.; Stamper, D.L.; Schaad, D.C; Leopold, S.S.:Minimally-invasive total knee arthroplasty versus medial parapatellar total knee arthroplasty: New approach appears to facilitate recovery, but learning curve is lengthy. J Bone Joint Surg Am, 89:1794-1503, 2007.
- Lynch, J.R.; Cunningham, M.R.A.; Warme, W.J.; Wolf, F.M.; Schaad, D.C.; Leopold, S.S.:Commercially-funded and United States-based research is more likely to be published; good-quality studies with negative outcomes are not. J Bone Joint Surg Am, 89-A (5); 1010–18, 2007.
- Lee, M.B.; Schmale, G.A.; Porter, M.; Leopold, S.S.: Osteoporosis and total hip arthroplasty—An update. Current Med Lit Rheumatol, 26(1): 1–10, 2007.
- Cunningham, M.R.A.; Warme, W.J.; Wolf, F.M.; Leopold, S.S.:Industry-funded positive studies not associated with better design or larger size. Clin Orthop, 457; 235–41, 2007.
- Lenters, T.R.; Wolf, F.M.; Leopold, S.S.; Matsen III, F.M.; Franta, A.K.:Arthroscopic compared with open repairs for recurrent anterior shoulder instability: A systematic review and meta-analysis of the literature. J Bone Joint Surg Am, 89-A: 244–54, 2007.
- Lynch, J.R.; Schmale, G.A.; Schaad, D.C.; Leopold, S.S.:Important demographic variables impact the musculoskeletal knowledge and confidence of academic primary care physicians. J Bone Joint Surg-Am, 88-A (7): 1589–95, 2006.
- Morgan, H.D.; Cizik, A.M.; Leopold, S.S.; Hawkins, D.S.; Conrad, E.U.:Survival of tumor megaprostheses replacements about the knee. Clin Orthop Relat Res, 450: 39–45, 2006.
- Nystuen, C.M.; Leopold, S.S.; Warme, W.J.; Simmons, G.E.:Cancellous impaction and cortical strut allografting for revision shoulder arthroplasty - A case report. J Shoulder Elbow Surg, 15: 244–248, 2006.
- Leopold, S.S.: Web Commentary—"Sodium hyaluronate in the treatment of osteoarthritis of the ankle: A controlled, randomized, double-blind pilot study." J Bone Joint Surgery (Electronic), 2006.
- Morgan, H.D.; Battista, V.; Leopold, S.S.:Constraint in Primary Total Knee Arthroplasty: How much is enough?J Am Acad Orthop Surg 13: 515–24, 2005.
- Cuddihy, E.; Wei, C.; Bartell, A.L.; Barrick, J.; Maust, B.; Leopold, S.S.; Spyridakis, J.H.: Conducting remote, Internet-based experiments on web design. IEEE International Professional Communication Conference Proceedings: 554–561, 2005.
- Leopold, S.S.: Web Commentary—“Early osteolysis in second-generation metal on metal hip replacement,” and “Diagnostic features of pelvic osteolysis on computed tomography: The importance of communication pathways.” J Bone Joint Surgery (Electronic), 2005.
- Leopold, S.S.; Morgan, H.D.; Kadel, N.J; Gardner, G.C.; Schaad, D.C.; Wolf, F.M.:The impact of educational intervention on provider confidence and competence in performing a simple surgical task. J Bone Joint Surg 87-A: 1031–1037, 2005.
- Morgan, H.D.; Leopold, S.S.:5 Points on impaction allografting of the femur in revision total hip surgery. Am J. Orthop 33: 381–383, 2004.
- Panackal, A.A.; Houze, Y.B.; Prentice, J.; Leopold, S.S.; Cookson, B.T.; Liles, W.C.; Limaye, A.P.:Prosthetic joint infection due to Helcococcus pyogenica. J Clin Micro: 42(6): 2872–2874, 2004.
- Morgan, H.D.; McCallister, W.; Cho, M.S.; Casnellie, M.T.; Leopold, S.S.:Impaction allografting for femoral component revision—Clinical update. Clin Orthop 420: 160–168, 2004.
- Leopold, S.S.; Casnellie, M.T.; Warme, W.J.; Dougherty, P.J.; Wingo, S.T.; Shott, S.:Endogenous cortisol production in response to knee arthroscopy and total knee arthroplasty. J Bone Joint Surg 85-A: 2163–2167, 2003.
- Leopold, S.S.; Warme, W.J.; Braunlich, E.F.; Shott, S.:Association between funding source and study outcome in orthopaedic research. Clin Orthop 415: 293–301, 2003.
- Leopold, S.S.; Redd, B.B.; Warme, W.J.; Wehrle, P.A.; Pettis, P.D.; Shott, S.:Corticosteroid versus Synvisc (Hylan GF-20) injections for knee osteoarthritis: A prospective, randomized trial. J Bone Joint Surg 85-A: 1197–1203, 2003.
Comment in: J Bone Joint Surg 86-A: 874; author reply 874; J Bone joint Surg 86-A: 874; author reply 874–875.
- Leopold, S.S.; Silverton, C.D.; Barden, R.M.; Rosenberg, A.G.:Isolated patellar component revision in total knee arthroplasty. J Bone Joint Surg 85-A: 41–47, 2002.
- Leopold, S.S.; Warme, W.J.; Pettis, P.D.; Shott, S.:Increased frequency of acute local reaction to intra-articular hylan G-F 20 (Synvisc) in patients receiving more than one course of treatment. J Bone Joint Surg 84-A: 1619–1623: 2002.
Comment in: J Bone Joint Surg 85-A: 1618–1619; author reply 1619–1620; J Bone Joint Surg 85-A: 1620; author reply 1620–1621; J Bone Joint Surg 85-A: 2050; author reply 2050–2051.
- "Top Reviewer" status, Clinical Orthopaedics and Related Research, 2012. One of 15 reviewers listed by the journal from their database of thousands of reviewers.
- Association of Bone and Joint Surgeons, Best Paper 2011. Received in Dublin, Ireland; Title: Testing for the presence of positive-outcome bias in peer review: A randomized controlled trial. An Abstract can be seen here.
- Faculty Sponsor - Resident Research Award (1st Place), 2009 Washington State Orthopaedic Association Annual Meeting, Seattle WA, 2009 (Resident: Christopher F. Wolf, MD)
- Faculty Sponsor - Jacquelin Perry Resident Research Award, Ruth Jackson Orthopaedic Society, 2007. (Resident: Joseph R. Lynch, MD).
- Faculty Sponsor - Frank B. Smith Research Award Paper, North Pacific Orthopaedic Society, Stevenson, WA. 2006. (Resident: Joseph R. Lynch, MD).
- Faculty Sponsor - Frank B. Smith Resident Research Award Paper, North Pacific Orthopaedic Society, Stevenson, WA. 2005. (Resident: Joseph R. Lynch, MD).
- Faculty Sponsor - Dehne Award, William Beaumont Army Medical Center. Principal investigator on resident’s project for Orthopaedic research award, 2001. (Resident: Brigham B. Redd, MD).
- Mid-America Orthopaedic Association Research Award. First-Year in Practice Research Travel Grant, 2000.
Previously Funded Projects
1. University of Chicago, Division of the Biological Sciences, Home Health Care Grant, “Warfarin vs. Enoxaparin in total knee arthroplasty: A prospective randomized study of thrombosis, bleeding, and difficulties of outpatient anticoagulation,” Principal Investigator, $22,000. 1997-2000.
2. William Beaumont Army Medical Center, Department of Clinical Investigation, WBAMC #00/08, “Intra-articular hip injection without fluoroscopic guidance–An anatomic assessment of technique and the structures at risk,” Principal Investigator, $15,100. December 13, 1999-December 13, 2000.
3. William Beaumont Army Medical Center, Department of Clinical Investigation, WBAMC #00/22, “Intra-articular corticosteroids versus hyaluronic acid injections for non-operative management of non-inflammatory arthritis of the knee: A prospective, randomized, blinded study,” Principal Investigator, $5,700. WBAMC Pharmacy Department, additional $25,000 material support. July 7, 2000-December 31, 2002.
4. William Beaumont Army Medical Center, Department of Clinical Investigation, WBAMC #01/20, “Measurement of normal endogenous glucocorticoid production in response to major and minor surgery procedures on the knee,” Principal Investigator, $9,045. June 15, 2001-December 31, 2002.
5. Orthopaedic Research Education Foundation/Journal of Bone and Joint Surgery Resident Journal Club Grant (2003), “Evidence-Based Medicine in Orthopaedics; Interpretation and Application of the Clinical Literature” Faculty Mentor to Wren McCallister, MD. $2,500.
6. FORE (Unrestricted Educational Grant) in collaboration with JBJS, “Relationships between non-scientific factors, study outcome, and eventual publication of orthopaedic research,” Principal Investigator, $28,000 taken from larger grant. January 2004 through January 2005.
7. Orthopaedic Research Education Foundation/Zimmer Orthopaedic Surgery Career Development Award, “Minimally-invasive total knee arthroplasty versus traditional-approach TKA,” Principal Investigator, $50,000. July 1, 2003-June 30, 2008.