What is an Orthopedic Surgeon?

Two spine surgeons operating.
Two spine surgeons operating. BSIP/UIG/Collection:Universal Images Group/Getty Images

What is an Orthopedic Surgeon?

An orthopedic surgeon is a board certified MD with specialty training who is concerned with diseases and injuries affecting the musculoskeletal system. 

The musculoskeletal system is responsible for the mechanical aspects of being able to move.  It consists of your soft tissue (ligaments, muscles and tendons) and your bones.  The American Academy of Orthopedic Surgeons includes nerves on this list as well, although many people feel more comfortable turning to neurosurgeons for complex spine surgery where nerves are involved.

 

Related: What is a Neurosurgeon?

An orthopedic surgeon is trained to treat all joints in the body but many choose to specialize.  Some are “hip guys,” or “knee guys,” while others specialize in spine.  A review published in the May 2015 issue of the Journal of Bone and Joint Surgery found that sub-specialization among orthopedic surgeons has risen significantly in the last decade. The authors suggest that going for a fellowship in spine surgery is not a waste of time for orthopedists; post training, 85% of procedures they performed were on the spine.  This number is up from previous decades, the authors report.

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While many people associate a visit to the orthopedist’s office with impending surgery, the range of things one can do for you is wider than that. You might see an orthopedic surgeon for a 2nd or 3rd opinion, or to get a diagnosis and non-surgical treatment.

As with most doctor’s visits, a trip to an orthopedist starts with a medical interview and a physical exam. The doctor will likely order diagnostic tests such as x-ray, MRI, blood or other as well.

From there, she may prescribe pain medication or a home exercise program, or refer you to a physical therapist.

  Or, she may send you home with information that will help you manage your injury or condition.

Reasons an orthopedic surgeon might refer you to physical therapy include, according to a survey that was published in the journal Archives of Orthopedic Trauma Surgery, strength training, gait training, to offset a loss of range of motion, or if you’ve failed to progress in your healing.

Interestingly, the survey revealed that resident surgeons, as well as surgeons who had been practicing their craft for over 20 years were the least likely to refer their trauma patients to physical therapy, saying they viewed PT as less important in cases of orthopedic trauma.  Residents indicated they felt that simply prescribing a home exercise program to their patient was good enough for achieving the intended improvement outcomes.

Orthopedic Surgery

And then, of course, there’s the surgery.  Orthopedic surgeons routinely perform arthroscopy  which uses inserted cameras and equipment to address problems inside a joint.

 Typically, though, this type of procedure is limited to the extremities, i.e., shoulders, knees, hips, etc.  Orthopedic surgeons also routinely perform joint replacement surgery, as well as internal fixation, which is surgery to help mend broken bones.

As far as spine surgery goes, an orthopedist's perform fusion, a very standard operation in which two adjacent vertebra are welded together with the use of bone grafts and/or instrumentation.  Instrumentation is a term that refers to small devices such as metal rods or plates that are implanted in vertebrae to give the spine stability while the bones knit together.

Orthopedic surgeons sometimes perform scoliosis corrections surgery, as well.

Sources:

Dusik, C., Buckley, R., Robertson-More, C. Orthopedic surgeon perspectives on appropriate referral of trauma patients to physical therapy (PT). Arch Orthop Trauma Surg. May 2013. Accessed: Feb 2016. http://www.ncbi.nlm.nih.gov/pubmed/23443530

Orthopaedics. OrthoInfo website. AAOS. Accessed Feb 2016. http://orthoinfo.aaos.org/topic.cfm?topic=a00099

Horst, P., Choo, K., Bharucha, N., Vail, T. Graduates of Orthopaedic Residency Training Are Increasingly Subspecialized: A Review of the American Board of Orthopaedic Surgery Part II Database. J Bone Joint Surg Am. May 2015. Accessed Feb 2016. http://www.ncbi.nlm.nih.gov/pubmed/25995502

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