What is Orthopedic Surgery?
Orthopedic surgery is an operative procedure performed by an orthopedic specialist or orthopedic surgeon. Its purpose is to treat injuries and diseases of the spine and musculoskeletal system of the body.
This complex system includes bones and joints, ligaments, tendons, muscles, and nerves, allowing a person to move, work, and be active. Surgical procedures can also correct nervous system problems.
In practice, orthopedic surgery consists of various procedures. For example, installing implants, repairing broken bones, and restoring the function of damaged or deformed joints.
An orthopedic surgeon will perform a thorough evaluation of the patient to plan the most appropriate treatment. Either through a conservative (non-surgical) approach or surgery.
Purpose and Indications of Orthopedic Surgery
The main goal of orthopedic surgery is to restore normal function to the damaged musculoskeletal system. This includes the ability to move, walk or use the affected limb.
So, what do orthopedic surgeons treat? Below are some of the things that doctors do to restore normal function to a damaged musculoskeletal system:
- Joint replacement
Joint replacement surgery is done to replace a damaged joint with an artificial joint. For example, spine surgery . The procedure can help sufferers move without pain and stiffness.
After joint replacement, patients can return to their normal activities. This surgery can improve quality of life and overall health.
- Bone cutting
Bone cutting procedures aim to align and reshape bones and joints. For example, the jaw, elbows, spine, shoulders, hips, knees, legs, toes and feet.
There are many surgical techniques and variations of the technique. The surgeon will discuss the best option for your specific bone problem, with minimal pain and discomfort.
- Treat and diagnose structural joint problems
The method is a minimally invasive procedure performed through small incisions. Some of the conditions include arthritis, rotator cuff tears, carpal tunnel syndrome, and anterior cruciate ligament tears.
- Overcoming nervous disorders
If a musculoskeletal problem is affecting the nerves that run through the area, orthopedic surgery may be performed. The goal is to relieve pressure and restore normal nerve function.
This is done by connecting the damaged nerve ends (primary or end-to-end nerves). If the nerve cannot be reconnected, the doctor will perform a nerve graft.
- Jointing of the wrist bones
Surgery is used to treat severe arthritis or wrist injuries. It is usually done when other non-surgical treatments have failed to resolve the disorder.
The procedure involves part or all of the wrist. The main goal is to reduce pain and improve grip strength.
- Lengthen limbs
Limb lengthening is a surgical treatment that can reduce, or correct, differences in limb length. This treatment also stretches the surrounding muscles, tendons, and ligaments.
- Hip labral repair
A labral tear is an injury to the tissue that holds the ball and socket of the hip together. This problem causes pain, decreased range of motion in the hip, and a sensation of a locked hip.
The cause is excessive traumatic injury or abnormality in the shape or alignment of the hip bone. If surgery is needed, doctors usually do it with a minimally invasive approach.
Benefits of Orthopedic Surgery
The procedure is useful for treating disorders caused by accidents, trauma, injuries or chronic conditions. To overcome these problems, surgeons perform several steps, such as:
- Diagnosis of injury or disorder.
- Treatment with medications, injections, casting, bracing, surgery, or other options.
- Rehabilitation by recommending exercises or physical therapy to restore movement, strength, and function.
- Prevention by providing information and care plans to prevent injury or slow the progression of disease.
Groups Who Should Undergo Orthopedic Surgery
The procedure needs to be done by people who have congenital abnormalities, such as scoliosis or leg injuries, as well as elderly people with mobility problems or movement disorders.
You can also see an orthopedic surgeon if you have musculoskeletal symptoms and don’t know the cause. Some of these musculoskeletal symptoms and conditions include:
- Constant or occasional pain that lasts more than three months.
- Range of motion becomes limited.
- Symptoms that affect daily activities.
- Difficulty standing or moving.
- An acute injury that does not improve with simple treatments, such as ice or pain relievers.
Before undergoing surgery, schedule an appointment with your doctor to get a proper diagnosis or treatment recommendations. Seeing an orthopedic surgeon does not always result in surgery.
Because of their expertise, orthopedic surgeons are qualified to determine whether surgery is the best option. They will determine which procedure will provide the best results.
In addition, there are some musculoskeletal injuries that are quite dangerous and require immediate medical attention. Go to the nearest emergency room (ER) immediately if you experience:
- Broken bones, especially if they are open fractures (the bone is visible) or you have multiple fractures.
- Severe pain or other concerning symptoms, such as fever, inability to bear weight or move a limb, severe bleeding, or loss of consciousness.
To find out when a dislocation requires surgical treatment , you can first check your condition with a doctor who can determine the right treatment steps.
Orthopedic Surgery Alert
There are some groups who should not undergo orthopedic surgery. This is to prevent the risk of side effects during and after the procedure.
- Pregnant women.
- Having an allergy to anesthetics.
- Have an allergy to latex.
- Taking regular medication due to chronic illness.
- Currently taking blood thinners.
Types of Orthopedic Surgery Operations
The most common orthopedic surgical procedures are as follows:
- Arthroscopy
This is a minimally invasive technique that doctors use to diagnose and repair damaged joint tissue. For example, torn ligaments or floating cartilage.
This procedure will use an arthroscope. This is a tool equipped with a tiny camera and surgical instruments that are inserted through small incisions in the skin near the joint.
- Osteotomy
The method involves cutting and changing the shape of the bone. The main goal is to repair the inflamed knee joint. The procedure can also be performed on the pelvis, jaw, chin, toes, and spine.
- Arthroplasty
This is a type of orthopedic surgery to replace a joint usually due to osteo and rheumatoid arthritis. The procedure involves replacing the entire joint, such as a knee replacement or hip replacement.
- Repair network damage
This includes treatment for damaged muscles, torn ligaments or tendons. While muscle strains and sprains can be treated with rehabilitation or surgery if the case is more serious.
- Corrective surgery
Orthopedic procedures are often used by doctors to correct structural abnormalities or musculoskeletal disorders, especially the spine and legs. This is necessary when the condition affects mobility, limits function, or causes long-term problems if left untreated.
Osteotomy and fusion surgery are two such orthopedic surgical procedures. Osteotomy involves cutting and repositioning bones to correct deformities, while fusion surgery, as the name suggests, involves welding or fusing bones together.
- Ligament reconstruction
Ligament reconstruction is a surgical procedure that can repair, tighten, or replace torn ligaments. Ligaments are connective tissues that hold bones together at joints. Ligaments provide stability, which helps prevent excessive movement that can lead to dislocation.
Well, all the above mentioned orthopedic surgeries are performed using local or general anesthesia. For major surgeries like knee replacement, the patient may be asked to donate blood (or prepare) in case a transfusion may be needed during the surgery.
Orthopedic Surgery Preparation
There are several things that patients need to prepare before undergoing orthopedic surgery. Here are some of them:
- Generally, patients are asked to fast first.
- Tell your doctor about all the medicines, over-the-counter medicines, herbs, and vitamins you are taking.
- Tell your doctor a list of allergies and drug and food sensitivities.
- Bring your insurance card (if you have one).
- The doctor will review, discuss, and then ask the patient to sign a consent form.
- The doctor will confirm the surgical site and mark the area on the skin.
- Give your cell phone, reading glasses, hearing aids, and other personal items to a friend or family member before entering the operating room.
Orthopedic Surgery Procedures
The doctor will perform orthopedic surgical procedures according to their type. Here are some examples:
1. Arthroscopy
Arthroscopy is an outpatient procedure, meaning patients can go home the same day as the procedure. The procedure takes about an hour. The doctor will:
- Make two or three small incisions (about the size of a buttonhole) in the treatment area.
- Inserting an arthroscope and other small surgical instruments into small incisions.
- Viewing images sent from the arthroscope to a monitor to examine joints, cartilage, ligaments, and tendons.
- Making a diagnosis or treating a problem through surgery by referring to images on a monitor screen.
- Withdraw the arthroscope and surgical instruments from the patient.
- Close the incision with stitches and a bandage.
2. Arthroplasty
Doctors use different techniques depending on the type of surgery and the joint area. Just before the procedure, the patient will receive anesthesia to minimize discomfort.
Furthermore:
- The doctor even makes an incision and removes the damaged joint.
- Then they replaced it with an artificial joint.
- The doctor uses stitches, staples, or surgical glue to close the incision and bandage it.
Surgeons can perform some joint replacement procedures using minimally invasive techniques. These techniques use fewer incisions and special tools.
Recovery time for minimally invasive procedures can be shorter than for conventional procedures. The surgeon will recommend the most appropriate procedure for the patient.
3. Osteotomy
Recovery depends on the type of osteotomy, the specific surgical technique, and the amount and severity of bone damage. Patients may also require a cast, splint, or crutches to limit movement of the bone and joint.
Doctors do this by:
- Giving anesthesia or anesthetic to provide a numbing sensation to minimize discomfort.
- The surgeon will make an incision, then continue by cutting the problematic part of the bone.
- The doctor will fill the empty part with metal plates and bolts. It can also be done with bone graft tissue.
- Finally, the doctor will cover the incision with a bandage.
4. Ligament reconstruction
First, the doctor will give you anesthesia to make you feel comfortable. Next, the doctor will do the following steps:
- The surgeon will access the problem area by making an incision using minimally invasive techniques.
- Ligament replacement can be performed using autografts (ligaments transferred from elsewhere in the body), or allografts (transferred from a donor or cadaver).
- Once completed, the doctor will stitch the incision area and cover it with sterile gauze.
- Patients need to stay for a few days after the procedure. Here, the doctor will monitor until they are completely healed.
5. Carpal tunnel surgery
Just like any other surgical procedure, first, the doctor will give you anesthesia to numb your body. Next, here is what the doctor will do in carpal tunnel surgery:
- Make an incision in the palm of the hand, above the carpal tunnel ligament.
- Cutting the ligament relieves pressure on the median nerve. Surgery can be done by making a single incision on the palm side of the hand, or by making several small incisions.
- Once completed, the doctor will close the incision area.
- The medical team will take the patient to the recovery room. The recovery process varies depending on the complexity of the surgery and the individual.
Usually a doctor or physiotherapist recommends physical therapy. This step aims to help recovery and restore strength and flexibility in the hand and wrist.
After Orthopedic Surgery
After the procedure, a cast is usually placed to protect the repaired area. The amount of time you will need to recover depends on the procedure you had.
Although patients can often go home within a few days, it usually takes a few days to weeks to allow the bones and ligaments to regain their full strength.
Therefore, you should not do any heavy activity on the injured area unless the area has fully recovered.
In addition, after orthopedic surgery, patients usually also require rehabilitation. The goal is to restore full movement and function in all affected parts.
That’s why orthopedic surgeons work closely with physical therapists and occupational therapists to help patients improve their range of motion and return to everyday activities.
Complications and Side Effects of Orthopedic Surgery
There are several potential side effects that may occur in patients, including:
- Wound infection
Wound infections occur when germs enter the surgical wound. To prevent this, doctors usually give antibiotics during surgery. This disorder is rare in patients with normal health.
- Bleeding
Some procedures, such as revision joint replacement or complex fracture management, carry an increased risk of bleeding. This risk can be minimized by changing the type of anesthesia and certain medications.
- Nerve injury
Symptoms may include partial or complete loss of skin sensation or muscle strength. These side effects are usually temporary and may improve over time.
- Large blood vessel injury
Damage to large blood vessels is very rare but can be fatal. This disorder can lead to gangrene or tissue death and loss of limbs.
- Deep vein thrombosis
Deep vein thrombosis refers to blood clots that form in the deep veins of the legs. Common causes are immobility and blood backing up to the heart.
Other side effects may include:
- High fever.
- Swelling in the area of surgery.
- The affected area feels stiff and tingly.
- Discharge of pus or foul-smelling fluid.
- Severe pain that doesn’t get better.
- Allergic reaction to anesthetic injection.
- Stiffness in the joints.
- Tissue or nerve damage in the surgical area.
- Repetitive damage to bones, joints, tendons, and ligaments.
Side Effects That Require Treatment
Seek medical help immediately if you experience any problems during the recovery process. Signs may include:
- High fever.
- There is a smelly discharge from the surgical area.
- Swelling and redness in the area of the surgery.
- Stiffness and tingling in the area of the operation.
- Severe pain that does not improve within several weeks.
Places to Perform Orthopedic Surgery
Orthopedic surgery can usually be done at a hospital or orthopedic clinic. You can make an appointment with a surgical specialist to find out more about the procedure.
Orthopedic Surgery Costs
The price of a fracture surgery is around 1,33,580/- in Indian Rupees. The orthopedic cost includes the cost of the procedure, medicine, hospitalization, and consultation. However, the cost can vary depending on the place you choose.