What Is an Orthopedist?

Orthopedic doctors treat joints, muscles, and bones

Orthopedist meeting with patient with arm in a sling

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An orthopedist, also referred to as an orthopedic doctor, orthopedic physician, or orthopedic surgeon, is a member of the healthcare team whose specialty is treating and preventing deformities of the skeletal and muscular system including muscles, joints, bones, cartilage, ligaments, and tendons. Someone may seek treatment from an orthopedist following significant pain, swelling, and deformity related to a joint injury or severe sprain to a muscle, ligament, or other skeletal structure. Treatments provided by an orthopedist often focus on surgery and the healing or aftercare following surgery, along with other conservative treatments.

Concentrations

An orthopedic doctor is an integral part of a healthcare team, as this doctor plays a large role in the rehabilitation of a variety of injuries. This doctor closely monitors a patient’s progress in rehabilitation therapies such as occupational therapy and physical therapy. Similar to any other physician, an orthopedist also assesses the need for other services and specialties to assist in a patient’s care.

Orthopedists treat a variety of conditions which relate to the musculoskeletal system. Conditions involving direct trauma or repeated trauma due to overuse of a bone, joint, muscle, or tendon will benefit from treatment by an orthopedist.

Orthopedists can also treat general and chronic conditions including:

Joint replacement is one of the most common reasons why someone might see an orthopedist. Someone may need a joint replacement due to severe arthritis which is causing the joint to no longer function properly. A joint replacement may also be needed for those who have sustained direct trauma to a joint, which cannot be fixed through the surgical or non-surgical placement of fractured bones.

An orthopedist can also treat more specific conditions including but not limited to:

Procedural Expertise

Orthopedists can address a patient’s ailments through both non-surgical and surgical treatments. The methods which an orthopedic physician uses are largely dependent on the type of injury or diagnosis, along with an evaluation determining which methods have previously been attempted.

Orthopedists are trained to perform several types of surgery, including arthroscopy, joint fusion, internal fixation, joint replacement, osteotomy, and soft tissue repair.

Arthroscopy is a robotic-assisted procedure involving the use of cameras to both diagnose and repair tears, swelling, and scar tissue within joints.

Joint fusions and internal fixations both use devices such as metal rods, screws, plates, and pins to join bone fragments together. This joining of bone fragments promotes the healing of each individual piece into its previous state of a single, fully joined bone.

An osteotomy involves the cutting of a bone deformity to allow for more appropriate positioning.

Soft tissue repair is a surgical option which repositions tendons or ligaments which have been torn, excessively stretched, or injured in another way.

Joint Replacement

Depending on the severity of the injury or condition of the joint, joint replacements may be the most appropriate surgical choice. A joint may be fully replaced (called a total joint replacement), partially replaced, or the joint can undergo a revision replacement.

Each of these joint replacement surgeries consists of removing the damaged joint and replacing it with an artificial version. The joint which is being replaced dictates what material the joint is made of. More load-bearing joints such as knees and hips are typically made of metals such as cobalt, chromium, stainless steel, and titanium. Smaller joints may be made of resilient plastic or ceramic.

Non-Surgical Treatments

Orthopedists are also trained in the use of non-surgical treatments. These include prescribing medications, recommending various exercises, and suggesting lifestyle changes and modifications to assist with the prevention of injury and deformity.

After the evaluation process, an orthopedist may also determine a patient would benefit from rehabilitative therapies such as occupational therapy, physical therapy, or alternative therapy such as acupuncture. An orthopedist is able to make the appropriate referrals to assist in the rehabilitation process, which would then be monitored by the orthopedist at follow-up visits.

Orthopedic Tests

Orthopedists can perform a variety of tests on bones, joints, and muscles to determine the root cause of pain and diagnose a patient. These tests vary based on the joint, but one example is Neer’s test for rotator cuff impingement. This test is very general and simply shows the presence of a rotator cuff impingement, not which structures are problematic. For this reason, it should be combined with the range of other tests for the shoulder joint.

Other examples of orthopedic tests are the anterior and posterior drawer tests along with valgus and varus stress tests on the ligaments of the knee. Again, these are preliminary tests which indicate the presence of issues with the ligaments in the knee, meaning these should be followed up with additional testing to make a definitive diagnosis.

The straight leg test can be used to test sensitive nerves, range of motion, and strength of the lower leg. Pain or changes in sensation when completing this test may indicate a sciatic nerve condition or other issues with the joints and muscles of the leg.

Subspecialties

Orthopedic surgery itself is a specialty of the medical field; however, there are many sub-specialties within this field. These sub-specialties include:

Training and Certification

Orthopedic doctors are required to complete medical school in order to receive a certification and license as a medical doctor. In order to treat patients and perform surgeries, an orthopedic doctor must fulfill all requirements associated with becoming a doctor. This includes obtaining a four-year bachelor’s degree in a science or health-related field, completing four years of academic coursework as part of medical school, followed by a four to five-year orthopedic residency at a hospital.

An orthopedist who has successfully completed each of these requirements may hold either MD or DO following their name.

  • MD refers to a doctor of medicine which is granted to those who have graduated from a school of medicine.
  • DO refers to a doctor of osteopathic medicine which is granted to those who have graduated from a school of osteopathic medicine.

There are some differences between the schooling for each of these professions, but both are equally qualified to treat patients as an orthopedic surgeon.

It is required by these credentialing boards for orthopedists to display their certifications and diplomas in order to demonstrate their credibility to the patients they treat. It is important to look for these documents when entering the office of an orthopedist in order to ensure they are practicing according to the required standards.

Appointment Tips

A patient can receive a referral to see an orthopedic surgeon by visiting their primary care physician. If you are demonstrating increased pain, swelling, tingling, difficulty walking, moving, or completing daily activities due to joint, bone, muscle, or tendon disorders, a primary care physician will likely determine the need for evaluation and treatment by an orthopedist.

A good practice to follow before any medical appointment is to keep a note of your symptoms. This may include recording details of pain, swelling, loss of motion, strength, and ability to sleep or participate in daily activities.

Before your appointment you should also note:

  • When you are experiencing symptoms (day, evening, while you sleep)
  • What types of activities aggravate these symptoms (sitting, standing, exercising, bearing weight)
  • The intensity or type of pain you are experiencing (burning, shooting, dull, aching pain on a scale of one to ten)

It is also helpful to inform your orthopedist what types of treatments have or have not worked before. This will help your doctor more efficiently determine what the best course of action is.

If you have them, bring any reports or imaging such as X-rays or MRIs when visiting your doctor. If you recently had imaging done due to a recent diagnosis or injury to the muscle or joint, this may already be sent to your orthopedist. If you have imaging which shows the progression of the joint or bone damage, it may help to contact your previous doctor and locate these records.

An orthopedist will need to examine the area around the joint, muscle, or tendon so it is important to go into your appointment with layers of clothing that can easily be removed. Loose pants will allow for quick access to view the knee or hip joint, and so on.

If this is your first appointment with an orthopedist, ensure you arrive early to fill out the necessary paperwork with the receptionist. Not only is this paperwork required for insurance purposes, but doing a good job filling out your surgical and medical history will help the doctor know what to address first.

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