What's up everyone, Dr. TJ here. Last weekend, during our MIS Cadaver workshop, one of my attendees asked me something that really made me think. He asked me, TJ, why is there so much fighting online about fixation versus non-fixation? Why can't surgeons get along? You know what? He's absolutely right. It's 2025 and we're still arguing like it's Yankees versus Red Sox or something. So look, if you're tired of the tribal warfare in MIS and want an honest, balanced discussion about both approaches, hit that subscribe button and like this video. Because I'm about to share something that might surprise you. Let me be transparent with you guys. For years, I was firmly in one camp. I loved my non-fixation techniques. Revered in ISHAM, Modified Wilson, Reverse Austin, etc. And I still do. They're beautiful procedures when done right. And honestly, I used to be skeptical about fixation-based MIS. Really skeptical. But here's what changed my mind. Exposure and education. The more I taught, the more I learned. The more surgeons I met from different backgrounds, the more I realized. We are all trying to achieve the same thing. Pain-free, happy patients. Here's what's interesting about this whole debate. Nonfixation for certain procedures is becoming more accepted. DMMO for metatarsalgia, most surgeons are comfortable with that. Hamlet corrections, pretty standard now. Fib metatarsal osteotomies, widely accepted. But first ray nonfixation, that's where people get nervous. And I get it, I really do. The first ray carries more load. It's more critical for function. The stakes feel higher. But here's the thing. The evidence shows both approaches can work beautifully. Let me share some research that opened my eyes. A 2025 systemic review looked at 22 studies comparing techniques. And what they found was fascinating. Both fixation and non-fixation MIS showed faster recovery than open surgery, lower complication rates, higher patient satisfaction. The 2022 meta-analysis with over 1600 feet, it showed that success wasn't about fixation versus non-fixation. It was about surgeon experience and patient selection. And the long-term study on revered denition, 79 month follow excellent results without fixation. But you know what? I've also seen beautiful mica results, studying Siri procedure outcomes. The data supports both. So if both can work, what really matters? Well, surgeon training and comfort level? That's for one. Patient factors, bone quality, activity level, patient expectations, deformity characteristics, severity, instability, associated conditions, post-up protocols, you know, both techniques need proper aftercare. A masterfully done non-fixation procedure beats a poorly done fixation case. But equally, a well-executed mica beats a sloppy revered denition procedure. So it's not the technique, it's the execution. Now, I see these LinkedIn discussions where colleagues say things like, well, there's no evidence for non-fixation or that's not evidence-based. And honestly, that comes from lack of exposure, not lack of evidence. The evidence exists, it's published, it's peer reviewed. But if you've only learned one way, if you've only been exposed to one philosophy, everything else seems foreign, maybe even dangerous. That's not malicious, it's just limited experience. This is why in our MIS intensive program and cadaver workshop, I teach what I know best, the foundational non-fixation MIS techniques that I've mastered over years. But here's where I'm taking things in 2025 and beyond. I'm building a platform where surgeons can learn everything. I mean every MIS technique. That means bring in the best experts for each technique. You want to learn mica? I'll bring in someone who's done thousands of them. You want to master Siri procedure? I'll get you the surgeon who perfected it. Because here's the truth. I'm an expert in non-fixation techniques. That's my wheelhouse. Revered Naisha, Modify Wilson, Reverse Austin. I can teach those in my sleep. But I'm not too proud to admit when someone else is the better teacher for different approach. My vision for these workshops isn't just about teaching my way. It's about creating the most comprehensive MIS education experience available anywhere. So imagine a workshop where I teach the foundational non-fixation techniques, a mica expert demonstrates their approach, a series specialist shows their pearls, everyone learns from everyone. That's not bias. That's complete education. So you get exposed to every tool in the toolbox, taught by the people who know each tool best. Then you decide what works for your hands. This approach does something else too. It brings our community together. Instead of separate camps teaching in isolation, we create a space where all philosophies coexist, where fixation advocates and non-fixation experts share the same stage, where surgeons can see both approaches side by side, taught at the highest level. That's how we end the tribal warfare through education, exposure, and mutual respect. You know what's funny? While we are arguing about screws versus no screws, our patients are just hoping someone can help them walk without pain. They don't care about our philosophical debates. They care about results. And guess what? Both approaches can deliver those results when done properly. So I want to hear from you, but let's keep it constructive. What's your experience with fixation or non-fixation? Have you tried both? What did you learn? What factors make you choose one over the other? If you don't mind, share your appearance in the comments, not your prejudices, please. Let's learn from each other. Best insights get featured in my next video. I'm not just building workshops, I'm building bridges between techniques, between philosophies, between surgeons who might never otherwise share their knowledge. And here's something exciting. I'm actually building partnerships to make these comprehensive workshops happen. If you're a company, for example, that believes in education, that wants surgeons to be properly trained in your techniques or your instrumentation that values skill over sales, let's talk. Because together we can create something special. A place where surgeons learn everything, where all techniques are represented fairly, where education comes first. So if you want to be part of this vision, learning from multiple experts, getting exposed to all the options, check out our upcoming workshops. In 2025, we're expanding, bringing in more experts, creating the most comprehensive MIS education platform in the world. You will learn non-fixation techniques from me and other doctors and fixation techniques from the masters who perfected them. So links in the description for the MIS intensive program as well. Because education should give you options, not limitations. Imagine if we stopped fighting and started collaborating. Imagine if fixation experts and non-fixation masters share their best techniques. Imagine if we choose procedure based on evidence and patient needs, not tribal loyalty. So that's the future I want for MIS. And it starts with conversation like this. This is Dr. TJ. Look, whether your team fixation, team non-fixation, or still figuring it out, we're all on the same team when it comes to helping patients. Hit subscribe, share this with a colleague who needs to hear it. And let's keep pushing MIS forward together. Remember, it's not about being right, it's about doing right by our patients. Build a smarter practice, not a harder one. I'll see you in the next video. Peace.