Definition & Overview
Orthopaedic surgery is an operative procedure performed by a qualified orthopaedist specialist or orthopaedic surgeon to treat musculoskeletal problems affecting the bones, joints, muscles, tendons and ligaments caused by accident, trauma, injury or chronic condition. Orthopaedic surgery can also correct problems of the nervous system linked to the spinal column, as well as congenital defects and musculoskeletal issues caused by aging.
Who should undergo orthopaedic surgery & expected results
Patients are usually referred by general practitioners to an orthopaedic specialist for treatment of accident or injury such as spine or limb deformity, bone fracture, chronic arthritis, among many others. Orthopaedists can treat very young patients, usually for congenital deformities such as scoliosis or clubbed foot, young athlete needing an arthroscopic operation, down to senior patients with mobility issues. Practically anyone with problems in the bones, muscles and connective tissues can seek the expertise of an orthopaedic expert to alleviate the symptoms and for appropriate treatment.
Doctors of orthopaedics perform three important tasks:
- Diagnose disorders and injuries through physical examination as well as tests such as x-rays, MRI, ultrasound or blood tests
- Treat injuries usually through medication and/or surgery (performed by an orthopaedic surgeon)
- Recommend physiotherapy or regular exercise to maximize and restore strength, movement and functionality of the treated area
Common operations in orthopaedic surgery
There are dozens of kinds of orthopaedic surgical operations performed by surgeons everyday. Some of the most common are the following:
Arthroscopy - an advanced minimally invasive technique for diagnosing and repairing damaged joint tissue performed with the use of probes, thin tubes and small instruments
Bone fracture repair - surgical procedures for treating broken ankle, leg, hip, ribs, arm, collarbone (virtually any bone for that matter); involves incisions through which the bones are fixed and aligned, often with the use of screws or splints
Arthroplasty - a range of techniques for replacing whole joints such as the hip or the knees, such as for chronic cases of arthritis; this involves replacing diseased joints with prosthetic rubbery material to restore movement in the joints
Damaged tissue repair - a surgical procedure where torn ligaments or tendons are reconstructed through grafts taken elsewhere in the body
Corrective surgery - a range of procedures performed to correct misalignment and deformities of the limbs or spine to improve and optimize movement; among usual procedures are fusion surgery (welding together two parts to form a single bone) and osteotomy (cutting and reposition of the bone).
How the procedure works
As mentioned earlier, orthopaedic surgeons provide an extensive range of treatments. However, before a definitive treatment is suggested, patients are made to undergo extensive testing to determine the nature of the bone or muscle problem. The orthopaedist will ask you about the history of the disorder, previous treatment sought, and other pertinent information related to your condition. You may be asked to undergo tests such as x-rays, computed tomography (CT) scan, magnetic resonance imaging (MRI), blood tests or myelograms to elucidate the extent of the problem in detail.
Depending on the diagnosis, you may be recommended to take medication, undergo surgery, perform rehabilitative or alternative therapies, or go through a combination of these treatment methods. Surgery is often the last resort if your ailment does not respond to other non-surgical treatment. If surgery is deemed the best option, preoperative procedures such as routine diagnostic testing will be performed prior to your operation.
All orthopaedic surgeries, including the common operations mentioned above, are performed under local anesthesia (often with sedation) or general anesthesia. For major operations such as knee replacement, patients may be asked to donate some blood (or prepare) in case transfusion may be needed during the operation.
What to expect after orthopaedic surgery
After the procedure, a plaster cast or sling is often placed to protect the area repaired. The amount of time required for recovery depends on the procedure performed, although patients are often able to go home within a few days. However, it usually takes a few to several weeks for the bones and ligaments to regain full strength. As such, you will be advised to refrain from subjecting the injured area to rigorous activities unless it is already fully recovered. The usual rule of thumb for injuries of the bone, for instance, is that the period it takes to fully regain strength is about the same period for the fracture to completely heal. This means that if you have been in a cast for four weeks, you will need another four weeks to regain strength.
Aside from time for complete healing, most of orthopaedic surgeries require rehabilitation to fully restore motion and function in all affected parts. As such, orthopaedic surgeons work hand-in-hand with physical therapists as well as occupational therapists who assist patients in enhancing their range of motion and getting back to their daily activities. The length of time needed and frequency for rehabilitation will depend on the surgery performed and severity of the condition. Total hip replacement surgery, for instance, require rehabilitation for at least six months.
The majority of patients who go through orthopaedic surgery fully-recover from their injuries. However, the degree of success is dependent on one's general health, age, medical problem and innate willingness to comply with therapy post-surgery.
Possible risks and complications
Just like any surgical operation, there is a degree of risk in orthopaedic surgeries. Among complications that rarely occur are: adverse or allergic reaction to anesthesia, excessive bleeding, post-surgical clot formation and infection. Inflammation at the site where prosthetics, grafts, screws, and other materials foreign to the body may also occur. In surgeries involving the spine, there is a risk of causing damage to the nerves. However, mortality during orthopaedic surgical procedures is very rare. Despite these risks, there are no other alternatives available today that can provide the treatment that orthopaedic surgeries can offer for relief of musculoskeletal conditions.
American Academy of Orthopaedic Surgeons. “Orthopaedics.”Available: http://orthoinfo.aaos.org/topic.cfm?topic=a00099 Canale, S. T. Campbell's Operative Orthopedics. St. Louis: Mosby, 2003.
Fallon, L. F. Jr., MD. “Orthopaedic Surgery.”Available: http://www.surgeryencyclopedia.com/La-Pa/Orthopaedic-Surgery.html
National Health Service. “Overview: Orthopaedics (Orthopaedic Surgery.”Available: http://www.nhs.uk/conditions/orthopaedics/Pages/Introduction.aspx