When was the first orthopedic surgery

MacIntosh pioneered the first successful surgery for the management of the torn anterior cruciate ligament of the knee. This common and serious injury in skiers, field athletes, and dancers invariably brought an end to their athletics due to permanent joint instability.

Working with injured football players, Dr. MacIntosh devised a way to re-route viable ligament from adjacent structures to preserve the strong and complex mechanics of the knee joint and restore stability. The subsequent development of ACL reconstruction surgery has allowed numerous athletes to return to the demands of sports at all levels.

Modern orthopaedic surgery and musculoskeletal research has sought to make surgery less invasive and to make implanted components better and more durable. The use of arthroscopic tools has been particularly important for injured patients. Arthroscopy was pioneered in the early ' s by Dr. Masaki Watanabe of Japan to perform minimally invasive cartilage surgery and re-constructions of torn ligaments. Arthroscopy helped patients recover from the surgery in a matter of days, rather than the weeks to months required by conventional, 'open' surgery.

Knee arthroscopy is one of the most common operations performed by orthopedic surgeons today and is often combined with meniscectomy or chondroplasty--both of which are removal of a torn cartilage.

The modern total hip replacement was pioneered by Sir John Charnley in England in the s. He found that joint surfaces could be replaced by metal or high density polyethylene implants cemented to the bone with methyl methacrylate cement. Since Charnley, there have been continuous improvements in the design and technique of joint replacement arthroplasty with many contributors, including W. Harris, the son of R. Harris, whose team at Harvard pioneered uncemented arthroplasty techniques with the bone bonding directly to the implant.

Knee replacements using similar technology were started by McIntosh in rheumatoid arthritis patients and later by Gunston and Marmor for osteoarthritis in the 's. The modern knee replacement was developed by Dr. John Insall and Dr. Uni-compartment knee replacement, in which only one side of an arthritic knee is replaced, is a smaller operation and has become popular recently.

Joint replacements are available for other joints on a limited basis, most notably shoulder, elbow, wrist, ankle, and fingers. In recent years, surface replacement of joints, in particular the hip joint, have become more popular amongst younger and more active patients. This type of operation delays the need for the more traditional and less bone-conserving total hip replacement, but carries significant risks of early failure from fracture and bone death.

One of the main problems with joint replacements is wear of the bearing surfaces of components. This can lead to damage to surrounding bone and contribute to eventual failure of the implant.

Use of alternative bearing surfaces has increased in recent years, particularly in younger patients, in an attempt to improve the wear characteristics of joint replacement components. These include ceramics and all-metal implants as opposed to the original metal-on-plastic. The plastic actually ultra high molecular weight polyethylene can also be altered in ways that may improve wear characteristics.

The treatment of children with muscoloskeletal problems remains an integral part of modern orthopaedic surgery. Many fractures and injuries occur in children due to their high activity level and unique immature skeleton. Treatment of fractures in children is different than adults due to active growth plates in their bones. Damage to the growth plate can lead to significant problems with later bone growth, and at-risk fractures have to be monitored with care.

The treatment of scoliosis is a mainstay of pediatric orthopaedics. For poorly understood reasons, curvature develops in the spine of some children, which if left untreated leads to undesirable deformity and may progress to cause chronic pain and breathing problems.

The treatment of scoliosis is quite complicated and often involves a combination of bracing and surgery. Children have other unique musculoskeletal conditions that have been a focus of orthopedics since Hippocrates, including conditions such as club foot and congenital dislocation of hip also known as developmental dysplasia of the hip. In addition, infections in bones and joints osteomyelitis in children are common. Nicholas Andry coined the word "orthopaedics", derived from Greek words for "correct" or "straight" "orthos" and " child " "paidion" , in , when at the age of 81 he published Orthopaedia: or the Art of Correcting and Preventing Deformities in Children.

In the U. The Greeks and Romans subsequently began to study medicine in a systematic manner, and greatly improved our understanding of orthopedic anatomy and surgical technique. After a period of little progress during the Middle Ages, rapid advancement was noted during the Renaissance, including the description of various injuries, improvements in surgical technique, and development of orthopedic hospitals. Collectively, these advances provided the foundation for modern orthopedics.

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