Orthopedic Surgery
Overview
Orthopedic surgery tests and procedures help doctors diagnose, treat, and monitor problems affecting the bones, joints, muscles, ligaments, and tendons. These techniques play a key role in restoring mobility, relieving pain, and improving quality of life for patients dealing with injuries, chronic pain, or degenerative conditions.
Imaging tests like X-rays, MRIs, and CT scans show what’s happening inside the body, while other procedures such as bone scans or arthrograms help detect issues that may not appear on standard imaging. Diagnostic tools give important information to guide treatment decisions and surgical planning.
Understanding Orthopedic Surgery
Orthopedic surgeons correct problems with the musculoskeletal system. Common examples include joint replacement, fracture repair, and minimally invasive procedures for sports injuries. Before surgery, doctors perform various diagnostic tests such as X-rays, MRIs, and CT scans to determine the exact nature and location of the problem.
Based on the evaluation and imaging results, the orthopedic surgeon chooses the best treatment option. Some surgeries are elective, meaning the patient can plan them in advance, like knee or hip replacement.
Imaging and Diagnostic Tests
| Test Name | Purpose |
|---|---|
| X-ray | Detects fractures, arthritis, and bone disease. |
| MRI | Shows detailed images of bones, cartilage, and ligaments. |
| CT scan (Computed Tomography) | Offers cross-sectional images of bones and joints. |
| Bone scan | Checks for tumors, infection, or small fractures. |
| Bone density test | Measures bone strength for osteoporosis. |
| Ultrasound | Evaluates soft tissue, foreign bodies, and blood flow. |
| Arthrogram | Highlights joint spaces for cartilage and ligament evaluation. |
| Myelogram | Assesses spinal cord, nerves, and vertebrae. |
| Electromyogram (EMG) | Tests muscle and nerve activity. |
| Blood tests | Help identify inflammation, arthritis, or infection. |
Goals and Indications
The main goal of orthopedic surgery is to restore function and reduce pain. Indications for surgery include severe arthritis, fractures that do not heal with other treatments, birth defects, or injuries caused by accidents.
Surgery may be recommended if nonsurgical treatments, such as medication or physical therapy, do not provide sufficient relief. Elective procedures are scheduled when it is safe and convenient for the patient, while emergency surgeries are performed immediately after an injury.
Doctors evaluate the patient’s medical history, physical exam findings, and results from diagnostic tests to determine whether surgery is necessary. They consider the risks, benefits, and expected outcomes to select the most appropriate approach for each individual.
Common Types of Orthopedic Surgery
Orthopedic surgeons treat injuries and diseases of the bones, joints, and muscles. Many procedures aim to relieve pain and restore movement. Each surgery is chosen based on the patient’s needs and health.
| Surgery Name | Area Treated | Main Purpose |
|---|---|---|
| Knee Replacement | Knee | Reduce pain, restore movement |
| Hip Replacement | Hip | Improve joint function |
| ACL Reconstruction | Knee ligament | Stabilize knee |
| Shoulder Replacement | Shoulder | Increase range of motion |
| Spinal Fusion | Spine | Reduce pain, increase stability |
| Fracture Repair | Various bones | Fix broken bones |
- Knee Replacement: Surgeons replace damaged parts of the knee joint with artificial parts.
- Hip Replacement: Surgeons replace worn or injured hip joints with metal or ceramic parts.
- ACL Reconstruction: Surgeons replace a torn ligament in the knee with a new ligament.
- Shoulder Replacement: Surgeons replace damaged shoulder joints with artificial materials.
- Spinal Fusion: Surgeons join two or more bones in the spine together.
- Fracture Repair: Surgeons use metal plates, rods, or screws to hold broken bones in place.
Other operations fix tendon injuries, remove bone spurs, or repair torn cartilage. Each procedure aims to improve the person’s ability to move and complete daily activities.
Surgical and Repair Procedures
- Arthroscopy: Surgeons use minimally invasive techniques to diagnose and treat joint issues
- Joint Replacement: Surgeons operate when arthritis or damage is severe (hips, knees, shoulders, etc.)
- Ligament Reconstruction: Surgeons repair injuries like anterior cruciate ligament (ACL) tears
- Bone Grafting: Surgeons repair bone loss or defects using healthy bone tissue
- Meniscus Repair and Transplantation: Surgeons restore function from cartilage tears in the knee
- Spinal Fusion and Decompression: Surgeons address spinal instability and nerve compression
- Nerve Surgeries: Surgeons repair or graft nerves damaged by injury or disease
- Tumor Removal: Surgeons excise bone or soft tissue tumors
- Prosthesis Implementation: Surgeons replace damaged bones or joints with artificial parts
Preoperative Evaluation for Orthopedic Surgery
A careful preoperative evaluation helps doctors lower risks and plan for a successful surgery. Tests and scans check the patient’s overall health and assess the specific problem that needs surgery.
Essential Preoperative Tests
Most patients see their primary care physician for a history and physical examination before surgery. This visit checks for risk factors such as heart disease, diabetes, or lung issues. Common baseline tests include:
| Test Name | Purpose |
|---|---|
| Complete blood count (CBC) | Checks for anemia or infection |
| Electrolytes | Monitors fluid and mineral balance |
| Blood glucose | Screens for diabetes |
| Coagulation studies | Assesses blood clotting ability |
| Electrocardiogram (ECG) | Looks for heart problems |
| Chest X-ray | Evaluates lungs and heart |
Older adults or people with ongoing health problems might need more tests. Results help guide care, especially if there are risks for side effects or problems during surgery.
Advanced Imaging and Diagnostic Procedures
When planning orthopedic surgery, doctors often order advanced imaging to see the exact location and extent of joint or bone damage. The main scans used are MRI, CT, and ultrasound. MRI provides clear images of soft tissues like ligaments and discs. CT scans give detailed views of bones.
Ultrasound allows doctors to look at soft tissues and fluid without using radiation. Surgeons use these scans to check for hidden injuries or complications and to plan the best approach. In some cases, additional diagnostic tools, such as bone scans, help diagnose infection or cancer.
Medications and Perioperative Management
Before orthopedic surgery, doctors review all the medications a patient takes. This includes prescription drugs, over-the-counter medicine, vitamins, and supplements. A careful medication history helps reduce surgery risks. Doctors may recommend stopping or adjusting some medicines before surgery.
For example, aspirin can increase the risk of bleeding, so doctors often advise stopping it several days before the procedure, unless needed for certain conditions. An anesthesiologist checks the patient’s medication list to avoid drug interactions. They may also suggest changes to usual routines, such as not eating, drinking, or taking some drugs on the day of surgery.
Common Steps in Perioperative Medication Management
- Review all medicines and supplements.
- Stop or adjust drugs that affect bleeding, like aspirin.
- Discuss blood thinners or steroids with the doctor.
- Follow instructions for fasting and which medicines to take on surgery day.
| Medication Type | Usual Action Before Surgery |
|---|---|
| Aspirin | Often stopped to lower bleeding risk |
| Blood Thinners | Adjusted or stopped as directed |
| Steroids | May be continued or adjusted |
| Herbal Supplements | Usually stopped |
Patients should always talk to their healthcare team about any medication changes. They should not stop or change any medicine without clear instructions from their doctor or nurse.
Preventing and Managing Surgical Complications
Surgical complications can happen even with careful planning. In orthopedic surgery, the main concerns are cardiac, pulmonary, and other postoperative problems. Understanding ways to lower these risks is important for each patient.
Steps to Prevent Complications
- Keep medical conditions like diabetes and high blood pressure under control.
- Stop smoking before surgery to help lung and heart health.
- Follow preoperative instructions from your healthcare provider.
- Use special devices, such as compression stockings, to lower blood clot risk.
Cardiac complications may include irregular heartbeat or heart attack during or after surgery. Doctors monitor the heart carefully and may order tests before the operation. Medications support heart function and prevent clots. Pulmonary complications often involve breathing problems or pneumonia.
Early movement, deep breathing exercises, and sometimes the use of incentive spirometers help keep the lungs healthy. Postoperative complications, such as infections or joint stiffness, require close observation. Keeping the surgical site clean and following activity guidelines can help prevent problems.
If any swelling, redness, or pain increases, patients should contact their surgeon right away. Open and clear communication between the patient and the surgical team is key.
What to Expect Before, During, and After the Surgery?
Before orthopedic surgery, the care team reviews the patient’s medical history and checks vital signs like blood pressure and temperature. Blood tests or imaging like X-rays may be needed. The team shows the patient how to clean and care for the surgical area. Doctors also discuss any medicines the patient needs to stop or start before surgery.
It is important to arrange transportation, as driving afterward is usually not allowed. During surgery, the team tracks the patient’s vital signs closely and follows a plan made before the procedure. Family members may get updates from a patient liaison in the waiting area. Key points during surgery:
- Surgeon follows a set procedure
- Anaesthesia keeps the patient comfortable
- Safety checks are completed to reduce risks
After the operation, nurses show the patient how to take care of the wound and change the bandage. Washing hands before touching the surgical area is important. Watch for these signs and tell the doctor if they appear:
- Redness or swelling around the wound
- Drainage or strange smell
- Fever or pain that gets worse
Most patients need rest and time off normal activities. The doctor gives advice about moving, pain control, and when to return for check-ups. A quick guide:
| Step | What Happens |
|---|---|
| Before | Tests, medicine review, prepare for surgery |
| During | Monitoring, surgery, updates to family |
| After | Wound care, follow-up, activity advice |
How Should You Prepare for Surgery?
tart preparing for orthopedic surgery by following your doctor’s instructions closely. Talk with your healthcare team about any medications, allergies, or previous reactions to anesthesia.
Eat a healthy diet with enough protein, fruits, and vegetables to support healing. Your doctor may order blood tests to check your nutritional status if needed. Many doctors ask patients to stop smoking and av
Common Steps to Prepare
- Arrange transportation for surgery day and recovery.
- Set up a recovery area at home with needed supplies.
- Prepare comfortable, loose-fitting clothes.
- Follow any fasting guidelines about when to stop eating or drinking.
Pre-Surgery Checklist Example
| Task | Completed? |
|---|---|
| Reviewed medicines | ☐ |
| Blood tests done | ☐ |
| Quit smoking or alcohol | ☐ |
| Prepared home for return | ☐ |
| Arranged transportation | ☐ |
Family or friends can provide support to ease stress and boost confidence before surgery. Some people find it helpful to join support groups or talk with others who have had similar procedures. Doctors may give exercises to improve strength before surgery. Following these plans helps with recovery and reduces the risk of problems.
Recovery Times
Recovery after orthopedic surgery depends on the type of procedure, the patient’s health, and how closely they follow aftercare instructions.
Average Recovery Times for Common Surgeries
| Procedure | Average Recovery Time |
|---|---|
| Total Knee Replacement | About 12 weeks |
| Hip Replacement | 3 to 6 months |
| Arthroscopic Knee Surgery | 1 to 2 months |
| Shoulder Surgery | 3 to 6 months |
| Lumbar Spinal Fusion | 3 to 6 months |
Some patients may recover faster or slower. Physical therapy and home exercises help support healing. Doctors usually recommend rest, activity restrictions, and regular follow-ups. Keep the wound clean and follow all care instructions. Some clinics use Enhanced Recovery After Surgery (ERAS) programs to reduce pain, improve outcomes, and shorten recovery time.
Signs of good recovery include reduced pain and increased movement. Swelling and stiffness may take weeks or months to fully resolve. Following your care team’s advice is key—missing appointments or not following instructions can delay healing.
Role of Rehabilitation in Orthopedic Surgery
Rehabilitation plays a key part in helping patients regain strength, movement, and function after surgery. Most people begin rehab soon after their procedure. A physical therapist develops a customized plan, which may include exercises, stretches, and balance training. Therapists may also use equipment or aids to improve mobility and safety. Main goals of rehabilitation include:
- Reducing pain and swelling.
- Restoring joint movement and muscle strength.
- Improving walking or daily activities.
- Preventing stiffness and complications.
Rehabilitation may take place in a hospital, clinic, or at home, depending on the surgery and overall health. Sessions often begin gently and grow more intensive as healing continues. ERAS programs are also used in orthopedic care to support faster recovery and a quicker return to daily life.
Table: Common Rehabilitation Activities
| Activity | Purpose |
|---|---|
| Range-of-motion | Improve flexibility |
| Strength training | Build muscle strength |
| Gait training | Improve walking pattern |
| Pain management | Control pain and swelling |
Physical therapists work closely with patients, teaching correct movement and watching for signs of problems. With steady progress, most patients improve over weeks to months.
