Orthopedics is a branch of medicine that focuses on the care of the musculoskeletal system. This system consists of muscles, bones, joints, ligaments, and tendons.
A person who specializes in orthopedics is known as an orthopedist. Orthopedists use surgical and nonsurgical approaches to treat musculoskeletal issues, such as sports injuries, joint pain, and back problems.
This article provides an overview of orthopedics. It outlines the different conditions that orthopedists treat and explains what a person can expect during an orthopedic appointment.
The article also covers the qualifications necessary to become an orthopedist.
Orthopedics, also known as orthopedic surgery, is a branch of medicine that focuses on the care of the skeletal system and its interconnecting parts. These parts include the following:
There are generally two types of orthopedists: surgical and nonsurgical. The former are called orthopedic surgeons, while nonsurgical orthopedists include physiatrists and physical medicine and rehabilitation specialists.
An orthopedist often works as part of a larger orthopedic treatment team. This team may include:
- physician assistants
- nurse practitioners
- occupational and physical therapists
- athletic trainers
Orthopedists treat a wide variety of musculoskeletal conditions. These conditions may be present from birth, or they may result from an injury or age-related wear and tear.
Below are some of the most common conditions that an orthopedist may treat:
- joint pain from arthritis
- bone fractures
- soft tissue injuries, which are those that affect muscles, tendons, and ligaments
- back pain
- neck pain
- shoulder pain and problems, such as bursitis
- carpal tunnel syndrome
- overuse and sports injuries, including sprains, tendinitis, meniscus tears, and anterior cruciate ligament (ACL) tears
- congenital conditions, such as clubfoot and scoliosis
- bone cancer
A person may wish to ask the following questions:
- What nonoperative treatments are available?
- Am I a good candidate for this procedure?
- What surgical methods will the surgeon use?
- What are the risks or potential complications of the procedure?
- What are the benefits of the procedure?
- How long will the benefits last?
- What is the success rate of this procedure?
- What will I need to do to get the best results?
- How and where will the surgeon perform the procedure?
- If complications occur, how will the surgeon fix them?
A vital decision that a person has to make before an orthopedic surgery is choosing a licensed and accredited surgeon from a competent professional association.
It is important to check that a surgeon:
- is a graduate of an accredited medical school
- has completed a residency in orthopedic surgery
- has certification with the American Board of Orthopedic Surgery (ABOS) or the American Osteopathic Board of Orthopedic Surgery (AOBOS)
- has the experience and sufficient professional training to perform the procedure
- works only in accredited medical facilities
- adheres to medical education requirements, standards in patient safety, and a strict code of ethics
A person can use the ABOS and American Academy of Orthopedic Surgeons (AAOS) websites to find an orthopedic surgeon.
During the first appointment, the orthopedist will work to diagnose the person’s condition. This can include conducting a physical examination and taking X-rays.
In some instances, the doctor may carry out in-office tests or order additional tests to confirm the diagnosis.
The process of diagnosis will also involve the orthopedist:
- asking about the person’s symptoms
- reviewing the person’s medical record to gather more information about their medical history and overall health
- carrying out a physical examination
- reviewing any X-rays that the person underwent before the appointment
The orthopedist may also order additional diagnostic tests. These may include:
An orthopedist may perform an in-office procedure to help diagnose and treat certain musculoskeletal conditions.
The American Academy of Orthopaedic Surgeons states that X-rays are “the most common and widely available diagnostic imaging technique.”
An orthopedist will often perform X-rays in-office, allowing them to diagnose certain conditions during a person’s appointment. They may also deliver injections, such as corticosteroid injections to relieve inflammation, and perform ultrasound scans.
Some acute injuries, such as fractures and dislocations, require the orthopedist to manipulate the bone or joint and immobilize it using a splint, cast, or brace.
In addition to in-office treatments, a person’s orthopedist may recommend one or more of the following to treat chronic musculoskeletal conditions:
- over-the-counter anti-inflammatory medications
- rehabilitation and physical therapy
- home exercise programs
- mobility aids
- surgery, when other treatments fail
An orthopedist may specialize in a particular branch of orthopedic medicine. These branches are called subspecialties.
Some orthopedic subspecialties include:
- hand and upper extremity
- foot and ankle or podiatry
- orthopedic oncology, including tumor and cancer care
- pediatric orthopedics
- sports medicine
- spine surgery
- trauma surgery
- joint replacement surgery
The sections below examine some surgical procedures that an orthopedist may perform as part of their work.
Total joint replacement (TJR)
TJR surgery is one of the most common elective surgeries in the United States.
During a TJR, or arthroplasty, the doctor will remove the worn-out surfaces of a damaged joint and use a prosthesis as a replacement to replicate the functions of a typical healthy joint.
Many people can perform daily activities more quickly after a total joint replacement.
Arthroscopic surgery is a minimally invasive procedure that uses an arthroscope to diagnose joint problems.
An arthroscope is a long, thin camera — about the size of a buttonhole — that an orthopedic surgeon will insert into a person’s joint, most commonly the knee or shoulder. The camera connects to a video monitor that allows them to see the inside of the joint.
The surgeon can then use several small, thin instruments to fix various problems by making minor additional incisions.
Arthroscopic surgery of the knee is the most common type of orthopedic surgery that takes place in the U.S. An orthopedist may perform arthroscopic surgery to repair common joint injuries, such as meniscus tears, ACL tears, and rotator cuff tears.
It can take 1 week to several months for a person to recover fully from an arthroscopy.
Fracture repair surgery
An orthopedic surgeon may recommend fracture repair surgery to restore the normal anatomy of a more severely broken bone. To stabilize the bone, they can use different types of implants. These include rods, plates, screws, and wires.
Following a fracture repair surgery, it is common for a person to lose muscle strength and range of motion in the injured area. However, the doctor will recommend specific exercises to restore normal muscle strength, joint motion, and flexibility.
Bone grafting surgery
In bone grafting surgery, an orthopedic surgeon uses bone from a person’s body or a donor to repair and strengthen diseased or damaged bones. They may also use a synthetic bone substitute and biological factors when natural bone grafts are unavailable.
During a spinal fusion surgery, the doctor will fuse two or more vertebrae to correct problems with the spine. This procedure allows the vertebrae to heal into a single, solid mass of bone.
An orthopedic spine surgeon may perform a spinal fusion for some back and neck problems, including scoliosis and injuries to the vertebrae or intervertebral disks.
To become an orthopedic surgeon, a person must:
- complete an undergraduate college degree
- graduate from an accredited medical school with a Doctor of Medicine or a Doctor of Osteopathy degree
- complete 5 years of training in an orthopedic residency program that has approval from either the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada
- obtain a medical license and optional board certification
- complete continuing medical education and exams to stay current and maintain certifications
After completing the 5-year residency program, many orthopedic surgeons choose to complete an additional 1–2 years of fellowship training in one of the subspecialty areas.
Orthopedics is a medical specialty that focuses on treating injuries and diseases of the musculoskeletal system. Some conditions are present at birth, whereas others may occur due to injury or age-related wear and tear.
Orthopedists often work as part of a broader orthopedic team that may include physician assistants, nurse practitioners, athletic trainers, and occupational or physical therapists. Together, they help diagnose, treat, and rehabilitate people with musculoskeletal conditions or injuries.
All orthopedists must undergo extensive training to obtain their medical license. They must continue ongoing education and training to maintain it.