Musculoskeletal Surgeries Explained

Definition

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

Bones are rigid structures that make up the body’s skeleton. They provide structural support and protect vital organs. Joints are the connection point between bones, and ligaments, which are strong bands of tissue, further reinforce them. Tendons attach muscles to bones, while skeletal muscles are contractile tissues that allow the body to move and maintain its posture. Orthopedics, or orthopedic surgery, is a medical field that specializes in the care, diagnosis, and treatment of the musculoskeletal system.

Who might require musculoskeletal surgery?

Musculoskeletal surgery refers to various procedures that aim to:

• 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 instances:

1. Trauma

Trauma from sports-related injuries and car accidents may cause fractures and dislocations that require surgery.

2. Infections

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

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

3. Degenerative diseases

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

Common degenerative diseases of the musculoskeletal system include:

• osteoarthritis (OA)
• osteoporosis
• degenerative disk disease, such as spondylosis

OA and spondylosis may cause severe pain and damage. A doctor may recommend surgery for these conditions when nonsurgical treatments do not improve a person’s symptoms. Individuals with severe osteoporosis have very fragile bones and may need surgery to prevent fractures.

4. Overuse injuries

Overuse injuries, which health experts also call cumulative trauma disorders (CTDs) or repetitive strain injuries, may occur due to:

• repetitive work-related activities
• overuse
• staying in one position for too long

These expose muscles and tendons to constant wear and tear and repetitive stress, causing pain and inflammation. Carpal tunnel syndrome, neck pain, shoulder pain, and low back pain are examples of CTDs. Carpal tunnel release surgery is the most common surgery people undergo on the wrist and hand in the United States.

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

5. Cancer

Cancer can develop in the bone or soft tissues. Surgery is the usual treatment for musculoskeletal cancers, such as sarcoma and bone cancer. If individuals with these types of cancer do not receive treatment, they may require limb amputation. The cancer may also spread to other areas of the body.

How do they perform musculoskeletal surgery?

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

An anesthesiologist will give a person either general or local anesthesia. 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 tissues with tissues collected from other parts of the body.

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

These surgeries are typically minimally invasive, and people undergo them as outpatients.

Other examples of this procedure include:

• fasciotomy
• muscle repair
• tendon repair

Open reduction

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

In case of severe injuries, surgeons may use external fixators to keep the bones in place.

Learn more about bone fracture repair here.

Osteotomy

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

Surgeons use 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 spinal osteotomy to correct spine curvature and reduce pain.

Moreover, osteotomies help correct deformities in the 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 the damaged parts of the joints and replace them with implants. They will also include a spacer between the implants to ensure the joint moves smoothly.

Hip replacement and knee replacement surgeries are examples of this procedure.

A 2019 study found that total joint replacement improves a person’s quality of life and pain levels. This makes it a valuable treatment for people with hip and knee OA whose bodies do 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 deformity
• improve joint stability
• increase strength

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

Possible risks and complications

Orthopedic surgeries carry possible risks and complications. These include:

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