Orthopedic surgery is the medical discipline focused on the diagnosis, correction, prevention, and treatment of patients with skeletal deformities, disorders of the bones and joints, and injuries to the musculoskeletal system. This specialty is dedicated to restoring function and mobility, helping people maintain active lifestyles. Orthopedic care addresses a wide spectrum of problems, ranging from sudden, traumatic sports injuries to long-term issues like chronic joint degeneration. The field employs both advanced surgical techniques and non-operative interventions.
What Orthopedic Surgeons Treat
The scope of an orthopedic surgeon’s practice is defined by the musculoskeletal system, which encompasses the body’s bones, joints, ligaments, tendons, muscles, and nerves. These interconnected structures are responsible for movement, stability, and providing the body’s framework. An orthopedic surgeon’s primary role is to manage issues that compromise the function, stability, or comfort of this system.
This management involves a comprehensive approach that includes diagnosis, treatment, and rehabilitation to restore movement and strength. While orthopedic surgeons are trained to operate, they also frequently utilize non-surgical methods to treat conditions affecting these structures. Their focus is generally on mechanical problems, such as those caused by injury, congenital defects, or wear-and-tear, distinguishing their role from rheumatologists who primarily manage systemic, inflammatory musculoskeletal diseases like rheumatoid arthritis.
Common Conditions and Injuries
Orthopedic specialists address a broad range of specific problems. One major category includes fractures and trauma, which are breaks in bones from high-impact events or stress. Injuries to soft tissues are also common, such as sprains (tears to ligaments) and strains (affecting muscles or tendons).
Degenerative conditions form another large part of orthopedic practice, most notably osteoarthritis, where the protective cartilage in joints like the knee or hip wears down over time. Sports-related injuries frequently seen include anterior cruciate ligament (ACL) tears in the knee and rotator cuff tears in the shoulder. Chronic issues like carpal tunnel syndrome and congenital deformities like scoliosis or clubfoot are also managed within this field.
Surgical and Non-Surgical Treatments
Orthopedic surgeons are trained in a wide variety of therapeutic options. Non-surgical treatments are typically the first line of defense for many musculoskeletal problems, including prescribing anti-inflammatory medications to manage pain and swelling.
Surgeons also frequently use injections to deliver concentrated medications directly to the site of injury or degeneration. Corticosteroid injections provide temporary relief from inflammation. Viscosupplementation involves injecting gel-like hyaluronic acid into a joint, such as the knee, to improve lubrication in cases of osteoarthritis. Physical therapy is also fundamental, guiding patients through targeted exercises to rebuild strength, flexibility, and range of motion.
When non-surgical options no longer provide adequate relief or when the injury is acute and severe, surgical intervention becomes necessary. Joint replacement surgery, or arthroplasty, is a common procedure where a damaged joint surface is removed and replaced with an artificial implant made of metal, plastic, or ceramic. Minimally invasive techniques, such as arthroscopy, involve inserting a small camera and instruments through tiny incisions to diagnose and repair joint issues like torn cartilage or ligaments.
Other procedures include internal fixation, which uses metal plates, screws, or rods to stabilize complex bone fractures during the healing process. Soft tissue repair focuses on reattaching torn tendons or ligaments, such as repairing a torn Achilles tendon or reconstructing a damaged ACL. Osteotomy is a reconstructive procedure that involves cutting and reshaping bone, often performed to realign a joint and shift weight away from a damaged area.
Specializations in Orthopedic Surgery
Orthopedic surgery has become specialized, with most surgeons pursuing additional training to focus on a particular area of the body or a specific patient population. This allows them to develop expertise in complex techniques within their chosen niche.
- Hand and Upper Extremity Surgery: Focuses on the mechanics of the hand, wrist, forearm, elbow, and shoulder. Surgeons manage conditions like carpal tunnel syndrome, trigger finger, complex fractures, and tendon ruptures, often using microsurgery to restore fine motor function.
- Pediatric Orthopedics: Treats children from infancy through adolescence, addressing growth plate injuries, congenital deformities like hip dysplasia and scoliosis, and gait abnormalities. Treatment is tailored to account for the child’s ongoing skeletal development.
- Sports Medicine: Manages injuries related to athletic performance, often involving the knee and shoulder joints. Specialists perform arthroscopic surgery for ligament reconstructions (e.g., ACL repair) and meniscus tears, emphasizing a return-to-play philosophy.
- Spine Surgery: Addresses disorders of the neck and back, including degenerative disc disease, spinal stenosis, herniated discs, and scoliosis. Treatment ranges from decompression surgery to spinal fusion, often requiring collaboration with neurologists.
- Joint Replacement (Arthroplasty): Focuses on the reconstruction and replacement of damaged joints (hip, knee, shoulder, and ankle). Surgeons use implants to alleviate pain caused by severe arthritis or trauma and maximize post-operative mobility.
- Orthopedic Trauma: Specializes in the treatment of severe, complex fractures and injuries resulting from high-energy accidents. This involves the surgical stabilization of broken bones in the extremities, pelvis, and acetabulum, often in emergency settings.
- Musculoskeletal Oncology: Addresses benign and malignant tumors of the bones and soft tissues. Oncologists perform complex limb-sparing surgeries, requiring close collaboration with oncologists and radiation therapists to provide comprehensive cancer care.
The Education and Training Path
The path to becoming an orthopedic surgeon requires a sustained commitment to education and training. It begins with completing a four-year undergraduate degree, typically focused on pre-medical sciences. This is followed by four years of medical school to earn a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree.
After medical school, aspiring orthopedic surgeons must secure a position in an orthopedic surgery residency program, which lasts a minimum of five years. This residency provides intensive, hands-on training across all areas of the specialty, including trauma, joint replacement, and pediatric orthopedics. During this time, residents refine their surgical skills and participate in clinical research.
Many orthopedic surgeons pursue a fellowship after residency, which adds one to two years of focused training in a sub-specialty. Upon completion of all training, surgeons must pass written and oral examinations to become board-certified and obtain a state medical license to practice independently.
When to See an Orthopedic Surgeon
The decision to consult an orthopedic surgeon often depends on the severity and persistence of musculoskeletal symptoms. If you experience pain in a joint, muscle, or bone that does not improve after a few weeks of rest, ice, and over-the-counter medication, a consultation may be warranted. A sudden loss of function, such as the inability to bear weight or a significantly reduced range of motion, is a strong indicator for evaluation.
Acute, severe injuries, such as a suspected broken bone or a major ligament tear, should prompt immediate attention. A referral to an orthopedic specialist typically occurs after an initial assessment by a primary care physician or emergency room doctor. Persistent chronic pain that interferes with daily activities or sleep also signifies a need for specialized expertise.