Daniel F. Haber, MD’s Practice
Orthopedic surgeons are medical doctors who specialize in bone, muscle, and joint surgery. This includes corrective procedures, such as removing torn cartilage or replacing a joint.
Some orthopedic surgeons specialize in specific areas such as shoulder surgery, hand surgery, or joint replacement.
Orthopedic surgeons can be board-certified through the Board of Orthopaedic Surgery, which is recognized by the American Board of Medical Specialties.
Definition
Orthopedic (sometimes spelled orthopaedic) surgery is surgery performed by a medical specialist, such as an orthopedist or orthopedic surgeon, trained to deal with problems that develop in the bones, joints, and ligaments of the human body.
Purpose
Orthopedic surgery corrects problems that arise in the skeleton and its attachments, the ligaments and tendons. It may also deal with some problems of the nervous system, such as those that arise from injury of the spine. These problems can occur at birth, through injury, or as the result of aging. They may be acute, as in injury, or chronic, as in many aging-related problems.
Orthopedics comes from two Greek words, ortho, meaning straight and pais, meaning child. Originally orthopedic surgeons dealt with bone deformities in children, using braces to straighten the child’s bones. With the development of anesthesia and an understanding of the importance of aseptic technique in surgery, orthopedic surgeons extended their role to include surgery involving the bones and related nerves and connective tissue.
The terms orthopedic surgeon and orthopedist are used interchangeably today to indicate a medical doctor with special certification in orthopedics.
Many orthopedic surgeons maintain a general practice, while some specialize in one particular aspect of orthopedics, such as hand surgery, joint replacements, or disorders of the spine. Orthopedics treats both acute and chronic disorders. Some orthopedists specialize in trauma medicine and can be found in emergency rooms and trauma centers treating injuries. Others find their work overlapping with plastic surgeons, geriatric specialists, pediatricians, or podiatrists (foot care specialists). A rapidly growing area of orthopedics is sports medicine, and many sports medicine doctors are board certified orthopedists.
Precautions
Choosing an orthopedist is an important step in obtaining appropriate treatment. Patients looking for a qualified orthopedist should inquire if they are “board certified” by their accrediting organization.
Description
The range of treatments done by orthopedists is enormous. It can cover anything from traction to amputation, hand reconstruction to spinal fusion or joint replacements. They also treat broken bones, strains and sprains, and dislocations. Some specific procedures done by orthopedic surgeons are listed as separate entries in this book, including arthroplasty, arthroscopic surgery, bone grafting, fasciotomy, fracture repair, kneecap removal, and traction.
In general orthopedists are attached to a hospital, medical center, trauma center, or free-standing surgical center where they work closely with a surgical team including an anesthesiologist and surgical nurse. Orthopedic surgery can be performed under general, regional, or local anesthesia.
Much of the work of the surgeon involves adding foreign material to the body in the form of screws, wires, pins, tongs, and prosthetics to hold damaged bones in their proper alignment or to replace damaged bone or connective tissue. Great improvements have been made in the development of artificial limbs and joints, and in the materials available to repair damage to bones and connective tissue. As developments occur in the fields of metallurgy and plastics, changes will take place in orthopedic surgery that will allow the surgeon to more nearly duplicate the natural functions of the bones, joints, and ligaments, and to more accurately restore damaged parts to their original range of motion.
Preparation
Patients are usually referred to an orthopedic surgeon by a general physical or family doctor. Prior to any surgery, the patient undergoes extensive testing to determine the proper corrective procedure. Tests may include x rays, computed tomography scans (CT scans), magnetic resonance imaging (MRI), myelograms, diagnostic arthroplasty, and blood tests. The orthopedist will determine the history of the disorder and any treatments that were tried previously. A period of rest to the injured part may be recommended before surgery is prescribed.
Patients undergo standard blood and urine tests before surgery and, for major surgery, may be given an electrocardiogram or other diagnostic tests prior to the operation. Patients may choose to give some of their own blood to be held in reserve for their use in major surgery, such as knee replacement, where heavy bleeding is common.
Aftercare
Rehabilitation from orthopedic injuries can be a long, arduous task. The doctor will work closely with physical therapists to assure that the patient is receiving treatment that will enhance the range of motion and return function to the affected part.
Risks
As with any surgery, there is always the risk of excessive bleeding, infection, and allergic reaction to anesthesia. Risks specifically associated with orthopedic surgery include inflammation at the site where foreign material (pins, prosthesis) is introduced into the body, infection as the result of surgery, and damage to nerves or to the spinal cord.
Normal results
Thousands of people have successful orthopedic surgery each year to recover from injuries or restore lost function. The degree of success in individual recoveries depends on the age and general health of the patient, the medical problem being treated, and the patient’s willingness to comply with rehabilitative therapy after the surgery.
Key Terms
Arthroplasty
The surgical reconstruction or replacement of a joint.
Prosthesis
A synthetic replacement for a missing part of the body, such as a knee or a hip.
Range of motion
The normal extent of movement (flexion and extension) of a joint. For Your Information