It's a super competitive field- I'm sure there are people who match without it, but honestly, if you want to make yourself an attractive candidate I would do it.
I am doing ortho research with someone I emailed who does work I'm interested in. It's working out brilliantly- not only am I getting the research and papers, but I've made great connections with the attendings and residents. I've also learned a lot by scrubbing in and actually participating in surgeries (putting in screws, learning to suture, drilling and chiseling bone).
If you really want to do ortho- find a way to get involved in research you are actually interested in. I've had great success just emailing attendings and showing up to cool surgeries with residents, and going to grand rounds and journal club.