Types and who might need it

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Musculoskeletal problems can limit a person’s ability to move and function. This in turn can drastically affect their ability to work and perform daily activities.

According to the World Health Organization (WHO), injuries and musculoskeletal conditions are common, affecting 1.71 billion people around the world. They are also the number one cause of disability in the world.

This article explains what musculoskeletal surgery is, who might need it, how surgeons perform it, how to prepare for it, and what the possible risks it entails.

The musculoskeletal system is made up of bones and soft tissues, such as muscles, joints, ligaments, and tendons. These provide support and stability to the body and allow movement.

Bones are rigid structures that make up the skeleton of the body. They provide structural support and protect vital organs.

Joints are the connection point between bones and ligaments, which are strong bands of tissue, further strengthen them.

Tendons attach muscles to bones, while skeletal muscles are contractile tissues that allow the body to move and maintain posture.

Orthopedics, or orthopedic surgery, is a medical field specializing in the care, diagnosis and treatment of the musculoskeletal system.

Musculoskeletal surgery refers to various procedures aimed at:

  • manage or improve symptoms
  • reduce pain
  • improve mobility
  • correct alignment
  • restore function
  • improve overall health and well-being

A person may require musculoskeletal surgery in the following cases:

Trauma

Trauma from sports injuries and car accidents can cause fractures and dislocations that require surgery.

Infections

Bacteria can reach the bone through the blood or spread from a nearby infected area to the bone. It can happen after injury or surgery and can lead to a bone infection that health experts call osteomyelitis.

Osteomyelitis can cause severe pain and permanent bone damage if left untreated.

Degenerative diseases

Constant wear and tear can weaken and deteriorate structures such as joints over time.

Common degenerative diseases of the musculoskeletal system include:

Osteoarthritis and spondylosis can cause severe pain and damage.

A doctor may recommend surgery for these conditions when non-surgical treatments do not improve a person’s symptoms.

People with severe osteoporosis have very fragile bones and may need surgery to prevent fractures.

Overuse injuries

Overuse injuries, which health experts also call cumulative traumatic disorder (CTD) or repetitive strain injury, can occur due to:

  • repetitive work-related activities
  • abuse
  • stay in one position too long

These expose muscles and tendons to constant wear and tear and repetitive stress, causing pain and inflammation.

Examples of CTD are carpal tunnel syndrome, neck pain, shoulder pain, and lower back pain.

Carpal tunnel release surgery is the The most common people have wrist and hand surgery in the United States.

According to Global Burden of Disease Study 2017, low back pain is the most common musculoskeletal problem and the leading cause of disability.

Cancer

Cancer can grow in bones or soft tissues.

Surgery is the usual treatment for musculoskeletal cancers, such as sarcoma and bone cancer.

If people with these types of cancer do not receive treatment, they may require limb amputation. Cancer can also spread to other parts of the body.

The type of procedure an orthopedic surgeon performs will depend on the type of injury or the person’s condition.

An anesthesiologist will administer general or local anesthesia to a person. During open surgery, the surgeon will make large incisions. During arthroscopic surgery, on the other hand, the incisions will be small.

Below we list some common musculoskeletal procedures:

Soft tissue repair

Surgeons perform this procedure to repair torn ligaments and tendons. This involves replacing damaged tissue with tissue taken from other parts of the body.

For example, in anterior cruciate ligament (ACL) reconstruction, surgeons may use the hamstring tendon or the patella tendon to replace the torn ACL.

These surgeries are generally minimally invasive and people have them on an outpatient basis.

Here are other examples of this procedure:

Open reduction

During open reduction surgeries, doctors realign fractured bones using equipment such as pins and plates. These hold the bones together and help them heal properly.

In severe injuries, surgeons may use external fixators to hold the bones in place.

Learn more about repairing bone fractures here.

Osteotomy

Osteotomy is a procedure that cuts and reshapes bones to realign joints or correct deformities.

Surgeons use the knee osteotomy to relieve pressure on the knee joint and transfer a person’s body weight to the healthier side of the knee.

Doctors may also perform a spinal osteotomy to correct the curvature of the spine and reduce pain.

In addition, osteotomies help correct deformities in joints affected by rheumatoid arthritis.

Joint replacement

During joint replacement surgery, the surgeon removes damaged joints and replaces them with a ceramic, plastic, or metal prosthesis.

They will remove damaged parts of the joints and replace them with implants. They will also include a spacer between the implants to ensure that the joint moves smoothly.

Hip and knee replacement surgeries are examples of this procedure.

A Study 2019 have found that total arthroplasty improves a person’s quality of life and pain levels. This makes it a valuable treatment for people with osteoarthritis of the hip and knee whose body does not respond to conservative treatment.

Joint fusion surgery

Joint fusion surgery, or arthrodesis, involves fusing two or more bones in order to:

  • reduce pain
  • limit deformation
  • improve joint stability
  • increase strength

The surgeon can remove damaged joint areas and fuse the bones together using pins and plates.

Orthopedic surgeries carry risks and possible complications. These include:

  • reactions to anesthesia
  • infection
  • blood clots
  • excessive bleeding
  • nerve damage
  • limited range of motion
  • scar formation
  • injury

To ensure faster recovery and better results from surgery, a healthcare team may ask a person to do the following:

  • Prehabilitation: These are exercises that help a person prepare for surgery, prevent injuries, relieve pain and side effects, and recover faster.
  • Eat well and sleep well: Surgery puts stress on the body. A balanced diet and restful sleep help prepare the body for surgery.
  • Achieve moderate body weight: Achieving moderate body weight helps recovery.
  • Stop drinking alcohol and smoking: Quitting smoking can reduce complications during and after surgery. A 2014 study found that smoking increases the risk of infections and complications of wounds, lungs and neurology.
  • Stopping taking certain medications: The healthcare team may advise the person to stop taking certain medications, such as blood thinners, weeks or days before surgery.

Musculoskeletal injuries and conditions are very common and can have a huge impact on a person’s health and functioning.

Surgery is a treatment option for the majority of these conditions. However, it comes with certain risks and complications and requires careful planning, thought and preparation.


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