Orthopedic surgery

Orthopedic surgery or orthopedics also spelled orthopedics; is the branch of surgery concerned with conditions involving the musculoskeletal system. Orthopedic surgeons use both surgical and nonsurgical means to treat musculoskeletal trauma; spine diseases, sports injuries, degenerative diseases, infections, tumors, and congenital disorders. Originally, the term orthopedics meant the correcting of musculoskeletal deformities in children. Nicolas Andry, a professor of medicine at the University of Paris coined the term in the first textbook written on the subject in 1741.
Keeping patients safe during and after orthopedic outpatient surgery of all types arthroscopy; joint replacement, hand, spine, and other procedures will of ongoing concern as the frequency with which these procedures are increases and anesthesia and surgical protocols evolve. The American Academy of Orthopaedic Surgeons stated in a position statement that with the continued advancement of medical technology; comes more opportunities for outpatient surgery to be utilized. However, lingering concerns about the safety of outpatient orthopedic surgery remain.

Problems during outpatient surgery

Although orthopedic surgeons typically do not expect to encounter problems during outpatient surgery; they said it is important to run “through the scenarios and if the system of the local outpatient surgery center can handle” any problem that may occur. Outpatient surgery should be avoided in patients with organ failure or advanced cardiac disease, several sources who spoke with Orthopedics. However, surgeons should not limit which patients should undergo outpatient surgery; but, instead, should simply more selective of which procedures are performed in an outpatient setting, they said.

Outpatient spine procedures are now limit to smaller operations, such as vertebroplasty; microdiscectomy and anterior cervical discectomy and fusion; are performing in the healthiest, youngest patients, according to Michael Y. Wang, MD. However, by leveraging multiple technologies, Wang said he and his colleagues have able to perform more complex surgeries, such as lumbar spine fusions, through their awake spinal fusion program.

Resources for spine surgery

“They is trying to leverage technology as opposed to cherry-picking the best cases and that is a big departure from what normally happens,” Wang, professor of neurological surgery at the University of Miami, told Orthopedics. It is in response to the health care system, in response to the potential restriction and resources for spine surgery.
Adolph V. Lombardi Jr., MD, FACS, who operates at a surgical center at which 7,500 outpatient total joint replacement procedures between 2013 and 2018; said surgeons at the center perform outpatient total hip replacements, total knee replacements and partial knee replacements in about equal numbers; they have also completed a number of outpatient revision THRs and TKRs.