Conflicts of interest in medicine has created deep concerns about the integrity of medicine and raised doubts about the trustworthiness of the medical professional. New stories of conflict of interest in medicine have become a commonplace. The interactions between the medical professional and the biomedical device as well as the pharmaceutical industry has become so pervasive that the primary interest of the medical professional in protecting and promoting the welfare of the patient has been compromised. The professional judgement and actions have been influenced by secondary interests, the major fungible and quantifiable being financial interest. The industry influence not only affects the way we practice orthopaedics but also affects medical education and peer review publications. Peer review publications have been shown to exaggerate benefits of the industry products while at the same time downplaying the risks. These conflicts of interest in orthopaedic surgery are particularly common in spinal and joint replacement surgery where joint replacement has been described as a ‘fashion trade’. The introduction of new products appears to be an uncontrolled experiment which has been hijacked by large corporations. This article explores the unhealthy pervasive interaction between the orthopaedic surgeon and the medical devices as well as the pharmaceutical industry. It highlights how the biomedical and the pharmaceutical industry dominate all aspects of the healthcare system. With its wealth and political clout, its influence is present everywhere, from the use of devices and drugs, research, publications, trials, education and even formulation of CGPs.