Principles of surgical management of musculoskeletal conditions

Practical procedures for treatment of fractures and dislocations have been used since the time of Hippocrates in fourth century BC. Orthopaedic surgery became a recognized part of surgical treatment since the mid-nineteenth century, but saw major developments with the invention of x-rays and antibiotics in the early part of the twentieth century. Though orthopaedic surgery had started with an interest in the correction of deformities in children, the major musculoskeletal problems facing orthopaedic surgery today relate to osteoarthritis, trauma (including sports injuries), and osteoporosis. The practice of orthopaedic surgery has evolved with technology: advances in engineering and material science and increasing expectations towards faster rehabilitation have moved orthopaedics into the era of joint replacements, arthroscopy, and less invasive surgical procedures. This chapter aims to provide an evidence-based condensed overview of the surgical management for a broad spectrum of musculoskeletal disorders encountered by primary-care clinicians and rheumatologists.