We all know that surgical success depends on precision, skill, and planning—but what about the quality of the bone itself? For too long, the role of bone health in surgical outcomes has been under appreciated. Yet, poor bone quality can lead to hardware failure, delayed healing, and avoidable complications—especially in spine and orthopedic surgeries. The good news? We can do something about it before the first incision is made.

Our guest today is someone who’s been leading that charge. Dr. Paul Anderson is a Professor of Orthopedic Surgery at the University of Wisconsin School of Medicine and Public Health, and a globally recognized expert in spinal surgery and musculoskeletal care. He’s also one of the early champions of integrating bone health assessments into surgical planning—helping develop dedicated Bone Health Optimization (BHO) clinics that are reshaping the standard of care for surgical patients.

In today’s conversation, we’ll explore how to identify at-risk patients, what pre-surgical interventions can make a difference, and why surgeons and healthcare teams need to optimize before heading to the OR.