By definition, the role of every orthopaedic specialist centres on the treatment of conditions that affect the musculoskeletal system. But, while some choose to focus on those conditions that require surgical intervention, others prefer to provide the non-invasive type of treatments associated more with a physician. That being said, whether the larger part of their days may be spent in the operating theatre or predominately in a consulting room and at their patients’ bedsides, those days are likely to be both busy and varied.
For the surgeon too, there are career choices that influence their daily routine. Some specialist orthopaedic surgeons, for example, choose to dedicate their time to the treatment of trauma cases, such as those with musculoskeletal injuries as the result of a motor accident. By contrast, others prefer to concentrate their attention on non-trauma cases who, instead, might need elective surgery. On average, however, most will tend to divide their time between treating both trauma and elective patients as required and their activities will be governed by patients’ needs, the available theatre time, and the number of vacant beds.
Another option for orthopaedic specialists could be to pursue a diploma in sports medicine so as to gain greater insight into the diagnosis and treatment of those ailments and injuries most frequently experienced by professional athletes. The added knowledge could, for example, open up opportunities to provide services as a consultant to sports teams during prestigious international events, such as the Rugby World Cup.
What hospital duties may lack in glamour, however, are more than compensated by variety. A typical day for the average orthopaedic specialist will frequently begin with a ward round. This is an opportunity to evaluate the clinical status, investigative needs and potential treatment options for any new admissions, and to monitor the progress of those who have already undergone treatment. In a teaching environment, they may be accompanied by a group of medical students who, in their foundation years, are exploring their options or perhaps by an intern who has chosen to pursue a fellowship in this field.
Based on the outcome of the physical examination and any relevant test results, the orthopaedic specialist will then identify those who require surgery. They will then call for any necessary pre-operative tests to be completed before booking the required theatre time.
At this, point, the healthcare professional may be free to return to their consulting rooms and interview any patients who might have been referred by a primary care physician. On occasion, though, it can happen that a concerned member of the emergency room team dealing with external injuries to a crash victim will interrupt this routine with a phone call requesting the opinion and possible intervention of an orthopaedic specialist. The request could then lead to some unscheduled time in the operating room while repairing a complex femoral fracture to avoid the possibility that the patient could become permanently disabled.
Not all disabling conditions are quite as traumatic, however, although surgery may still be the only practical solution. The most common reason for a progressive reduction of mobility is osteoarthritis. This is the gradual erosion of the layers of cartilage that protect the articulating surfaces of the bones within a joint. While this may be a common side-effect of ageing, it is becoming more frequent in younger subjects too. Widely regarded as the most successful intervention devised by orthopaedic specialists, the solution is arthroplasty – replacement of the affected components of a joint with artificial ones.
Since the condition is not life-threatening, the surgery is elective and normally undertaken only when medication fails to relieve the pain and swelling, and movement becomes too difficult. It’s just another challenging task in the busy day of an orthopaedic specialist, but one that is changing lives on a daily basis.