Podcast Summary: Meet the 2025 Pillars of the AOFAS – Dr. Roger A. Mann

Podcast: The AOFAS Orthopod-Cast
Episode Title: Meet the 2025 Pillars of the AOFAS – Dr. Roger A. Mann
Release Date: November 12, 2025
Participants: Dr. Nick Strasser (Host), Dr. Pam Luke (Co-host), Dr. Roger Mann, Dr. Keith Wapner, Dr. Michael Coughlin

1. Overview

This episode is a tribute to Dr. Roger Mann, recipient of the 2025 AOFAS Legacy Pillar Award, and explores his transformational impact on foot and ankle orthopaedics. Through candid storytelling, Dr. Mann, Dr. Michael Coughlin (his first fellow), and Dr. Keith Wapner reflect on Mann's pioneering role in fellowship training, innovation in surgical techniques and devices, the evolution of educational resources like the textbook, and the enduring personal values he imparted to generations of orthopedic surgeons.

2. Key Discussion Points & Insights

A. The Origins of Foot and Ankle Fellowships

• Early Days & Creation (01:26 – 03:33)

  • Dr. Coughlin details how he convinced Dr. Mann to start a fellowship at a time when only one existed (New York City).
  • Their informal start—Coughlin offered to work with Mann for six months without pay, just healthcare.
  • The fellowship sparked a nationwide proliferation, now totaling over 50.

  “It really did start that way. And just think of the legacy that he left…”
  – Dr. Coughlin (02:55)

• Practical Challenges & Growth (03:33 – 07:44)

  • Dr. Mann faced challenges like housing fellows in the expensive Bay Area—eventually buying a condo for them.
  • Emphasis on family and creating a nurturing, home-like environment, with Joan (his wife) guiding fellows’ families.
  • 74 fellows trained over many years, each bringing their own flavor to the experience.

  “They truly interested in what you have to say. They really want to learn and that’s basically what we did.”
  – Dr. Mann (04:55)

B. Fellowship Camaraderie and Influences

• Teamwork and Dynamic Instructional Courses (07:44 – 08:49)

  • Memories of Dr. Ken Johnson, with whom Dr. Mann shared a friendly rivalry and co-hosted popular instructional courses.
  • The "two against one" debates with Dr. Johnson enlivened teaching and challenged audiences.

  “If I said it was white, he said it was black… But we'd always get our points across.”
  – Dr. Mann (07:31)

C. Dr. Mann’s Character and Mentorship

• Personal Stories of Compassion (08:49 – 10:22)

  • Dr. Wapner recounts when Dr. Mann supported him through his wife’s premature delivery by rearranging work so Wapner could travel home.

  “He had rearranged his entire schedule so I could go back early almost every week…”
  – Dr. Wapner (09:50)

D. Innovation: The Star Total Ankle and FDA Battle

• Taking on Failed Designs & Leading Change (10:22 – 20:29)

  • Dr. Coughlin describes early failures in total ankle design, how Dr. Mann’s biomechanical mindset helped identify and champion the successful STAR implant.
  • Mann’s European trip and recognition of a working prosthesis led to spearheading FDA approval in the U.S.

• Running the Clinical Trials (12:42 – 20:29)

  • Mann negotiated surgeon selection and trial design to protect integrity.
  • The epic process involved years of work, regulatory hurdles, and a pivotal presentation in front of the FDA, where clever strategizing by Coughlin swung approval.

  “So that’s what we did. I worked with Mike and put together a group of 10 surgeons for the prosthesis and 10 surgeons to do the arthrodesis as a comparison group. And it was a real battle…”
  – Dr. Mann (14:31)

  “You want to—when you’re going to get in a battle, you want to know what the enemy is going to do… And so the night before, I talked with Roger…”
  – Dr. Coughlin (16:31)

  Memorable Moment:
  Hilarious anecdote about the lawyer getting lost en route to the FDA, leaving Coughlin to solo the high-stakes opening of the approval meeting.
  (16:04 – 18:39)

E. The Ripple Effect: Building the Community

• Fellows Launching Fellowships (20:29 – 22:44)

  • Mann’s trainees went on to launch their own programs, accelerating the nationwide spread of structured foot and ankle training.
  • Recalls the pre-match era stress—waiting for months on end to hear about a position.

  “So many of his fellows have gone on and started their own fellowship programs…”
  – Dr. Wapner (20:46)

F. Enduring Educational Legacy

• Advice for Future Generations (22:44 – 25:24)

  • Emphasis on biomechanics as the foundation of surgical decision-making.

  “What I tried to do is try to turn the whole thing around and make biomechanics the basis of it.”
  – Dr. Mann (24:24)

• Mentorship Style (25:24 – 26:30)

  • Coughlin recalls the power of simply observing Mann in the OR, learning from his logic, restraint, and efficiency, not just hands-on practice.

• Transformative Learning & Textbooks (28:48 – 34:24)

  • Mann’s work with DeVries and Inman led to authorship and editorship of the foundational foot and ankle surgery textbook.
  • Describes the hours of work and eventual recruitment of Coughlin as co-editor.
  • First introduction of video textbooks—publisher resistance eventually giving way to acceptance, now considered standard in surgical education.

  “The video textbook was revolutionary. That was revolutionary… You could just sit and watch the videotapes and read it.”
  – Dr. Mann (32:40 & 34:09)

G. Giving Back

• Philanthropy and Return to UCSF (31:39 – 32:40)

  • Mann and his wife funded a foot and ankle professorship at UCSF, embodying his ethic of giving back to the community and the profession.

  “That’s indeed what this is all about, is getting something, but also giving back.”
  – Dr. Coughlin (32:21)

3. Notable Quotes & Memorable Moments

• Dr. Mann on Biomechanics:

  “If something wasn’t biomechanically correct, it’s not going to work.” (12:58)

• Dr. Coughlin on Fellowship Origins:

  “It really did start that way… now we have 50 some odd fellowships…” (02:55)

• Dr. Wapner on Mentorship Style:

  “He had this innate ability to take the most complex problems and just distill it down. And I used to always laugh because it was like painless learning.” (26:30)

• On the FDA Experience:

  “It’s a seminal event in your life because you’re going, this is really a big deal, and it’s all on this.” (18:48)

• On Giving Back:

  "Giving back is what makes all this a better place." (32:21)

4. Important Timestamps

• 01:26 – Dr. Coughlin recounts how the Mann fellowship started
• 03:33 – Dr. Mann elaborates on early logistical challenges and family atmosphere
• 07:44 – Memories of working and debating with Ken Johnson
• 08:49 – Dr. Wapner’s story: Dr. Mann's personal kindness in crisis
• 10:22 – Discussion of failed ankle replacements, trip to Denmark, inception of STAR total ankle
• 16:04 – The lost lawyer, Coughlin alone before the FDA
• 22:44 – Mann’s broader influence, the ensuing fellowship boom
• 23:41 – Advice for young surgeons: priorities and biomechanics
• 28:48 – The making of the textbook and transition to video-based learning
• 31:39 – The UCSF professorship and Mann’s philanthropic legacy

5. Advice & Final Reflections

• Dr. Mann: Master biomechanics, use them as your foundation for surgical choices.
• Dr. Wapner & Dr. Coughlin: Value observation and critical thinking over rote learning in training. Education should be supportive, not intimidating.

Overall Tone

The conversation was informal and warm, blending humility, humor, and deep respect for legacy and mentorship. The panel repeatedly emphasized generosity, practical wisdom, and the importance of nurturing future generations with both technical skill and human empathy.

For listeners and students of orthopaedics, this episode is not just a chronicle of achievement—it’s a call to excellence, innovation, and stewardship.