Asia and Europe are rapidly expanding hubs for orthobiologics, driven by aging populations, advancing infrastructure, and growing evidence for regenerative therapies. Regulatory heterogeneity across both regions remains a major barrier, highlighting the need for international collaboration to support safe, responsible innovation.

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

➢ Argentine orthopaedics was shaped by the influence of Dr. Vittorio Putti (Rizzoli Institute, Bologna, Italy). Dr. Carlos E. Ottolenghi, one of Dr. Putti's most distinguished disciples, together with Dr. José Valls, founded the Instituto de Ortopedia y Traumatología at Hospital Italiano de Buenos Aires in 1926. Prof. Ottolenghi transformed the Orthopaedic Service into a leading academic center and pioneer of subspecialization, serving as a foundational driver of orthopaedic development in Argentina and Latin America, while establishing strong international academic connections and collaborations.➢ Major milestones include the establishment of one of the earliest institutional bone banks and the performance of one of the world's first reported massive bone allograft reconstructions (1948); the performance of the first Charnley total hip replacement in the Americas (1967) and the first total knee replacement in Argentina (1970); and the early adoption of intramedullary nailing (1972), knee arthroscopy (1976), and femoral bone impaction allografting (1987). These contributions helped to define modern orthopaedic practice across Latin America and influenced global reconstructive strategies.➢ Advances such as surgical navigation (2010) and augmented reality (2025) have strengthened its role as a regional and globally connected center of excellence, particularly in musculoskeletal oncology.➢ Over the past 25 years, 180 residents and 160 fellows have been trained in our institute, and more than 500 indexed publications have been produced in the last 10 years, with alumni holding leadership roles across major orthopaedic centers worldwide, amplifying our institute's global footprint.➢ A merit-based, highly selective system based on excellence determines who becomes a staff surgeon. Currently, 85% of the actual staff surgeons completed residency training in our department, fostering a unique sense of institutional identity and perceived belonging. This experience reinforces the concept that excellence in orthopaedics transcends geographic boundaries and can emerge as a global reference from any setting committed to innovation, mentorship, and academic rigor.

➢ Multicenter studies remain rare in orthopaedics (9.9% of recent publications) due to regulatory complexity, restrictive data-sharing policies, and administrative delays, despite their proven value in generating robust, generalizable evidence.➢ Federated computing (FC) brings analytic code to each institution's data and returns only encrypted, aggregated results. This preserves patient privacy, maintains institutional control, and streamlines compliance by reducing or eliminating the need for complex data-use agreements.➢ Extensive applications in other medical fields show that FC can match or exceed the performance of centralized analyses across diverse data types (imaging, electronic health records, genomics, and surgical video) without centralizing sensitive information.➢ For orthopaedics, FC enables scalable, privacy-preserving collaboration on rare events, low-frequency outcomes, and practice variation across subspecialties. Broad adoption could expand research scope, improve evidence quality, and accelerate translation of findings into clinical care.➢ FC enables secure, privacy-preserving multicenter collaboration in orthopaedics, overcoming long-standing barriers to data-sharing and expanding the scope of clinically impactful research.