Reflections from a Lifetime in Orthopaedic Sports Medicine and Surgery

Per A. Renström, MD, PhD, SWEDEN

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2025 Congress - Freddie Fu Lifetime Achievement Award Honorary Lecture

Remembering Freddie Fu: A True Giant

Freddie Fu was a towering figure in orthopaedic sports medicine—a true visionary whose contributions spanned disciplines, countries, and generations. When he moved to Pittsburgh in 1978, he began building what would become one of the world’s most respected orthopaedic programs. Our paths crossed in 1984 when I became his first invited professor, which marked the beginning of a lifelong friendship. Freddie was not only an academic and surgical innovator, but a man deeply committed to people. In one of our last exchanges, I wrote to him calling him a “super GIANT,” to which he responded the same day, closing with, “I love you, Lena, and your email... I am privileged to know all of you before I wander into a brave new world.” Even in the face of his own mortality, he remained generous, loving, and connected. He inspired us all to strive for excellence with humility.

Freddie Fu and Per Renstrom

Early Influences: Education, Sports, and Value

I was fortunate to grow up in a family that deeply valued both intellectual pursuits and compassion. My mother was a brilliant, dynamic politician, while my father, a gentle and committed general practitioner, was often referred to as the “Albert Schweitzer of our town.” He instilled in us a reverence for knowledge and personal integrity. He often said, “Whatever happens in life, no one can take your education away from you.” My love for sports, especially football, shaped my youth. I played at every opportunity—during school breaks, in the evenings with friends, and on club teams. These early experiences taught me about movement, resilience, and collaboration, all of which later became foundational in my medical practice.

A pivotal moment came when I received a scholarship to Ohio State University in 1961–62. Not only did I get to play ice hockey at the collegiate level, but I also gave my first university lecture—on javelin throwing—to a class taught by US Olympic and Jesse Owens coach Larry Snyder. That experience gave me five years' worth of maturity and growth in one.

From Gothenburg to Global Science: The Evolution of a Career

My years at the University of Gothenburg were shaped by two mentors who profoundly influenced my trajectory: Professor Bengt Saltin, an international leader in exercise physiology, and Dr. Lars Peterson, a skilled orthopaedic surgeon. Bengt taught me to approach science with curiosity and discipline, while Lars demonstrated how clinical skill could be matched with academic excellence. Together, Lars and I co-authored Sports Injuries, first published in 1977. Now its fifth edition 47 years later (2024), this book has been translated into 14 languages and continues to serve as a trusted reference in the field.. These formative collaborations helped to define a career that sought to unite research, teaching, and clinical excellence into a cohesive whole. They opened the world for us.

Research Integrity and the Vermont and Stockholm Years

In 1983, I joined the University of Vermont, where I worked closely with Professor Robert J. Johnson, my third great mentor. Bob was a beacon of integrity and precision in science. Our research group —which also included Bruce Beynnon, Braden Fleming, Claude Nichols, and myself—became known for our rigorous standards and impactful studies. We were honored with numerous prestigious awards, including the Phi Kappa Delta Award (the most prestigious award in Orthopaedics) from AAOS/ORS, the O’Donoghue Award from AOSSM (twice), and the Albert Trillat Award from ISK and ISAKOS (twice). These were years of both scientific excitement and surgical challenges and refinement.

When I returned to Stockholm in 1997 and took leadership at Karolinska Institutet, I brought with me this culture of intellectual honesty and collaboration. Between 1997 and 2007, 17 doctoral students completed their PhDs under my guidance. We took the research from Vermont further into the surgical theatre. We hosted research retreats twice a year with global colleagues—spaces of deep learning, debate, and friendship as well as yoga. The colleagues in my group have become lifelong companions on the scientific, educational, and social journey

Research in the operating theatre.

Academic/University Activities Outside the Home University

True academic engagement transcends institutional boundaries. For two decades, I served as an external examiner for the MSc in Sports Medicine program at Trinity College, University of Dublin, Ireland, evaluating 35 theses from a diverse group of international students. As an expression of appreciation, in 2008, I was awarded an Honorary Fellowship by the Faculty of Sports and Exercise Medicine at both the Royal College of Physicians of Ireland and the Royal College of Surgeons in Ireland.

I also served as a peer reviewer for major scientific journals starting in the early 1980s. This work, while often time-consuming, has kept me intellectually sharp and in touch with global developments in the field. Evaluating the work of others not only strengthens scientific discourse but also builds bridges across borders—something that I have found deeply rewarding. I believe that all leading scientists should take part in the peer-review process, which is essential for preserving good quality.

Activities as Emeritus and During the Covid Isolation

Even after stepping back from official roles, I have remained active in both academia and authorship, I was appointed by the government to lead the Center for Swedish Sports Science, a position that I held for nine years. I have served on the board of the Karolinska Center for Sports Research for >15 years. The Covid pandemic, though isolating, offered time for reflection and writing. I completed an updated 700-page edition of Sports Injuries and authored two large personal works: a photographic family history and a memoir about my life as a sports medicine surgeon, the latter of which is now being translated into English. These projects reinforced my belief that intellectual and physical activity are key to maintaining vitality also as age rich.

Major Sports Medicine Activities–Being Part of Sports Teams and Boards

Early on, I was involved with CESU (Commission pour l´etude du Sport Universitaire) and the International University Sports Federation (FISU), serving as team doctor for six World University Games. I also served as physician for football/soccer teams, including GAIS in Gothenburg, the Swedish and US national football squads and the University of Vermont soccer team. In tennis, I chaired the Pixbo Tennis Club, chaired the Swedish Tennis Medical Commission, and served for nearly ten years as doctor for the Swedish Davis Cup team, including during their 1998 victory. Since 1998, I have been part of the ATP and ITF medical commissions and founded the Society for Tennis Medicine and Science (STMS) 1991.

These experiences taught me the unique dynamics of sports teams—the importance of trust, communication, and understanding each sport’s biomechanics. The locker room is its own world with a special language and navigating it has been very helpful in my clinical work.

Davis cup.

Olympic Games and Activities

As a boy, I was captivated by the 1960 Rome Olympics, particularly Wilma Rudolph, whose triumph despite childhood polio inspired me deeply. I had a dream to be an integral part of the Olympics someday. In 1988, I was elected to the IOC Medical Commission, first as a member of the Publication Advisory Commission and then as a member of the Games group. For many years, I led the Polyclinic activities for the IOC. The Polyclinic is the small hospital in the Olympic village, serving >25,000 athletes and leaders. The clinics handled everything from injuries and diseases to dental care, with surprising demand for optometry and physiotherapy. I also contributed to the development of Olympic medical research, culminating in scientific publications on injury and illness rates among athletes after each Olympic Games. For example, during the Beijing games in 2008, we treated 1,055 injuries (9.6%) in 9,672 athletes from 92 countries. Condoms have been distributed for free in the village since the Games in 1988; in Beijing in 2008, 400,000 condoms were distributed. Humorous moments—such as complaints about condom sizes by the Africans in the Olympic Village—humanized the enormity of the task. At the Paris Olympic Games in 2024, two condoms per person per day were distributed, enough for two hot moments per person per day. The mayor of Paris announced, “Being together here in the city of love should be something special.”

Participating in 11 Olympic Games, contributing to the setup and management of the Polyclinics, and receiving the Olympic Order in Gold from President Jacques Rogge in 2013 for 25 years of work for the Olympic movement were some of the most humbling honors of my career. I had a dream, and I managed to make it come true. Being an integral part of the Olympic movement is an unbelievable experience.

Sports Medicine Has Two Major Arms: FIMS and then IAA, ISK, and ISAKOS

The landscape of sports medicine has evolved with two major trajectories. FIMS, founded in 1928, has focused on general medicine, physiology, performance, and physical activity, providing an important platform for multidisciplinary exchange. I was elected to the FIMS Executive Committee in 1986 and then served as Vice President of FIMS between 1990 and 1998, gaining insights into global health promotion through sports. In parallel, IAA and ISK, and later ISAKOS (formed from the merger of IAA and ISK), was gradually becoming the leading authority on arthroscopy, knee surgery, and rehabilitation. Together, these organizations have helped to structure the modern pillars of our profession, combining deep clinical insight with preventive strategies and global collaboration.

Valuable Sports-Related Scientific Organisations

Organizations like the American College of Sports Medicine (ACSM), Orthopaedic Research Society (ORS), and International Society of Ligaments and Tendons (ISLT) has played critical roles in advancing our field. These institutions represent the intersection of basic science and clinical application. I've long advocated for greater inclusion of basic sciences—particularly in biology and biomechanics—in ISAKOS congresses. This integration strengthens evidence-based approaches in clinical practice and ensures that innovation is rooted in sound science.

Building up the International Orthopedic Sports Medicine Field

The modern field of orthopaedic sports medicine owes much to the development of arthroscopy. Masaki Watanabe performed the first partial meniscectomy in 1962, and Robert Jackson later introduced the arthroscope to North America. The 1970s and 1980s saw an explosion of interest and specialization. Societies such as the ACL Study Group, Herodicus Society, AANA, and Warthog Society have provided forums for open, intense discussion that has pushed surgical excellence and related science forward. These gatherings have shaped techniques and fostered lifelong mentorships.

First arthroscopic meniscectomy, 1962 (ISAKOS archives).

Defining Moments: Foundation of IAA (1974), ISK (1977), and ISAKOS (1995)

The formation of IAA and ISK marked the global consolidation of orthopaedic sports medicine and surgery. IAA was founded in 1974 by pioneers such as R. Jackson and Masaki Watanabe, and ISK followed in 1977, initiated by legends such as Don O’Donoghue, Albert Trillat and Jack Hughston. From combined congresses in Salzburg to Rome and Sydney, discussions matured into a historic merger in 1995 in Hong Kong, where ISAKOS was born. With strong leadership from figures such as Ken De Haven (the architect), Peter Fowler (the driving force), Gary Poehling, and Michele Johnson, ISAKOS has grown into a 4,000-member society representing >100 countries. The present Executive Director, Sue Reimbold, runs a very efficient office.

Today, ISAKOS is the undisputed world-leading organization in arthroscopy, knee surgery, and sports medicine. This is greatly due to a very strong worldwide leadership. ISAKOS honorary members complete this strong group of leaders.

The Presidents of IAA, ISK, and ISAKOS through 2009. From left: Fu, Aglietti, Marti, Bergfeld, Tooth, Tiejtiens, DeHaven, Jakob, Dandy, Poehling, Perugia, Fowler, Renström.

ISAKOS Regional Societies Have Grown Very Strong

(Asia-Pacific), and SLARD (South America) have emerged as powerful collaborators. Their great congresses, very successful journals, and recognition programs have helped to foster excellence. A personal highlight was my induction into the AOSSM Hall of Fame—an acknowledgment that connects my efforts with a global peer group. Besides many Americans, there are only 14 international inductees in AOSSM Hall of Fame. The network that these societies offer enables younger professionals to contribute meaningfully and to be mentored across borders.

Some Keys to Success for the Young Colleagues in Our Field

cultivate reliability and honesty; to me, strong integrity is the finest of qualities! Build meaningful relationships with family, colleagues, and patients; be generous in mentorship; and remain intellectually and physically active. Form interdisciplinary teams grounded in trust. Speak the language of sport when working in locker rooms and clinics alike. Take the time to educate patients about their care. Prepare thoroughly for surgery and be meticulous. Respect anatomy and function. Stay curious, participate in international congresses, and be globally engaged. The profession rewards those who commit to both scientific rigor and human empathy.

Remember, Family Support is Fundamental!

Behind every sustained career lies the support of loved ones. My wife Lena, with whom I’ve shared life for 58 years, has been my rock. Her unwavering belief, emotional insight, and patience have allowed me to pursue a demanding path. This award is also a tribute to our late son Torsten, who passed away unexpectedly this year at the age of 47. He brought endless joy and love to our family and friends. Remembering him, and sharing this honor with Lena, brings both comfort and pride to this moment.

Final Reflection

Receiving this Lifetime Achievement Award from ISAKOS, a global organization that represents the highest ideals in our field, is a humbling privilege. It affirms a life spent in learning, teaching, healing, and leading. I am grateful beyond words to be part of this international family. As Steve Jobs said, “The only way to do a grand job is to love what you do.” I can honestly say that have gone to work nearly every day with a smile. Enjoy your journey. Make it count.