An Overview of Orthopedic Surgery

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Orthopedic surgery is the medical specialty dedicated to the surgical treatment of issues related to the musculoskeletal system (i.e., the bones and connective tissues, such as ligaments and tendons). This involves a wide variety of procedures, from ACL and meniscus repair to hip replacement to spinal fusion and more. Orthopedic surgery may be done to treat condition-, age-, or accident-related concerns, and therefore may be carefully planned or entirely unexpected.

Surgeries of this type can also vary greatly in terms of how invasive they are, the risks they carry, and what it takes to recover from them.

While some use the terms orthopedist and orthopedic surgeon interchangeably, some make a clearer distinction, as those who perform such surgical procedures undergo additional specialized training.

Subspecialties

Over the years, the field of orthopedic surgery has expanded to encompass many subspecialties and the treatment of many musculoskeletal disorders in patients of all ages.

Some of the common orthopedic surgery subspecialties include:

  • Foot and ankle surgery
  • Hand surgery
  • Hip and knee reconstruction
  • Pediatric orthopedics
  • Spine disorders
  • Sports medicine
  • Trauma surgery

These and others often overlap with other medical specialties, including neurosurgery, plastic surgery, rheumatology, and podiatry. Orthopedic surgeons often have to work closely with other physicians in order to manage complex problems.

In addition, orthopedic surgeons work directly with primary care doctors, pediatricians, anesthesiologists, emergency room physicians, as well as non-physician clinicians such as physician assistants, athletic trainers, orthopedic technologists, nurse practitioners, and others.

Common Types of Surgery

Most orthopedic surgical procedures involve bones or joints. Some surgeries can be performed arthroscopically (by looking inside a joint with a camera), others through minimal incisions, and still others require larger, more invasive incisions.

Some of the more commonly performed orthopedic surgical procedures include ACL reconstruction, meniscus repair, and knee replacement.

It's important to reinforce the fact that the vast majority of people who consult with an orthopedic surgeon never actually go to an operating room for treatment. Orthopedic surgeons ensure that non-surgical options, if potentially useful, are explored before recommending surgery.

While many have the perception that an orthopedic problem needs to be treated with surgery in order for treatment to be successful, that is not always the case.

Risks of Orthopedic Surgery

There are risks associated with a surgical treatment any time one is performed. While most often these risks can be controlled, and most procedures are very safe, there are possible complications that you should understand if you're planning on orthopedic surgery.

Anesthesia-Related

Most patients will have some type of anesthetic when undergoing surgery. There is a broad spectrum of options for anesthesia for orthopedic procedures, which range from local anesthesia to a general anesthesia, with many options in between. Not every type of anesthesia will work for every surgery, but most often there are options that you may consider.

For some people, a specific type of anesthesia may be considered safer. Risks of anesthesia depend on a number of factors including the type of anesthesia, overall health and comorbidities, and the surgery being performed.

Infection

Another common risk of any orthopedic surgery is infection. This is probably the most common concern people have about their upcoming surgery. Infections after surgery can sometimes be simple to manage; other times they may require additional surgical procedures and prolonged treatment.

There are steps you can take when having an orthopedic surgical procedure that will help reduce the chance of having an infection.

Blood Clots

A blood clot can form in your veins after orthopedic surgery, a problem called a deep venous thrombosis (DVT). Sometimes DVTs can migrate from the veins and travel to the lungs where they can cause a pulmonary embolism (PE).

Often your surgeon will recommend treatment such as compression, mobilization, or blood thinners to prevent blood clots from forming.

Recovery

Recovery after orthopedic surgery depends on the specific procedure your surgeon has performed, as well as factors such as your age and adherence to your doctor's recommendations.

Most procedures involve some type of post-surgical therapy to regain joint mobility and restore strength to the extremity. In addition, many orthopedic conditions are preceded by poor mechanics or functioning of an extremity.

For example, many people with a rotator cuff tear in their shoulder have been compensating for months or longer. In order to restore normal shoulder mechanics, not only does the tear need to be surgically addressed, but the other muscles and joints around the shoulder may require treatment.

Pain is common after an orthopedic surgical procedure, but there are more and better options for managing post-surgical pain today than there have ever been in the past. More orthopedic surgeons are using long-acting local anesthetics, regional nerve blocks, and other techniques to control pain and limit the need for narcotic medications.

In general, surgeons try to limit the use of narcotic medications after surgery. These medications have potentially serious side effects and can become addictive, so they only used sparingly after orthopedic surgery.

A Word From Verywell

Make sure you know what your orthopedic surgery procedure entails and that you are prepared for it by asking good questions of your doctor. Ensuring you have equipment, medications, and any other necessities you'll need after surgery taken care of ahead of time will help get your recovery started right, so be sure to ask what's recommended. Most of all, take instructions related to re-starting activities seriously.

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Article Sources

  1. Swarup I, O'donnell JF. An Overview of the History of Orthopedic Surgery. Am J Orthop. 2016;45(7):E434-E438.

  2. American Academy of Orthopaedic Surgeons. Orthopaedics.

  3. Motohashi M, Adachi A, Takigami K, et al. Deep vein thrombosis in orthopedic surgery of the lower extremities. Ann Vasc Dis. 2012;5(3):328-33. doi:10.3400/avd.oa.12.00049

  4. Halawi MJ, Grant SA, Bolognesi MP. Multimodal Analgesia for Total Joint Arthroplasty. Orthopedics. 2015 Jul 1;38(7):e616-25. doi:10.3928/01477447-20150701-61


Additional Reading

  • American Academy of Orthopaedic Surgeons. OrthoInfo.