By Glenn Axelrod, MD
The Center for Orthopedic & Spine Care @ St. Joseph's
Syracuse Orthopedic Surgeons, PC
Orthopedic surgery is a surgical specialty which deals with diagnosis and treatment of medical conditions involving bone, muscle, and joints. Although it is a surgical specialty, the majority of patient can be treated non-operatively; we refer to that as conservative treatment. The conditions may be traumatic as well as non-traumatic. Most surgical procedures are considered to be elective, meaning that surgery is likely to lead to a better outcome than non-operative treatment, but that it is not absolutely medically necessary.
Understanding the above explanation helps patients more actively participate in their treatment plan. Beware of the surgeon who insists you need a hip replacement or need an anterior cruciate ligament reconstruction.
One of the things that attracts physicians to become orthopedic surgeons is the variety of conditions seen and the many treatment options of dealing with each of these problems. It is important that your orthopedist individualizes the treatment of your condition. The treatment should take a number of factors into consideration including gender, age, activity level (i.e., sports), weight, time availability (i.e., physical therapy), etc. In addition, the expectations of the surgery and the post operative course requirements must be discussed and accepted by both you and the physician.
Here are a couple of examples to help demonstrate the individualization of treatment. The first would be a forty-five year old weekend athlete who sustains an anterior cruciate ligament tear; that individual enjoys biking, swimming, and occasional jogging but does not play any high energy sports. This patient should probably not be treated the same way as a fifty-five year old aggressive athlete who skis, plays tennis, and basketball. The former would probably do well with a rehabilitation program; the latter would probably want an anterior cruciate reconstruction.
Another example would be a seventy five year old with significant knee arthritis who is relatively sedentary, has pain only when walking for distances and who has responded well to steroid injections given once or twice a year. This patient will probably be content and not be treated the same as the fifty-five year old with moderately severe arthritis who cannot go for walks because of severe knee pain and who has not responded well to medications, injections, physical therapy and is generally unhappy with their quality of life. The seventy-five year old will probably opt for continued conservative treatment whereas the fifty-five year old will most likely want to consider knee replacement surgery.
Dr. Axelrod completed his undergraduate and medical studies at the University of Rochester and completed his residency at University of Rochester/Strong Memorial Hospital. For more information on Dr. Axelrod, visit http://www.sjhsyr.org/723-Glenn-Axelrod.