Background & Scope
Orthopaedic surgery is a mixed-medical/surgical specialty that focuses on the diagnosis, treatment, and prevention of musculoskeletal disorders and injuries. This includes conditions affecting the bones, joints, ligaments, tendons, muscles, and nerves.
The scope of orthopaedic surgery is broad and includes both surgical and nonsurgical treatments. Some common surgical procedures performed by orthopaedic surgeons include joint replacements (such as hip and knee replacements), and fracture repair. Nonsurgical treatments include physical therapy, medication, and lifestyle changes.
Orthopaedic surgeons also specialize in specific areas of the body, such as the spine, hand, foot and ankle, hip, knee, and shoulder and also may specialize in pediatric orthopaedic surgery. These specialists have a deep understanding of the specific anatomy and mechanics of these areas, and have the skills and knowledge to provide the best possible treatment options.
Orthopaedic surgery plays a critical role in helping patients with musculoskeletal disorders and injuries to regain their mobility, reduce pain, and improve their quality of life. It also helps to prevent and manage conditions that can lead to chronic pain and disability.
In recent years, orthopaedic surgery has made significant strides due to advancements in technology and research, such as with minimally invasive procedures, arthroscopy, and robotic-assisted surgery. These advances have led to faster recovery times, less pain, and improved outcomes for patients.
Qualifications, Training, and Certifications
To become an orthopaedic surgeon, a physician must complete a five-year orthopaedic surgery residency program. During this time, trainees gain experience in the diagnosis, treatment, and management of musculoskeletal disorders and injuries. They will also participate in hands-on training through rotations in different orthopaedic subspecialties such as spine, hand, foot and ankle, hip, knee, and shoulder.After completing orthopaedic surgery residency program, a physician must pass a certification exam to become a board-certified orthopaedic surgeon. The American Board of Orthopaedic Surgery (ABOS) is the main organization responsible for certifying orthopaedic surgeons in the United States. Orthopaedic surgeons maintain their certification through the ABOS by meeting the requirements for continuing medical education and passing an oral examination every 10 years.
Conditions, Diseases, Treatments, and Procedures
Orthopaedic surgery is a specialty that deals with the diagnosis, treatment, and prevention of musculoskeletal disorders and injuries. Orthopaedic surgeons are experts in the structure and function of the bones, joints, ligaments, tendons, muscles, and nerves. They use a variety of techniques, both surgical and nonsurgical, to help patients recover from injuries, manage chronic conditions, and improve their quality of life.
Diagnoses: Orthopaedic surgeons use a variety of diagnostic tools, including physical examination, imaging studies (such as X-rays, MRI, and CT scans), and laboratory tests to identify the cause of a patient's symptoms. They also consider a patient's medical history and any previous treatments that have been attempted.
Treatments: Orthopaedic surgeons use a variety of treatments to help patients recover from injuries, manage chronic conditions, and improve their quality of life. These treatments include:
Nonsurgical treatments: Physical therapy, medication, and lifestyle changes are examples of nonsurgical treatments that can help patients manage musculoskeletal disorders and injuries.
Surgical treatments: Orthopaedic surgeons use a variety of surgical techniques to repair, replace, or remove damaged or diseased parts of the musculoskeletal system, including joint replacements (such as hip and knee replacements), spinal surgery, and fracture repair.
Diseases and conditions: Orthopaedic surgeons treat a wide range of diseases and conditions, such as:
Arthritis: a group of conditions that cause inflammation in the joints, leading to pain, stiffness, and limited mobility.
Osteoporosis: a disease that causes the bones to become weak and brittle.
Scoliosis: an abnormal curvature of the spine.
Degenerative disc disease: a condition in which the discs between the vertebrae of the spine degenerate and lose their ability to cushion and protect the spine.
Tendinitis: inflammation of a tendon, usually caused by repetitive motions or overuse.
Injuries: Orthopaedic surgeons treat a wide range of injuries, such as:
Fractures: a broken bone.
Dislocations: a bone that has been forced out of its normal position.
Sprains: an injury to a ligament, the tissue that connects bones to one another.
Strains: an injury to a muscle or tendon.
Procedures: Orthopaedic surgeons perform a wide range of procedures, such as:
Joint replacements: Hip, knee, shoulder, elbow, and ankle replacements, among others.
Spinal surgery (by orthopaedic spine surgeons): such as spinal fusion, laminectomy, and discectomy
Fracture repairs: such as intramedullary nailing, plate fixation, and external fixation
Arthroscopy: a minimally invasive surgical procedure that uses a small camera to view the inside of a joint
Tendon and ligament repairs and reconstruction
Amputation
Related Medical Specialties
While orthopaedic surgeons are experts in the structure and function of the bones, joints, ligaments, tendons, muscles, and nerves, there are other medical specialties that also play a role in the care of patients with musculoskeletal conditions.
Physical medicine and rehabilitation: Physical medicine and rehabilitation (PM&R) physicians, also known as physiatrists, specialize in the diagnosis and treatment of musculoskeletal conditions, including injuries and chronic pain. They use a combination of physical therapy, medication, and other nonsurgical treatments to help patients recover function and improve their quality of life.
Rheumatology: Rheumatologists specialize in the diagnosis and treatment of conditions that affect the joints, muscles, and bones, such as arthritis and osteoporosis. They work closely with orthopaedic surgeons to manage patients with these conditions and to help prevent or delay the need for surgery.
Physical therapy: Physical therapists work with patients to help them recover from injuries and surgeries, improve their strength and flexibility, and reduce pain. They use a combination of exercises, stretches, and manual techniques to help patients regain function and improve their quality of life.
Anesthesiology: Anesthesiologists administer anesthesia and monitor vital signs of patients during surgery. They work closely with orthopaedic surgeons to ensure that patients are comfortable and safe during their procedures.
Pain medicine (formerly pain management): Pain management specialists work with patients to manage chronic pain caused by musculoskeletal conditions, such as arthritis and back pain. They use a combination of medication, interventional procedures, and other therapies to help patients manage their pain and improve their quality of life.
Medical-Legal Cases Involving Orthopaedic Surgery
Medical-legal cases involving orthopaedic surgery can arise due to a variety of reasons, including allegations of malpractice, failure to diagnose, or misdiagnosis. As musculoskeletal injuries are likely the most frequent reason people sue in personal injury, orthopaedic surgeons are one of the most frequently required physicians needed in litigation.
For example, after knee replacement surgery, a patient complaining of persistent and excessive pain was later found on reoperation to have a misaligned implant. In another, a patient complained of symptoms of a rotator cuff injury but was not timely operated to repair the damage resulting in worsening of symptoms. Allegations of leg length discrepancy occur in cases involving the correct prosthesis size. Postoperative joint infections are a very common source of malpractice litigation and those cases commonly raise issues in infectious disease. Claims of unnecessary arthroscopy are also common; in those cases, malpractice may be an issue along with billing fraud. Many times, orthopaedic surgeons are sued because the attorney gets the case reviewed by a generalist in orthopaedic surgery rather than a specialist (e.g., in orthopaedic spine, foot and ankle, upper extremity, pediatric) and, frankly, gets the wrong answer. This is one reason it is critical to get cases reviewed early and by the correct expert.