General orthopaedics: Information & orthopaedic specialists

Qualifications and range of services of orthopaedic surgeons

Orthopaedics deals with diseases and disorders of

• bones,
• joints,
• muscles and
• tendons.

Orthopaedic specialists have completed at least six years of further training to become a specialist in orthopaedics and trauma surgery.

This qualification enables the experts to acquire in-depth knowledge in the fields of

• orthopaedics,
• surgery and
• trauma surgery

surgery.

Specialist training is based on the model training regulations of the German Medical Association. It specifies which examination and treatment procedures must be carried out and how often. Before the specialist examination, the doctor must, for example

• at least 300 sonographic examinations of the locomotor organs and
• over 200 surgical procedures

surgical procedures. The future experts must also have experience in the treatment of severely and multiply injured patients, including trauma management.

Trained orthopaedic specialists work either as doctors in private practice or at a specialized clinic.

What diseases do orthopaedic specialists treat?

Common typical illnesses or complaints are pain, such as

• Back and shoulder pain or
• pain as a result of fractures(broken bones).

But also patients with

• Torn tendons and ligaments,
• bone fractures or
• dislocations (e.g. dislocated joint)

also regularly present at an orthopaedic practice.

Typical clinical pictures in orthopaedics and trauma surgery are

• Sports injuries,
• Spinal diseases (e.g. scoliosis or spondylosis),
• herniated discs or spinal canal stenosis,
• Arthrosis (joint wear and tear),
• Arthritis (joint inflammation),
• osteoporosis (bone loss),
• pelvic obliquity and
• bone metastases from cancer
• and the resulting bone fractures.

Orthopaedics deals with the human musculoskeletal system © AlienCat | AdobeStock

What diagnostic procedures do orthopaedic specialists use?

Treatment is preceded by thorough diagnostics to uncover the causes of the complaints.

The diagnosis begins with an anamnesis, i.e. an interview with the patient. The experts inquire about the symptoms, the onset and course of the illness. This is followed by a physical and clinical examination.

After this, the orthopaedist can often already make a suspected diagnosis. This must now be confirmed and other causes ruled out at the same time.

This is usually followed by further imaging examinations. In orthopaedics

• the classic X-ray examination (e.g. to detect bone fractures),
• computed tomography(CT, e.g. for imaging bone fractures, bleeding, bruising, swelling and inflammation),
• magnetic resonance imaging(MRI, e.g. for imaging soft tissue organs, nerve tissue, cartilage and ligaments) and
• sonography (ultrasound, e.g. to visualize soft tissue and joints)

play an important role.

Bone density measurement is used for osteoporosis. Special procedures that are usually only carried out in the clinic are

• scintigraphy and
• single photon emission computed tomography (SPECT)

particularly in the case of infections and metabolic disorders of the bone as well as bone tumors.

Many disorders and diseases in orthopaedics can be diagnosed using X-rays © grieze / Fotolia

What treatments are used in orthopaedics?

Orthopaedic experts can rely on two principles in the treatment of orthopaedic diseases:

• conservative treatment and
• surgical treatment (orthopaedic surgery).

Depending on the symptoms and the underlying disease, one, the other or a combination may be used.

Typical conservative treatment methods are

• Electrotherapy / stimulation current therapy, e.g. in the treatment of pain conditions (e.g. TENS = transcutaneous electrical nerve stimulation for chronic pain), to relax and tense muscles and to improve blood circulation
• Drug therapy (incl. injections of medication) to treat pain and inflammation(pain therapy)
• Physical therapy and physiotherapy such as heat treatment (ointments, red light), massages, hydrotherapy, occupational therapy and ultrasound therapy

Due to the spatial and personnel requirements, operations are usually carried out in specialized orthopaedic clinics. Examples of orthopaedic surgery are

• Hip and knee replacement operations and the use of other artificial joints(endoprosthetics)
• Surgical treatment after acute spinal injuries and vertebral body fractures, for example due to osteoporosis
• Insertion of intervertebral disc prostheses
• Surgery for scoliosis (curvature of the spine)
• Arthroscopic, minimally invasive operations on the shoulder, elbow, hip, knee, ankle and foot, e.g. after torn ligaments, to remove a heel spur or to remove a calcium deposit in the shoulder
• Joint stiffening
• Repositioning surgery for knock knees or bow legs
• Partial meniscus removal(meniscus resection) or refixation