Types of Orthopaedic Surgery

The general goal of orthopaedic surgery is to restore mobility, stability and function, to reduce pain, and improve quality of life and overall health and well-being. Some surgeries correct deformities and improve appearance, while others prevent or reduce the risk of future injury or disability.

Many ailments can affect the musculoskeletal system, corresponding to a wide range of treatments and techniques. The context and needs of each patient are unique and the treatment team for a patient will design an approach that fits the specific needs of the patient. 

What types of orthopaedic surgery are there? 

Orthopaedic surgeries involve the removal, replacement, repair or reconstruction of a disorder within the musculoskeletal system. Removal surgeries involve taking out foreign objects, implants, or damaged tissue from the body. Replacement surgeries involve substituting damaged or diseased tissue or joints with biological substitutes or artificial implants. Repair and reconstruction surgeries involve fixing or rebuilding damaged or injured tissue or joints.

The following are some examples of surgeries that happen within each of these broad categories. 

Removal surgeries

1. Hardware removal: This type of surgery involves the removal of metal screws, plates, wires, or other hardware that was implanted during a previous orthopaedic surgery. Hardware removal may be recommended if the hardware is causing discomfort or interfering with the patient's range of motion.
2. Joint debris removal: Joint debris removal surgery involves the removal of debris from the joint space, such as bone fragments, cartilage, or other tissue. This type of surgery may be necessary if debris is causing pain, inflammation, or damage to the joint.
3. Synovectomy: Synovectomy is the surgical removal of the synovial membrane, which lines the joint capsule. This surgery may be recommended for patients with rheumatoid arthritis, as the synovial membrane can become inflamed and damaged, leading to pain and joint stiffness.
4. Tumour removal: Orthopaedic surgeons may perform surgery to remove tumours or other abnormal growths from the bone or surrounding tissue. This may be necessary to prevent the spread of cancer or to relieve pain and other symptoms.
5. Meniscectomy: A meniscectomy is the surgical removal of all or part of the meniscus, which is a C-shaped piece of cartilage in the knee joint. This surgery may be recommended if the meniscus is torn or damaged, and non-surgical treatments are not effective.

Replacement surgeries

1. Total joint replacement: This surgery involves the replacement of the entire joint, such as the hip or knee, with an artificial joint made of metal, plastic, or ceramic. Total joint replacement is typically recommended for patients with severe joint damage or osteoarthritis.
2. Partial joint replacement: Partial joint replacement involves the replacement of only the damaged or diseased part of the joint, such as the femoral head in the hip joint. This type of surgery may be recommended for patients with less severe joint damage.
3. Spinal fusion: Spinal fusion is a surgery that involves the fusion of two or more vertebrae in the spine to stabilize the spine and relieve pain. This surgery may be recommended for patients with spinal injuries or degenerative conditions.
4. Cartilage replacement: Cartilage replacement involves the replacement of damaged or missing cartilage in the joint with artificial cartilage or with tissue from another part of the body. This type of surgery may be recommended for patients with cartilage damage due to injury or osteoarthritis.
5. Ligament reconstruction: Ligament reconstruction involves the replacement of a torn or damaged ligament with tissue from another part of the body or with a synthetic ligament. This type of surgery may be recommended for patients with ligament injuries in the knee or shoulder.

Repair and reconstruction

1. ACL reconstruction: ACL reconstruction is a surgery that involves the reconstruction of the anterior cruciate ligament (ACL) in the knee. This surgery may be recommended for patients with a torn ACL, which can cause instability and pain in the knee joint.
2. Rotator cuff repair: Rotator cuff repair is a surgery that involves the repair of a torn or damaged rotator cuff tendon in the shoulder. This surgery may be recommended for patients with a rotator cuff injury, which can cause pain and weakness in the shoulder joint.
3. Tendon repair: Tendon repair involves the repair of a torn or damaged tendon in the body, such as the Achilles tendon in the ankle or the biceps tendon in the arm. This surgery may be recommended for patients with a tendon injury, which can cause pain and limited mobility.
4. Fracture repair: Fracture repair involves the repair of a broken bone in the body. This surgery may involve the use of plates, screws, or other devices to stabilize the bone and promote healing.
5. Cartilage repair: Cartilage repair involves the repair of damaged or injured cartilage in the joint. This may involve the use of specialised techniques to promote the growth of new cartilage tissue.

Conditions commonly treated by orthopaedic surgery

Treatment plans involving orthopaedic surgery are designed by a team of specialists and may involve both surgical and non-surgical approaches. Ideally, musculoskeletal conditions are first treated by non-surgical means, before surgery is considered. Below are some of the most common conditions that may involve orthopaedic surgery:

1. Arthritis: a group of conditions that cause joint pain, stiffness, and swelling. Treatment may include medication, physical therapy, lifestyle changes, and surgery.
2. Fractures: breaks in bones caused by trauma. Treatment typically involves immobilisation with a cast or splint, physical therapy, and surgery in some cases.
3. Torn ligaments: injuries to the tough bands of tissue that connect bones. Treatment may involve rest, physical therapy, and possibly surgery.
4. Rotator cuff tears: tears in the tendons or muscles of the shoulder joint. Treatment may include rest, physical therapy, and surgery in some cases.
5. Spinal stenosis: narrowing of the spinal canal that puts pressure on the spinal cord and nerves. Treatment may involve non-surgical approaches such as physical therapy and medication, as well as surgical approaches like decompression surgery, spinal fusion, or artificial disc replacement.
6. Herniated discs: a condition in which the material between the vertebrae of the spine presses on the nerves. Treatment may involve rest, physical therapy, and sometimes.
7. Osteoarthritis: a type of joint disease that involves the breakdown of joint cartilage and underlying bone. Treatment includes lifestyle changes, medication, physical therapy, and surgery in some cases.
8. Scoliosis: a skeletal condition in which the spine curves to the side. Treatment may involve physical therapy, bracing, and surgery in some cases.
9. Carpal tunnel syndrome: a condition caused by compression of the median nerve in the wrist. Treatment may involve rest, splinting, physical therapy, and surgery in severe cases.
10. Tendinitis: inflammation of a tendon. Treatment may involve rest, ice, physical therapy, medication, and surgery in some cases.