The Evolving Role of Bone and Joint Specialists

Mar 22, 2018 | Articles

The Evolving Role of Bone and Joint Specialists

 Given the need to hunt and kill wild animals in order to sustain their needs, and the frequency of hostility between rival groups, it is hardly surprising that primitive humans soon developed the basic skills required to repair broken arms and legs when required. Fossil evidence has revealed many incidences of fractured limbs successfully re-aligned which, in turn, seems to confirm that some forms of splints were in use as early as the New Stone Age. Lacking the knowledge and the facilities of the bone and joint specialists of today, it appears that these early healers were also prone to perform amputations whenever a repair may have been too difficult.

Splinting was definitely practiced in ancient Egypt, as several mummies with femurs and forearms secured by splints made of bamboo and reeds, and with an internal padding of linen, have been found. Also, a carving dating form around 2 800 BC clearly shows an individual walking with crutches. Often cited as the founders of modern medicine, the Greeks developed casts to immobilise broken limbs whilst healing, and also used strong bandaging to correct clubbed feet and scoliosis with variable success.

The interventions performed by these early bone and joint specialists were predominately non-surgical. It was not until the latter half of the1800s, with the understanding of the principles of asepsis and the value of ether as an anaesthetic, that the role of the orthopaedic surgeon began to expand. Later, with the development of X-rays and, some 55 years later, of penicillin, surgery would account for around half of all orthopaedic interventions undertaken, of which a large proportion now tends to be elective.

With the aid of techniques such as intramedullary nailing, modern bone and joint specialists are able to repair femoral and tibial shaft fractures unsuitable for splinting. The biggest advance in modern orthopaedics however, is undoubtedly the ability to replace worn and damaged joints in the shoulder, hip, or knee with artificial structures to restore normal mobility and free the subject from his or her pain.

Known as arthroplasty, these are elective procedures and will often be the sole focus for specialists in bone and joint surgery, leaving trauma cases to be handled by general orthopaedic surgeons. Most commonly, these replacements become necessary due to the effects of osteoarthritis. Although generally encountered in those over 65, the condition now appears to be affecting a growing proportion of those in their 50s and even younger.

The condition results in damage to the cartilage that normally protects the articulating surfaces, allowing them to grind together, causing pain and, in time, loss of mobility. Depending upon the extent of the damage, either a partial or total replacement will be required. Before operating however, in addition to X-rays, today’s bone and joint specialists will often perform a procedure known as arthroscopy. A tiny incision provides entry for a flexible tube with a light and camera at its tip. Video images of the interior of the joint are relayed to an eyepiece or monitor screen for inspection, enabling the surgeon to decide upon the best action.

With the services of an internationally-acclaimed bone and joint specialist, Life Wilgers Hospital in Pretoria caters for local and overseas patients with state-of-the-art orthopaedic procedures, including arthroscopy and arthroplasty.