Orthopedic Procedures

When you first see a doctor for symptoms of a musculoskeletal condition or injury, the doctor will likely recommend an orthopedic solution to the problem because orthopedic treatments can address a variety of bone, joint, and soft tissue disorders. Treatment goals can include correcting physical problems, lessening symptoms, reducing disability, and improving quality of life. Common conditions that may require an orthopedic procedure include:

• Arthritis including osteoarthritis, rheumatoid arthritis, psoriatic arthritis, and gout

• Back and spine conditions including herniated disc, spinal fracture, spinal stenosis, and sciatica and other nerve compression problems

• Deformities including bunions, clubfoot, and hammer toe

• Joint problems including bursitis, tendinitis, torn cartilage, sprains, and strains

• Muscle problems including pulled muscles and muscle tears

• Trauma including bone fractures, torn ligaments, and dislocated joints

• Tumors including cancerous (malignant) and noncancerous (benign) growths of the muscles, bones and joints

Orthopedic surgeons perform orthopedic procedures. Orthopedic surgeons treat, prevent and rehabilitate bone and joint problems. In addition to surgery, they also use medical approaches to manage these types of problems. Foot and ankle surgeons, hand surgeons, sports medicine doctors, and other types of specialists also perform orthopedic procedures.

The details of an orthopedic procedure will vary by location, surgical approach, and anesthesia. They can take place in a hospital, surgical center, or doctor’s office. They can also be either open surgery with a large incision or minimally invasive surgery with smaller incisions. Many orthopedic procedures are major surgeries involving significant recovery, but people typically recover faster from minimally invasive procedures compared to open procedures.  

These procedures usually require general anesthesia so you sleep through the surgery. Some outpatient procedures will also use general anesthesia. However, it may be possible to use regional anesthesia with sedation. Office procedures, including injections, may only involve local anesthesia at the site of the procedure.

Any surgery or procedure will involve risks and possible complications. These can sometimes be serious and may develop during surgery or while you are recovering. General risks of surgery include bleeding, infection, blood clots, and reactions to the anesthetic. The surgical team will take care of these problems immediately, and there are usually no long-term effects.

In most cases, orthopedic procedures are successful. Potential complications will vary depending on the specific procedure and may include:  

• Development of arthritis in the joint

• Dislocation, loosening, or wear and tear of the new joint, which may require additional surgery

• Muscle weakness

• Nerve, muscle, or blood vessel damage

• Persistent symptoms including pain and stiffness

• Poor healing or failure of a graft or repair

• Scarring within the joint or on joint structures, which may lead to stiffness and other problems

• Spinal headache from epidural anesthesia or injections

You can reduce your risk of certain complications by following all pre- and postsurgical care instructions. Choosing a surgeon with experience performing the specific procedure you need without complications will also help reduce your risk. Ask your surgeon what complications you are most at risk for and how he or she will treat them if they occur.

The steps you take before surgery can help improve your comfort and outcome. You can prepare for an orthopedic procedure by:

• Arranging a ride home and making sure someone can stay with you the first 24 hours.

• Getting preoperative testing if your doctor orders it. This will vary depending on the procedure and your medical history.

• Losing excess weight before surgery. This can have a positive affect the surgical approach and your recovery.

• Making sure all your healthcare providers have your complete medical history. This includes chronic conditions, allergies and medications. When listing medications, include prescriptions, over-the-counter drugs, herbal treatments, and vitamin supplements.

• Not eating or drinking before surgery as directed

• Stopping smoking as soon as possible to help the healing process

• Taking or stopping medications as directed

Knowing as much as you can about the procedure can help you approach surgery with confidence and realistic expectations. Make a list of questions and take them to your appointments. Questions you may want to ask your doctor include:

• Why do I need the orthopedic procedure you are recommending? Are there any other options we can try first?

• What complications might I encounter?

• What if the procedure does not improve my symptoms?

• How long will the procedure take? When can I go home?

• What restrictions will I have after the procedure? What kind of assistance will I need at home?

• When can I return to work and other activities?

• When will I start physical therapy? How many treatments are typically necessary for recovery?

• How will you manage my pain?

• What changes, if any, to my medication plan do I need to make?

• When should I follow up with you?

Knowing what to expect makes it easier to plan and prepare for a successful recovery after an orthopedic procedure.

For office procedures and minor surgeries, you should be able to go home after the procedure. However, major orthopedic procedures, such as total hip replacement, shoulder reconstruction, or spine surgery, may require a hospital stay that can last several days. For all orthopedic procedures, your team will give you instructions with details about activity level, medications (including pain control medicines), and follow-up appointments before you leave.

You may need to wear a cast, brace or sling or use crutches or a walker for a few weeks after surgery. Physical therapy (PT) is also a common part of recovery for orthopedic procedures. PT will help you regain strength, function and flexibility in the area. Full recovery can take several weeks or months, or even a year, depending on your specific condition and procedure, as well as your overall physical health.

Contact your doctor’s office between appointments if you have questions about your recovery. Call your doctor right away or seek immediate medical care if you have any of the following:

• Breathing problems or shortness of breath

• Confusion or changes in level of alertness

• Chest pain, pressure or tightness

• Drainage of pus, redness or swelling around your incision

• Fever. It’s common to have a fever right after surgery. Your doctor will give you instructions about when to call for a fever.

• Inability to urinate or move your bowels

• Leg pain, redness or swelling, which could mean you have a blood clot

• Unexpected bleeding

Most orthopedic procedures are successful at returning people to independence and an active lifestyle. Your results will depend on the amount of damage or disease you have before surgery. It is possible you may notice decreased abilities in certain areas or have difficulty with some movements. With joint replacements, you may need to avoid sports and activities that put too much stress on the joint. Talk with your doctor before surgery so you know what to expect from your long-term recovery.