I'm currently an intern in the Harvard Program and would like to add my 2 cents.
First off, when you go to a big-name program, there are going to be fellows. There is no way around this. Fellows want to work with big name attendings, and big name attendings practice at big name hospitals. As far as hospitals go, the Brigham and MGH are two of the most well known hospitals on the East Coast, if not the entire US.
The beautiful thing about Ortho is case volume, and trust me, these hospitals see plenty of volume. When you have enough cases (as is usually the case), whether or not there are fellows becomes inconsequential. Also, at BWH, the fellows can actually run OR rooms by themselves, which means they will take you through the cases. While it is a commonly held belief that fellows can hinder an experience, my thoughts are that they can actually be beneficial to your education. Operating with fellows is much less stressful and you can shoot questions from your hip without thinking twice.
Bottom line about the fellow issue...if you want to go to a big name program there are going to be fellows. Will you have nailed as many femurs as the person who attended a rural program down south where you ran through cases simply because they NEEDED an extra resident?..i'm not sure. Will you have worked with some of the best minds and teachers in their respective fields and feel comfortable handling some of the most complicated orthopaedic patients the world has to offer?...I think the answer is yes.
If you want to be a small-town orthopod who wants to bang out routine hips on healthy patients without doing a fellowship, then maybe a program that offers early and often operative experience is for you. If you want to go to a top-notch academic institution with the flexibility to be desired by most if not all fellowship programs, then Harvard would be a good option. Trust me, most of you will be doing fellowships. If you end up doing Hand you're sure as hell not going to care that you logged more knee-scopes than anyone else. But you will be able to say, yeah, i worked with Dr. Jupiter and this is how he taught me to do things...blah, blah blah.