Are you afraid of orthopedic surgery? Let's talk about it simply!

Does your mother or father suffer from knee pain and can't climb stairs? Or have you heard of a friend who broke their arm while playing cricket and had to have a cast put on? Maybe you yourself have hip pain or back pain and are afraid of a doctor talking about surgery. Many of us cringe a little when we hear the words "Orthopaedic Surgery," or surgery involving bones, joints, and muscles. But is this really something to be afraid of? Let's talk about it today to clear up all the doubts you have about it.

Simply put, what is orthopedic surgery?

Think of our body as a beautifully built house. The frame of that house, that is, the walls, the roof, the windows and doors, is our skeleton. In medicine, we call this the musculoskeletal system. This is what helps us stand up straight, walk, run, lift weights, in short, perform all kinds of movements.

So this `musculoskeletal system` is made up of several main parts:

• Bones: The framework that gives shape and strength to our bodies.
• Muscles: Parts that help move bones.
• Joints: Places where two bones connect together. Like the hinges on a door. These are what allow us to bend and extend our limbs.
• Tendons and ligaments: Strong, band-like structures that connect muscles to bones and bones to each other.
• Cartilage: A smooth, rubbery substance that prevents bones from rubbing against each other inside joints.
• Soft tissues: The other tissues that surround all of this.

Now you probably understand how important this system is. These parts can be damaged due to an accident, aging, or other medical condition. Then we feel pain, cannot walk, and cannot even do our daily tasks. At such times, we call the surgeries that are performed to repair, rebuild, or replace the damaged parts with new ones `Orthopaedic Surgery`.

What types of surgeries are these? What parts of the body are they performed on?

Orthopedic surgeons are trained to work on different parts of the body. So, not all surgeries are performed by the same doctor. Some specialize in knees, others in spines. It's like having a mechanic who builds a car engine and a mechanic who tinkers.

You can get a good idea about this from the table below.

Two of the most common surgeries performed in Sri Lanka are ACL surgery and knee replacement surgery.

What happens before, during and after surgery?

Okay, now let's see how this whole process works. Knowing this step by step will reduce your fear a lot.

Before the surgery... (Consultation)

Once it is determined that you need surgery, you will first be referred to a specialist who specializes in your condition. We call this meeting a `consultation`.

The doctor will ask you about your full medical history. That is, how long have you had the pain, how did it start, what other illnesses do you have, what medications are you taking, etc. Then, he will examine the area where you are in pain. If you have any X-rays or MRI scans, he will also look at them carefully to understand your exact condition.

Then the doctor will schedule your surgery. If it's an emergency, you may have to have the surgery right away. Otherwise, it may be a few days or weeks later.

On the day of surgery...

On the day of your surgery, you will be admitted to a hospital ward. A nurse will come and change you into a surgical gown. You will need to remove any jewelry, such as necklaces, bracelets, or rings. Your blood pressure and pulse rate will then be checked, and an IV line may be placed in your arm.

You will then be taken to the operating theatre. There you will be examined by an anesthesiologist. He or she will put you to sleep so that you do not feel any pain during the operation. Don't be afraid of this, they are highly trained in this.

The surgeon will begin the operation after you fall asleep.

• If a bone is broken, it is set straight and fixed with screws, pins, rods or plates.
• If a ligament is torn, the damaged part is removed and replaced with a piece of healthy tissue from another part of your body, or a graft from someone else.
• If a joint is worn out (arthritis), metal or plastic caps are placed over the worn out bone fragments to make the joint function smoothly again. This is what we call a joint replacement.

After the surgery is complete, the incisions are closed with stitches and covered tightly with a bandage.

After surgery... (recovery period)

After the surgery, you will be moved to a recovery room. You will stay there until you regain consciousness from the anesthesia. Then you will be taken back to the ward. For some surgeries, you can go home the same day. For some serious surgeries, you will have to stay in the hospital for a few days.

When you go home, you will be given a series of instructions on how to care for your stitches, and what you should and shouldn't do. Following these instructions exactly is very important for a speedy recovery. You will need a lot of rest in the early days. So it is a great help if you have someone to help you with the homework.

The doctor will give you follow-up appointments to check on your wound's healing. You may also need to have another X-ray.

Often, after these types of surgeries, you will be referred to physical therapy . This means that you will be given exercises under the supervision of a specially trained person to strengthen and improve the range of motion of the operated arm, leg, or joint. This is something that you should do without getting bored.

What are the benefits and risks of these surgeries?

Like anything, these surgeries have benefits and very minor risks.

Advantages:

• Pain relief: You can get rid of persistent pain.
• Increased body function: You can bend, straighten, and walk better.
• Improve range of motion: You will be able to do things you couldn't do before.
• Correct fixation of broken bones: The bone is fixed precisely, without pulling.
• Removal of malignant tumors: Removal of potentially life-threatening tumors.

Risks:

Although these are very rare occurrences, it is important to be aware of them.

• Bleeding
• Infection
• Joint pain or stiffness
• Blood clots
• Muscle weakness
• Numbness

Your doctor will explain these risks to you thoroughly before the surgery.

When should you see a doctor immediately after surgery?

Once you return home after surgery, it is very important to pay attention to changes in your body. If you experience any of the following symptoms, call your doctor immediately or go to the hospital's Emergency Department (ETU).