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Orthopedist Has Propensity for Both the Old and the New


In the last 15 years, Robert Booth, Jr., MD, has performed more total knee arthroplasty surgeries than any other physician in the United States. Though he's performed more than 25,000 knee procedures in his career, he says he never gets bored of the challenge.

Robert Booth

Here’s one for the record books. In the last 15 years, Robert Booth, Jr., MD, orthopaedic surgeon and medical director at the Aria 3B Orthopaedic Institute, has performed more total knee arthroplasty surgeries than any other physician in the United States.

Okay, it’s not like leading Major League Baseball in home runs over a 10-year span, but the accomplishment, and what’s behind it, are impressive. And Booth is quick to point out the significance.

“I’m pleased that I was able to touch that many lives,” he says. “People have a moderate amount of choice as to who will care for them. The fact that so many people allowed me to operate on them would suggest I was probably doing a good job, which is very gratifying.”

Humble and successful—a nice combination.

Three Important Sentences

Booth’s father was a radiologist, the first physician in the family, and he often took his son with him to work.

“I always liked the intellectual side of medicine,” Booth says. “And once I got to see the clinical side, I was pretty well hooked.”

However, he also fell in love with English literature, and at one point was a graduate student at Oxford University studying poetry. That’s when his father, convinced that Booth would not be able to support himself as an English professor, intervened.

“He sent me a letter while I was at Oxford that had 3 lines,” Booth recalls. “It read, ‘The money is cut off. It’s time you learned a trade. I recommend medicine.’”

Short and sweet, but to the point. Booth got the message, but decided to forge his own path rather than join his father in radiology. It was a time before cat scans and MRIs. It was just taking pictures, Booth says. Not being able to make use of his hands—a skill he was taught by his grandfather.

“I love fixing things,” he explains. “I like the mechanics, and the positivity of something assembled and fixed. It fits my personality. And next to delivering babies, orthopedics appeared to be one of the more positive and cheerful things doctors could do.”

That was 30 years ago, a time period Booth refers to as the beginning of the revolution, when modern joint replacement came into its own.

“It changed people’s lives,” he says. “And I’ve been very fortunate to be part of that; to have been there from the beginning.”

New Experiences

Booth says he is often asked whether he gets bored doing the same procedure over and over again. To the contrary, he says that because he has been able to experience as many knee surgeries as he has—almost 25,000 over his career, by his own count—he has been able to see differences and opportunities better than someone who engages in a much smaller number of surgeries.

“That’s been a big help for me,” he says. “And it’s helping industry, the universities, and the teaching programs create better knees.”

As evidence, Booth says that his achievement of having performed the most TKA surgeries in the US over the last 15 years has paid great dividends. It means he has been able to perform surgeries quickly, which is part of minimizing complications. And the sheer volume of surgeries means that he has noticed patterns that have helped him develop ideas for creating better knees.

“For years we’ve run a course here where people come to learn to do surgery more rapidly, more effectively, and with fewer complications,” Booth says. “Harvard Business School choose us as a case study, and sent a team down to study how we could do so many more surgeries, and with better results, and fewer complications.”

And Booth says he loves fixing knees.

“That’s really my passion, to help design and create better knees.

Love for Americana

Outside of his practice, Booth has become an avid antique collector with a particular love and focus on Americana pieces. But that appreciation, he says, dates back to his maternal grandparents who ran a dairy in Roxborough. Every 5 or 6 years they would save up some money and venture down to Pine Street, what Booth refers to as the heart of Americana, in Philadelphia, at least, and purchase a piece of furniture.

“She had this living room—Chippendale chairs and such—and it was a sacred place,” Booth recalls. “As a boy, I put my hands in my pockets when I went in there so that I wouldn’t touch anything. It wasn’t exactly a livable place, but it was a nice collection they put together.”

Booth married when he was a medical resident. His wife was a school teacher. Together, he says, they had little money to purchase furniture for their home, so he made some. However, they gradually deteriorated.

“I’m not quite the carpenter with furniture that I am with knees,” he admits.

His wife convinced him to consider furniture made by the Shakers, a religious sect that branched off from the Quaker community. The Shakers had a strong underlying concept that you do every job as well as you can no matter how small or menial a task it may be. That included making furniture. Booth and his wife purchased several tables and chairs, began reading and learning about all the different types of Shaker materials, and started their collection. They have since done several exhibits for the Philadelphia Antiques Show.

It’s an addiction, Booth confesses, but a healthy one.

Eye on Design

As for the literary interests he had in college, Booth says he quenches those desires by reading 4 newspapers each day, about 20 magazines a week, and roughly one book a week.

“I was writing for a while, but I haven’t for some years now,” he says. “I used to write some rather desultory poetry, but it’s very hard to get things published.”

What isn’t hard is the work he continues to do designing knees. Booth recently finished designing his sixth knee and is currently working on his seventh.

“We have 43 different tops and 11 different bottoms,” he says. “There are Asian knees now to accommodate the fact that their anatomy is a little different. And the gender knee, because women’s knees are distinctly different than men’s knees. Not forcing everybody down one common pathway to whatever our design was, that has been enormously gratifying.”

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