Orthopedic Surgery: 200-plus Years of Progress

Orthopedics made headlines in 1741 with the publication of a paper about correcting deformities in children. The first hip replacement, performed in 1891 in Germany and using an artificial femoral head made of ivory, was considered an alternative to amputation. Since then, procedures have grown ever less invasive and more effective.

From Wartime Injuries to Sports Medicine

Orthopedics (also spelled orthopaedics, and pronounced the same) as a field received a major developmental thrust from war. As soldiers appeared in the clinic with damaged limbs, orthopedic surgery was inspired to become more skilled at saving lives and preserving function.
Today’s orthopedic field is fueled to a large degree by the worldwide popularity of sports. From the professional athlete on the ski hill or tennis court . . . to the weekend warrior with a blown knee or tennis elbow, orthopedic surgeons are confronted with challenges that constantly encourage them to refine surgical methods.

As long ago as the 1950s, surgeons began to use arthroscopic techniques to repair and treat torn tissues such as the anterior cruciate ligament (ACL) in the knee. These minimally invasive techniques, with their faster recovery and less scar tissue, quickly became popular for a variety of injuries.

Orthopedic surgeons are fully trained medical doctors with an additional four or five years spent studying the specialty. They bring to the operating theatre a broad knowledge of human physiology, and are qualified to offer advice on training, rehab, lifestyle, and other health-related issues.

Some orthopedic surgeons specialize in certain body parts, such as the hand or spine. Others specialize in a treatment modality such as reconstruction. Still others delve deep into an area of interest like sports medicine or pediatric orthopedics.

Orthopedics is not a garden-variety specialty. In the United States, only 3-4% of all practicing physicians are orthopedic surgeons, according to the U.S. Department of Labor.

Today’s frontier is in the art and science of joint replacement. Orthopedic specialists are now capable of giving a patient a brand-new knee or shoulder, using man-made materials that bind to the body’s own tissues.
Joint reconstruction is another frontier, where the skill of the surgeon is as crucial as his or her choice of prostheses.

The most common procedures for orthopedic surgery today, in order of popularity, are as follows, according to the American Board of Orthopaedic Surgery:

  • Knee arthroscopy or meniscectomy
  • Shoulder arthroscopy and decompression
  • Carpal tunnel
  • Removal of support implant
  • Knee arthroscopy and ACL reconstruction
  • Knee replacement
  • Repair of femoral neck fracture
  • Repair of trochanteric fracture
  • Debridement of skin/muscle/bone fracture