General Orthopaedics
Orthopaedics (alternatively, orthopedics) is a medical specialty focused on the diagnosis and treatment of conditions, disorders, and injuries of the muscles, bones, joints, tendons, ligaments, and nerves. A doctor who specializes in this medical specialty is called an orthopaedic (alternatively, orthopedic) surgeon.
The word arthritis literally means “joint inflammation.” Arthritis refers to a group of more than 100 rheumatic diseases and other conditions that cause pain, stiffness, and swelling in joints. Rheumatoid arthritis is a disease that damages the lining surrounding our joints while also destroying our bones, tissue, and joints over time. Osteoarthritis is a progressive condition that slowly damages the cartilage surrounding the ends of bones and is common in the hip, knee, or spine.
Bursitis is an inflammation or irritation of a bursa, which is a fluid-filled sac located around a joint. Bursitis causes a reduction in or a loss of motion at the affected joint. Bursitis typically occurs in the heel, hip, knee, shoulder, or thumb.
Cartilage is a soft, rubbery, gel-like coating on the ends of bones, where they articulate, that protects joints and facilitates movement.
A ligament is an elastic band of tissue that connects bone to bone and provides stability to the joint.
A tendon is a band of tissue that connects muscle to bone.
Tendonitis, medically known as tendinitis, is an inflammation or irritation of a tendon. Chronic strain, overuse or misuse of a tendon leading to a repetitive stress injury, or a serious acute injury can lead to a weakness, tear, or swelling of the tendon tissue, resulting in pain and stiffness near the tendon. Tendonitis usually occurs in the elbow, hip, knee, shoulder, thumb, or wrist, but can occur anywhere there is a tendon.
The general rule of thumb is to use ice in the acute stage of an injury (within the first 24-48 hours), or whenever swelling is showing. Ice helps to reduce inflammation and swelling by decreasing blood flow to the area that is injured. The general guideline is to apply ice indirectly (not directly on the skin) for 20 minutes, remove the ice for at least 20 minutes, and repeat as necessary.
Heat is used to increase blood flow, which helps promote pain relief after inflammation and swelling subside. Heat is also used to assist in warming muscles up prior to exercise, any physical activity, or physical therapy.
Orthopaedic Specialists
An orthopaedic doctor, also known as an orthopaedist, is a medical doctor (M.D.) or a doctor of osteopathy (D.O.) who specializes in the musculoskeletal system—bones, joints, muscles, ligaments, tendons, and nerves.
Orthopaedic surgeons are specialized in the musculoskeletal system; many orthopaedists specialize in certain areas of the body, such as foot and ankle; hand and wrist; or back, neck, and spine. Additionally, orthopaedic doctors may focus on a specific field of orthopaedics, like pediatrics, sports medicine, or trauma.
Board-certified orthopaedic surgeons have successfully completed a minimum of 13 years of formal education:
Undergraduate: Four years of study in a college or university
Medical School: Four years of study in a school of medicine
Orthopaedic Residency: Five years of study at a major medical institution
Board-Certified, Fellowship-Trained Orthopaedic Surgeons Have Completed:
Undergraduate: Four years of study in a college or university
Medical School: Four years of study in a school of medicine
Orthopaedic Residency: Five years of study at a major medical institution
Fellowship Training: One year of specialized education in an accredited fellowship program
All orthopaedic surgeons continue their medical education yearly to stay current in orthopaedic knowledge and skills.
Once a doctor has completed an orthopaedic residency at a major medical institution, the American Board of Orthopaedic Surgery offers a written test to become board-eligible. If the written test is passed, the doctor becomes “eligible” to take the oral test, after two years in practice. When the doctor passes the oral exam, the doctor becomes “board-certified” and is considered a Diplomate of the American Board of Orthopaedic Surgery.
The intent of the certification process, as defined by the board members of the American Board of Medical Specialties, is to provide assurance to the public that a certified medical specialist has successfully completed an approved educational program and an evaluation, including an examination process designed to assess the knowledge, experience, and skills requisite to the provision of high-quality patient care in that specialty.
A fellowship-trained orthopaedic surgeon is a doctor who has completed a minimum of 13 years of education and has completed an additional year of specialty training in a specific field of orthopaedic surgery in an accredited fellowship program. There are fellowships in several areas of orthopaedics: foot and ankle; hand and wrist; and back, neck and spine. Additionally, orthopaedic surgeons may focus on a specific field of orthopaedics, like pediatrics, sports medicine, or trauma.
A physiatrist is a medical doctor specializing in nonsurgical pain management, physical medicine and rehabilitation, and neurological studies.
A primary care sports medicine doctor is an expert in the field of sports medicine. Either through advanced fellowship training or through years of clinical experience, a primary care sports medicine doctor has learned the skills to take care of athletes of all ages, sports, and levels of competition. Primary care sports medicine doctors often serve as team doctors to professional sports teams or are personal doctors to elite level athletes.
A physician assistant, commonly referred to as a PA, is a healthcare professional licensed to practice medicine with doctor supervision. Physician assistants can treat patients and write prescriptions. PAs are trained to recognize when patients need the attention of a supervising doctor or specialist. Physician assistants see patients in the office as well as assist the doctors in surgery.
A physical therapist is licensed by the state and specializes in therapy programs for musculoskeletal injuries and disorders, sports injuries, postoperative rehabilitation, and massage therapy.
An occupational therapist is licensed by the state and specializes in the treatment of the upper extremity (hand, wrist, elbow, and shoulder) and work injuries. The services provided by occupational therapists include patient education, joint range of motion, adaptive techniques, splinting, and workplace evaluations.
Tests & Treatments
Arthroscopic surgery is a surgical procedure that is commonly performed to diagnose and treat problems within the joint. By using high-tech cameras, the orthopaedic surgeon inserts a small instrument, called an arthroscope, into the joint.
The arthroscope contains a fiber optic light source and small television camera that allow the surgeon to view the joint on a television monitor and diagnose the problem, determine the extent of injury, and make any necessary repairs.
A bone density test is used to diagnose osteoporosis, which is a disease that causes weakening of the bones that can ultimately results in fractures. In the past, osteoporosis could only be detected after a person’s bone broke; however, by using a bone density test, it is possible to know one’s individual risk of breaking bones before one breaks.
A bone density test uses X-rays to measure the amount of calcium and other bone mineral packed into the segment of bone. Common areas that are tested using a bone density scan include the spine, hip, and forearm.
Corticosteroids, more commonly referred to as cortisone, is a steroid that is produced in the body naturally. Synthetically produced cortisone can also be injected into soft tissues and joints to help decrease inflammation.
While cortisone is not a pain reliever, pain may diminish as a result of reduced inflammation. In orthopaedics, cortisone injections are commonly used as a treatment for chronic conditions such as bursitis, tendonitis (medically referred to as tendinitis), and arthritis to reduce swelling, pain, and joint stiffness.
A computed tomography (CT) scan, also known as CAT scan, produces images that are similar in detail and in quality to an MRI; however, the CT scan takes a 360-degree picture of internal organs and the spine and vertebrae. CT scans provide cross-sectional views of the body and provide clearer imaging than an MRI.
An epidural is a steroid injection used to help decrease the inflammation of spinal nerves to help relieve pain in the neck, back, arms, and legs from conditions such as herniated discs, spinal stenosis, and radiculopathy. Cortisone is injected directly into the spinal canal, and some patients only need one injection to relieve pain; however, it normally requires two or three injections to provide significant pain relief.
A fusion is a procedure in which bones are fused together with bone grafts and internal devices (such as metal rods and screws) to heal into a single solid bone.
Internal fixation is a treatment to hold pieces of a broken bone in the correct position with metal plates, pins, or screws while the bone is healing.
Joint replacement surgery is a surgical procedure that is performed to replace an arthritic or damaged joint with a new, artificial joint, called a prosthesis. Joint replacements can be performed on every joint in the body, but most commonly performed in the knee, hip, shoulder, and elbow.
Joints contain cartilage, a soft, rubbery gel-like coating on the ends of bones, where they articulate, that protects joints and facilitates movement and over time, or if the joint has been injured, the cartilage wears away and the bones of the joint start rubbing together. As the bones rub together, bone spurs may form, and the joint becomes stiff and painful. Most people have joint replacement surgery when they can no longer control the pain with medication and other treatments and the pain is significantly interfering with their lives.
An X-ray is a procedure performed that uses a safe form of radiation to provide a two-dimensional picture of your body to use as a screening tool to evaluate for causes of many common disorders, such as bone breaks, joint and spine injuries or conditions, and arthritis or osteoporosis.
Magnetic Resonance Imaging, commonly referred to as an MRI, is an advanced technology that uses magnetic fields and radio waves (like microwaves and the AM and FM bands on your radio) to visualize the inner workings of the body.
The pictures produced by MRI help the radiologist clearly and accurately detect and define the differences between healthy and diseased tissues, especially in the soft tissues. It can reveal many health problems at their earliest, most treatable stages.
Non-steroidal anti-inflammatory drugs (NSAIDs) are non-prescription, over-the-counter pain relievers such as aspirin, ibuprofen, and naproxen sodium. They are popular treatments for muscular aches and pains, as well as arthritis and help in reducing swelling, pain, and joint stiffness.
Osteotomy is a procedure to correct bone deformity by cutting and repositioning the bone.
An outpatient surgery is a surgery that does not require the patient to stay in the hospital overnight; it is commonly known as an ambulatory surgery. Outpatient surgery has grown in popularity due to the improvement in technology.
Soft tissue repair is a treatment to mend or fix soft tissues, such as tendons or ligaments.
