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Orthopaedic Surgery

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What is Orthopaedic Surgery?

Orthopaedic Surgery, also commonly referred to as Orthopaedics, is a branch of surgery that deals with the treatment of the musculoskeletal system, including bones, joints, muscles, ligaments, tendons, nerves, and even the skin. A person who specialises in Orthopaedic Surgery is known as an Orthopaedic Surgeon or Orthopaedist.

An orthopaedic surgeon or orthopaedist specialises in the diagnosis and treatment of musculoskeletal disorders. He or she uses both non-surgical and surgical methods of treatment to provide relief to individuals suffering from injuries, fractures, infections, degenerative diseases, and other health issues that affect the musculoskeletal system.

What Education and Training is Involved with Orthopaedic Surgery?

To become an orthopaedic surgeon, an individual must complete:

  • Four years of study in a college or university
  • Four years of study in medical school
  • Five years of training in an orthopaedic residency
  • Obtain a medical license and optional board certification
  • One or more additional years of fellowship training in one of the subspecialty areas

What are the Subspecialties of Orthopaedic Surgery?

Although orthopaedic surgeons are familiar with all aspects of the musculoskeletal system, many orthopaedists specialise in certain areas, such as:

  • Knee Replacement and Reconstruction
  • Hip Replacement and Reconstruction
  • Hand and Wrist
  • Foot and Ankle
  • Orthopaedic Trauma
  • Orthopaedic Oncology (bone tumours)
  • Paediatric Orthopaedic Surgery
  • Spine
  • Shoulder and Elbow
  • Sports Medicine

What Does an Orthopaedic Surgeon/Orthopaedist Treat?

An orthopaedic surgeon/orthopaedist treats a wide variety of musculoskeletal disorders. These disorders may be present from birth, or they may occur from an injury or age-related wear and tear.

Some of the common conditions treated by Orthopaedic surgeons include:

  • Bone fractures
  • Soft tissue injuries, such as injury to the muscles, tendons, and ligaments
  • Joint pain from arthritis
  • Neck pain
  • Back pain
  • Carpal tunnel syndrome
  • Hip and knee disorders
  • Shoulder pain and problems, such as bursitis
  • Overuse and sports injuries, such as sprains, strains, meniscus tears, tendinitis, and anterior cruciate ligament (ACL) tears
  • Congenital conditions, such as scoliosis and clubfoot
  • Bone tumours
  • Spine deformities
  • Muscle, joint, and bone infections
  • Ankle or foot surgeries
  • Nerve issues
  • Sports injuries
  • Degenerative changes, such as osteoarthritis

How Does an Orthopaedist Diagnose an Orthopaedic Condition?

In order to diagnose an orthopaedic condition and recommend suitable treatment, an orthopaedist will ask questions regarding the condition and conduct a detailed review of the medical records and a thorough physical examination of the patient. An orthopaedist may also order additional diagnostic tests such as X-rays, MRI, bone scans, blood tests, nerve conduction studies, and CT scans for a detailed evaluation of damage to bones and soft tissues and to confirm the diagnosis.

What are the Treatment Options Used by Orthopaedic Surgeons to Treat Orthopaedic Conditions?

Treatment options include both non-surgical and surgical remedies.

Non-Surgical Treatment

The most common non-surgical treatment recommended for orthopaedic conditions, such as sprains and strains is rest, ice, compression, and elevation (RICE). The RICE method needs to be followed immediately after injury to relieve pain and inflammation and should be continued for at least 48 hours.

  • Rest: You should take rest from regular exercises or daily activities as needed. 
  • Ice: Apply an ice pack over the injured area for 20 minutes at a time. This should be done four to eight times a day. A cold pack, ice bag, or plastic bag filled with crushed ice and wrapped in a towel can be used. 
  • Compression: Compress the injured area with elastic wraps, special boots, air casts, and splints to reduce swelling. 
  • Elevation: Keep the injured area elevated on a pillow, above the level of the heart to help decrease swelling.

Your orthopaedist may recommend other conservative treatments if RICE does not provide satisfactory relief. These include:

  • Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs such as aspirin and ibuprofen are employed to reduce swelling and pain.
  • Immobilisation: Immobilisation is minimising or eliminating the movement of the injured area to prevent further damage and promote healing. Casting and splinting are the commonly rendered non-surgical treatment options for injuries related to the bones and soft tissues (muscles, tendons, ligaments). It helps to stabilise fractures and reduce pain, swelling, and muscle spasms.
  • Physical Therapy and Rehabilitation: Physical therapy and rehabilitation involve exercises that get the injured area back to normal condition. The exercise starts with gentle range-of-motion exercises followed by stretching and strengthening exercises.
  • Other Therapies: Other common non-surgical therapies involved in the treatment of orthopaedic conditions include injection therapy, regenerative medicine, acupuncture, cold packs or cryotherapy, heat packs or thermotherapy, and therapeutic ultrasound.

Surgical Treatment

Surgery is the last resort for the management of orthopaedic conditions and is indicated only if conservative techniques are not helpful. Surgery is performed to repair torn tendons and ligaments or to realign broken bones. Your surgeon may recommend a minimally invasive arthroscopic procedure or an open technique with a larger incision to treat your condition. The minimally invasive arthroscopic surgery is performed through tiny incisions, about 1 cm each, with an arthroscope - a small fibre-optic viewing instrument with a tiny lens, light source, and video camera on its end. The camera attached to the arthroscope displays the image of the joint on a monitor, allowing your surgeon to determine the extent and type of damage. Miniature surgical instruments are then inserted through the other incisions to carry out the required repair.

Some of the common orthopaedic surgeries performed for treating an orthopaedic condition include:

  • Total Knee Replacement: Total knee replacement, also called total knee arthroplasty, is a surgical procedure in which the worn-out or damaged surfaces of the knee joint are removed and replaced with an artificial prosthesis. Total knee replacement surgery is commonly indicated for severe osteoarthritis of the knee.
  • Total Hip Replacement: Total hip replacement is a surgical procedure in which the damaged cartilage and bone are removed from the hip joint and replaced with artificial components. Total hip replacement surgery is commonly indicated for severe osteoarthritis of the hip.
  • Anterior Cruciate Ligament (ACL) Reconstruction: Anterior cruciate ligament (ACL) reconstruction is a surgical procedure to replace the torn or damaged ACL ligament in your knee with a new ACL tissue graft obtained most commonly from your own body (autograft) or in rare cases from a deceased donor (allograft). The anterior cruciate ligament (ACL) is one of the major stabilising ligaments in the knee. When this ligament tears, unfortunately, it does not heal on its own and often leads to the feeling of instability in the knee, requiring reconstruction to correct the abnormality.
  • Rotator Cuff Surgery: A rotator cuff is a group of tendons in the shoulder joint providing support and enabling a wide range of motion. Major injury to any of these tendons may result in a tear. Rotator cuff surgery is a surgical procedure to repair an injured or torn rotator cuff.
  • Hand and Wrist Surgeries: As the hands and wrists are utilised so often in day-to-day activities, they are susceptible to damage through injuries, wear and tear, and arthritis. Fractures and dislocations to the hand or fingers, wrist, tendonitis, and carpal tunnel syndrome are some of the deformities that can be corrected with orthopaedic surgery.
  • Foot and Ankle Surgeries: The foot and ankle are complex joints involved in movement, and providing stability and balance to the body. They are flexible structures that consist of 26 bones, 33 joints, and many muscles, tendons and ligaments. Foot and ankle surgeries are procedures performed to treat foot and ankle structures with deformities, injuries, structural issues, and damage from diseases like diabetes or arthritis.
  • Bone Fracture Repair: Orthopaedic surgery is commonly employed to treat fractures where the bone/bone fragments are reduced or repositioned into their normal alignment. Orthopaedic implants such as wires, nails, plates, and screws are then used to secure the damaged bones together. This method is commonly utilised for managing fractures such as a broken leg, rib, hip, collar bone, or ankle.
  • The Society of British Neurological Surgeons
  • British Orthopaedic Association
  • Maharshi Dayanand University