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The Living Skeleton

Presenter: Dr. Heidi Bloom, M.D.

What do orthopedic surgeons treat? Orthopedic surgery encompasses problems and diseases of the entire musculoskeletal system, which means orthopedists work with disorders of bone, joints, related tumors and soft tissues such as ligaments and tendons. Orthopedists treat a spectrum of ages from babies to elderly people. For instance, they fix hip fractures in older people, screen adolescents for scoliosis (curvature of the spine) and babies for hip dysplasia.

What kinds of problems do orthopedic surgeons encounter? Almost everyone has either direct experience with a fracture or sprain. After treatment most of these acute injuries resolve without any further problems. However, some injuries develop into chronic disorders and may require long-term treatment involving exercises, drugs, and surgery such as with total joint replacement. Examples of acute and chronic injuries are found in The Living Skeleton (refer to: http://www.accessexcellence.org/RC/VL/xrays/)

Sports related injuries are another area in which orthopedists play a major role. This subspecialty of orthopedics is called "sports medicine". From managing the career threatening injuries of professional athletes in sports like football and basketball to treating the shin splints of a weekend warrior, the orthopedist must evaluate the course of action to be taken that will give the most satisfactory outcome for that individual.

What does the future look like? In the forefront of orthopedic research is the tantalizing possibility of regrowing bone and cartilage. If new cartilage can be generated at the site of a worn out joint, this may reduce the need for total joint replacements, decrease pain and suffering in a growing elderly population, and save money from lost productivity and medical treatment. Fewer total joint replacements will provide a significant reduction in the costs of medical care. For example, assuming there are no breakthrough preventative treatments for the conditions that lead to total knee replacements, by the year 2030 there will be an estimated 454,000 total knee replacement procedures annually, an 85 percent increase from 245,000 such surgical procedures in 1996. Total knee replacements cost thousands of dollars and require several days in the hospital at great cost.

Suggested questions for discussion:

1. Why do some fractures require surgery and plates and screws while others are treated with splints or casts?

2. How long does a fracture to take to heal and why do some fractures not heal? How do you treat a fracture so that it does heal?

3. Is there any evidence that joint supplements such as glucosamines help anyone?

Post your question for Dr. Bloom.


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