The hosts reflect on 2023’s most influential orthopaedic research, highlighting a surge of high-impact non-inferiority trials that challenge long-held assumptions—from nonoperative proximal humerus fracture care to alternative cervical and ankle procedures. They emphasize growing attention to perioperative optimization, including nutrition, thromboprophylaxis, and antibiotic stewardship, as well as emerging diagnostic shifts like ultrasound for pediatric forearm injuries. Global health evidence and microbiome science are seen as reshaping core concepts, while predictions for 2024 center on rapidly advancing AI and a rising focus on rehabilitation-driven outcomes.