General Orthopedics: Information & Orthopedic Specialists

Qualifications and Scope of Practice of Orthopedists

Orthopedics deals with diseases and disorders of

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

Orthopedic specialists have completed at least six years of advanced training to become board-certified specialists in orthopedics and trauma surgery.

This qualification ensures that these experts have in-depth knowledge in the fields of

• orthopedics,
• surgery, and
• trauma surgery

.

The basis for specialist training is the Model Training Regulations of the German Medical Association. These regulations specify which examination and treatment procedures must be performed and how frequently. Before taking the specialist examination, for example, the physician must have performed

• have performed at least 300 ultrasound examinations of the musculoskeletal system and
• more than 200 surgical procedures

. Future specialists must also demonstrate experience in the treatment of patients with severe and multiple injuries, including trauma management.

Trained orthopedic specialists work either in private practice or at a specialized clinic.

What conditions do orthopedic surgeons treat?

Common conditions and symptoms include pain, such as

• back and shoulder pain, or
• pain resulting from fractures (broken bones).

But orthopedic surgeons also treat patients with

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

regularly visit an orthopedic practice.

Typical conditions in orthopedics and trauma surgery include

• sports injuries,
• spinal disorders (e.g., scoliosis or spondylosis),
• herniated discs or spinal stenosis,
• osteoarthritis (joint wear and tear),
• arthritis (joint inflammation),
• Osteoporosis (bone loss),
• pelvic misalignment, and
• bone metastases in cancer patients
• as well as the resulting bone fractures.

Orthopedics deals with the human musculoskeletal system © AlienCat | AdobeStock

What diagnostic procedures do orthopedic specialists use?

Treatment is preceded by a thorough diagnostic evaluation to identify the causes of the symptoms.

The diagnosis begins with the medical history, i.e., the consultation with the patient. During this process, the experts ask about the symptoms, the onset of the illness, and its progression. This is followed by a physical and clinical examination. 

At this point, the orthopedist can often already make a preliminary diagnosis. This diagnosis must then be confirmed while simultaneously ruling out other possible causes.

This is usually followed by additional diagnostic tests, known as imaging studies. In orthopedics,

• conventional X-rays (e.g., to detect bone fractures),
• computed tomography (CT, e.g., to visualize bone fractures, bleeding, bruising, swelling, and inflammation),
• magnetic resonance imaging (MRI, e.g., to visualize soft tissues, nerve tissues, cartilage, and ligaments), and
• sonography (ultrasound, e.g., to visualize soft tissues and joints)

play an important role.

Bone density measurement is used in the diagnosis of osteoporosis. Specialized procedures, which are usually performed only in hospitals, include

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

—particularly in cases of bone infections, metabolic disorders of the bone, and bone tumors.

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

What treatments are used in orthopedics?

When treating orthopedic conditions, orthopedic specialists can rely on two principles:

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

Depending on the symptoms and the underlying condition, one or the other—or a combination of both—may be used.

Typical conservative treatment methods include:

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

Due to the space and staffing requirements, surgeries are usually performed in specialized orthopedic clinics. Examples of orthopedic surgery include:

• Hip and knee replacement surgeries, as well as the implantation of other artificial joints (endoprosthetics)
• Surgical treatment following acute spinal injuries and vertebral fractures, for example due to osteoporosis
• Implantation of intervertebral disc prostheses
• Surgery for scoliosis (spinal curvature)
• Arthroscopic, minimally invasive surgeries on the shoulder, elbow, hip, knee, ankle, and foot—for example, following ligament tears, to remove a heel spur, or to remove a calcium deposit in the shoulder
• Joint fusion
• Corrective surgery for bowlegs or knock-knees
• Partial meniscus removal (meniscus resection) or meniscus repair