Techniques in Orthopaedic Surgery

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Orthopaedic surgery is a broad field of medicine that specialises in the surgical treatment of musculoskeletal conditions and injuries. Although new techniques are constantly being developed, this article provides an overview of seven of the most common techniques used in orthopaedic surgery today. 

Operative Techniques in Orthopaedic Surgery 

There are many types of orthopaedic surgery. Below, find some of the most common techniques used. 

1. Arthroscopy 

Arthroscopies are minimally invasive surgical procedures used to visualise, diagnose, and treat problems within a joint. An arthroscope consists of a small tube containing a tiny video camera and a light. The device is inserted into the body through a tiny incision and used to inspect the inside of a joint. 

An arthroscope is often used to plan for other types of surgeries, but with advanced surgical methods, many conditions can now be treated directly with an arthroscope and specialised surgical tools. 

2. Joint replacement 

Joint replacement surgery is a surgical procedure that involves the replacement of an arthritic or damaged joint with an artificial joint, also known as a prosthesis. This procedure is commonly performed on hip and knee joints. 

The damaged joint is removed and replaced with an artificial joint consisting of metal, plastic, or ceramic components. The artificial joint is designed to move and function like a normal joint, thus providing relief to the patient from the pain and stiffness caused by the damaged joint.

3. Osteotomy

An osteotomy is conducted to correct deformities or improve joint alignment by cutting and reshaping a bone. This procedure is commonly performed to treat arthritis, scoliosis, and fractures. 

An osteotomy can be done on any bone but is most often done on the hip, knee, and spine. Due to the precision required, the osteotomy is typically assisted by a computer navigation system to ensure accuracy and minimise complications. 

The procedure involves making an incision in the bone and securing the new position with plates, screws, or rods. Recovery time varies depending on the complexity and location of the surgery, typically taking several weeks. 

4. Soft Tissue Repair

Damaged or torn muscles, tendons, and ligaments are often repaired using suturing and tissue adhesives. Suturing involves using a needle and thread to stitch the torn tissue together, while tissue adhesives are a type of glue or tape used to close wounds and hold tissue together. The choice between suturing and tissue adhesives may depend on the size and location of the wound. 

Sutures are stronger and more secure but require a greater amount of time and skill to apply. Tissue adhesives, on the other hand, maybe quicker to apply but may not be as strong as sutures. In some cases, a combination of both suturing and tissue adhesives may be used to provide the best possible repair. 

5. Fracture Repair

Fracture repair involves making an incision to expose the fractured bone, reducing the fracture by realigning the bone fragments and then stabilising the bone with metal plates, screws, pins, rods, or wires. In some cases, bone grafts may be used to help the bone heal. 

Alternatively, nails or screws may be placed through the skin and into the bone and connected to a metal frame outside the body to hold the bone in place while it heals. 

Soft tissue repair may be necessary to repair any damaged ligaments, tendons, or muscles associated with the injury that caused the bone fracture. 

6. Spinal Surgery

Spinal surgery is a complex field that encompasses a range of surgical procedures aimed at treating conditions affecting the spine. The spine is made up of bones, tendons, ligaments, and intervertebral disks, and common conditions that can affect these structures include herniated discs, spinal stenosis, scoliosis, fractures, and deformities.

There are a variety of spinal surgeries, such as: 

  • A laminectomy involves removing a portion of the vertebral bone (the lamina) to relieve pressure on the spinal cord or nerve roots. This procedure is used to treat spinal stenosis, herniated discs, and other spinal conditions. 
  • A discectomy is used to remove a herniated or degenerative disc in the spine to relieve pressure on a nerve root or the spinal cord. The goal of the procedure is to reduce pain and improve mobility.
  • Spinal fusion is a surgical procedure that joins two or more vertebrae together to form a single, solid bone. It is used to treat a variety of conditions, including spinal instability, degenerative disc disease, scoliosis, and fractures. During the procedure, a surgeon will use bone grafts, metal plates, screws, and rods to join the vertebrae together. The goal of the procedure is to reduce pain and improve stability in the spine.
  • Spinal decompression is a type of therapy that involves stretching the spine using a traction table or similar motorised device. This helps to relieve pressure on the discs and nerves in the spine, which can help reduce pain and improve mobility. 
  • Spinal instrumentation involves the use of implants such as rods, screws, hooks, and wires to stabilise the spine and correct spinal deformities. It is used to treat conditions such as scoliosis, spondylolisthesis, and traumatic fractures.
  • Spinal cord stimulation (SCS) involves implanting a small device near the spine to deliver electrical pulses to the spinal cord. These pulses can help reduce pain signals from reaching the brain and can help reduce pain in certain conditions, such as chronic back pain, complex regional pain syndrome, and peripheral neuropathy.

Final Verdict: How Are Techniques In Orthopaedic Surgery Used?

Orthopaedic surgery offers a range of techniques to diagnose, treat, and manage conditions affecting the bones, joints, tendons, ligaments and muscles of the musculoskeletal system. From minimally invasive procedures such as arthroscopy and soft tissue repair to more complex surgeries such as joint replacement, osteotomy, and spinal surgery. Each treatment plan is unique and patients receive individualised care based on their needs.

Many orthopaedic surgeries utilise robotic techniques, due to the precision they require. Robotic surgery can help minimise any risks during and post-surgery.

One of the most complex orthopaedic surgeries to perform is spinal fusion surgery. This particular surgery lasts several hours and is often used to fuse two vertebrae together, to ease any pain with movement. The majority of spinal fusion surgery requires bone grafting.

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