Definition

Orthopedics, or orthopedic services, aim at the treatment of the musculoskeletal system. This includes your bones, joints, ligaments, tendons, and muscles.

Information

There can be many medical problems that can affect the bones, joints, ligaments, tendons, and muscles.

Bone problems may include:

• Bone deformities
• Bone infections
• Bone tumors
• Fractures
• Need for amputation
• Nonunions: failure of fractures to heal
• Malunions: fractures healing in a wrong position
• Spinal deformities

Joint problems may include:

• Arthritis
• Bursitis
• Dislocation
• Joint pain
• Joint swelling or inflammation
• Ligament and tendon tears
• Infection

Common orthopedic-related diagnoses based on body part include:

ANKLE AND FOOT

• Bunions
• Fasciitis of the sole of the foot called plantar fascitis
• Foot and ankle deformities
• Fractures
• Hammer toe
• Heel pain
• Heel spurs
• Joint pain and arthritis
• Sprains
• Tarsal tunnel syndrome
• Sesamoiditis
• Tendon or ligament injury

HAND AND WRIST

• Fractures
• Joint pain
• Arthritis
• Tendon or ligament injury
• Carpal tunnel syndrome
• Ganglion cyst
• Tendinitis
• Tendon tears
• Infection

SHOULDER

• Arthritis
• Bursitis
• Dislocation
• Frozen shoulder (adhesive capsulitis)
• Impingement syndrome
• Loose or foreign bodies
• Rotator cuff tear
• Rotator cuff tendinitis
• Separation
• Torn labrum
• SLAP tears
• Fractures

KNEE

• Cartilage and meniscus injuries
• Dislocation of the kneecap (patella)
• Ligament sprains or tears (anterior cruciate, posterior cruciate, medial collateral, and lateral collateral ligament tears)
• Meniscus injuries
• Loose or foreign bodies
• Osgood-Schlatter disease
• Pain
• Tendinitis
• Fractures
• Tendon tears

ELBOW

• Arthritis
• Bursitis
• Dislocation or separation
• Ligament sprains or tears
• Loose or foreign bodies
• Pain
• Tennis or golfers elbow (epicondylitis or tendinitis)
• Elbow stiffness or contractures
• Fractures

SPINE

• Herniated (slipped) disk
• Infection of the spine
• Injury to the spine
• Scoliosis
• Spinal stenosis
• Spinal tumor
• Fractures
• Spinal cord injuries
• Arthritis

SERVICES AND TREATMENTS

Imaging procedures can help diagnose or even treat many orthopedic conditions. Your health care provider may order:

• X-rays
• Bone scans
• Computed tomography (CT) scan
• Magnetic resonance imaging (MRI) scan
• Arthrogram (joint x-ray done with contrast material)
• Discography

Sometimes, treatment involves injections of medicine into the painful area. This may involve corticosteroid or other types of injections into joints, tendons, and ligaments, and around the spine.

Surgical procedures used in the treatment of orthopedics include:

• Amputation
• Arthroscopic surgeries
• Bunionectomy and hammer toe repair
• Cartilage repair or resurfacing procedures
• Cartilage surgery to knee
• Fracture care
• Joint fusion
• Arthroplasty or joint replacements
• Ligament reconstructions
• Repair of torn ligaments and tendons
• Spine surgery, including diskectomy, foraminotomy, laminectomy, and spinal fusion

Newer orthopedic services procedures include:

• Minimally invasive surgery
• Advanced external fixation
• Use of bone graft substitutes and bone-fusing protein

WHO IS INVOLVED

Orthopedic care often involves a team approach. Your team may include a doctor, a non-doctor specialist as well as others. Non-doctor specialists are professionals such as a physician assistant, nurse practitioner, or physical therapist.

• Orthopedic surgeons receive 5 or more extra years of training after medical school. They specialize in the care of disorders of the bones, muscles, tendons, and ligaments. They are trained to manage joint problems with both operative and non-operative techniques.
• Physical medicine and rehabilitation doctors have 4 or more extra years of training after medical school. They specialize in this type of care. They are also referred to as physiatrists. They do not perform surgery, although they can give joint and soft tissue injections.
• Sports medicine physicians are doctors with experience in sports medicine. They have a primary specialty in family practice, internal medicine, emergency medicine, pediatrics, or physical medicine and rehabilitation. Most have 1 to 2 years of additional training in sports medicine through subspecialty programs in sports medicine. Sports medicine is a special branch of orthopedics. They do not perform surgery, although they can give joint and soft tissue injections. They provide complete medical care to active people of all ages.

Other physicians that may be a part of the orthopedics team include:

• Neurologists
• Pain specialists
• Primary care doctors
• Psychiatrists
• Sports medicine specialists

Other health professionals that may be a part of the orthopedics team include:

• Athletic trainers
• Chiropractors
• Counselors
• Nurse practitioners
• Physical therapists
• Physician assistants
• Psychologists
• Social workers
• Vocational workers

References

Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW. Musculoskeletal system. In: Ball JW, Dains JE, Flynn JA, Solomon BS, Stewart RW, eds. Seidel's Guide to Physical Examination. 10th ed. St Louis, MO: Elsevier; 2023:chap 22.

McGee S. Examination of the musculoskeletal system. In: McGee S, ed. Evidence-Based Physical Diagnosis. 5th ed. Philadelphia, PA: Elsevier; 2022:chap 57.