The prevailing myth that orthopaedic surgeons only treat surgery patients is not only false, it’s misleading.
“My goal, like many of my sports medicine colleagues, is to treat patients in whatever means necessary to get them back to their desired level of activity,” said Endeavor Health orthopaedic surgeon Joseph Lamplot, MD.
Conservative approach
In fact, as Dr. Lamplot and the Endeavor Health orthopaedic care team work to improve patients’ pain and function, they typically recommend an array of nonsurgical options first, with hopes that more conservative treatments will help alleviate disfunction and discomfort.
“There are, of course, some acute traumatic injuries; certain fractures, tendon ruptures, and ligament injuries that require prompt surgery to avoid permanent loss of function and avoidable adverse outcomes,” said Dr. Lamplot. “These cases are fairly black and white. But the majority of the patients who come to us land in a gray area.”
Things like degenerative tears of the rotator cuff, osteoarthritis of the shoulder, hip and knee, and some meniscus tears are among the common conditions that land in that gray area and send people to a specialist’s office in search of pain relief.
Multiple therapeutic modalities
“We try and work through a treatment ladder starting with the least invasive therapeutic modality first,” said Dr. Lamplot. From physical therapy to anti-inflammatory medication to image-guided injections, many conditions are improved or resolved without surgery.
“It’s somewhat rare that I tell a patient on the first visit that they need surgery,” said Dr. Lamplot, who also cited obvious cases like an ACL tear in a young athlete where surgery is the first recommended course of action.
“Our job as surgeons is to walk our patients through each of the options, including the risks and benefits of each treatment plan at a level that each patient understands, while leaving adequate time to ensure their questions are answered,” added Dr. Lamplot.
While there are known risks associated with any surgery, there can also be risks of putting off surgery for certain conditions, as waiting longer may mean the injury is no longer repairable.
Individual patient goals are very important, and some patients want to do anything to avoid surgery. “Treatment for the same exact condition can look very different for two different patients with very different goals,” said Dr. Lamplot.
Individual patient goals matter
“As providers, we must have a thorough understanding of all treatment options to do a good job counseling patients. There are multiple ways to treat many of the conditions we encounter, and patients’ needs and desires vary from person to person, so having a comprehensive understanding of nonsurgical options is critically important,” said Dr. Lamplot.
Educating patients and setting expectations around pain and activity levels is even more important with an increasingly active, aging population, he added. With more and more older adults playing in recreational sports leagues, and flocking to pickleball courts there are important discussions about the best ways for them to stay active and manage aches and pains along the way.
“We need our aging athletes to remain active, but injuries happen. When they do, we need to have a plan to get them back in the game that best suits them,” he said.
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