I am an ortho resident and have reviewed apps over the past few years. Speaking for myself only, I hate to see applicants try to pump themselves up. Nothing is more irritating in a PS than someone who thinks they are the greatest...it makes me think that person is someone I won't enjoy working with no matter how smart they are.
So, I wouldn't address your grades, step 1 score, or AOA status in the PS- those things speak for themselves in the rest of the application.
You should write about the things (not already in the application) that will set yourself apart from the rest of the applicant pool. These can be about anything: interesting life experiences, what interests you about ortho, what interests you about a particular program, etc.

Regarding the letters, I make sure you have a strong letter from an orthopod, but that shouldn't make a difference about when you submit the application. Most programs don't look that hard at the apps until after the dean's letters are released anyway.

couldn't agree more about the ps advice from 2fingers........make you ps unique......i wouldn't mention scores, grades, aoa or any other thing that will already be in your application..........there are resources for finding examples of ps specific for each specialty, find them and get some ideas from them...................

as far as letters, you need to sort through the ortho programs websites and see what their requirements are for lor's.......most of them will require a letter from an orthopod and some may require ortho chairman letter....so you need to find out what each program specifically wants..............best place to find that is to look on the programs home web site or call them...........