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5 Common Orthopedic Incisions and Closure Methods

Nearly 30 million Americans will develop some type of musculoskeletal problem within the next year for issues involving the bones, joints, muscles, tendons, ligaments, and nerves in their body. To address the problem and ease their patients’ pain, orthopedic surgeons will perform a variety of surgical and nonsurgical treatments to address problems of the musculoskeletal system. Here’s a look at some of the most common procedures involving incisions both minimal and invasive.

Five Orthopedic Surgeries and Needed Incisions

1. Arthroscopic Surgery

A common procedure used in the diagnosis and treatment of problems inside a joint, "arthroscopy" literally means “joint” and “scope,” from the Greek words. It involves looking inside a joint with a tiny camera and light inserted through a small incision, usually about half an inch in length. Once the issue has been diagnosed, additional small incisions are made to treat the underlying problem (for example, a shaver that trims torn cartilage from a joint). Of course, not all problems can be solved arthroscopically, and in these cases another surgical approach will be recommended.

2. Total Joint Replacement

This surgical procedure involves removing an arthritic or damaged joint and replacing it with an artificial implant that functions like a normal, healthy joint. There are three common types of total joint replacement procedures.

  • Total knee replacement. Cartilage damage to the knee restricts movement and can be extremely painful. Depending on the severity of the damage to knee cartilage, often resulting from trauma, arthritis, or obesity, a patient may need partial or total knee replacement surgery. During the procedure, the surgeon moves the kneecap aside in order to cut away damaged bone and cartilage and replace it with safe metal and plastic components that mimic the natural movement of a knee. Incisions can range from about four inches to as many as ten based upon the amount of work needed.

  • Total hip replacement. Considered one of the most successful operations in all of medicine, total hip replacement surgery is performed on more than 300,000 Americans each year, according to the Agency for Healthcare Research and Quality. The procedure involves removing the ball and socket of a joint with arthritis and inserting a new one to allow for better movement. Traditionally, surgery involved a single, long incision, but if the scenario is right a surgeon may be able to employ less invasive tactics involving one or two shorter incisions to reduce scarring and increase recovery speed.

  • Total shoulder replacement. While not as common as knee or hip replacement (about 50,000 surgeries per year), total shoulder replacements are performed due to trauma, osteoarthritis, a lifetime of golfing, and a host of other reasons. The surgery involves replacing damaged bone and cartilage with an implant through an incision made between the deltoid and the pectoralis major muscles on the front of the shoulder. It includes the release of adhesions and contractures and removal of bone spurs that can affect range of motion and cause pain.

3. Rotator Cuff Repair

Consisting of a group of tendons and muscles in the shoulder, the rotator cuff helps to lift and rotate the arm, while keeping the shoulder joint in place. Most often it becomes damaged due to a fall injury or simple wear over time as the tendons tear or get pinched by the bones surrounding them. A partial tear in the tendon may need only a trimming or smoothing procedure known as debridement. Large or complex tears require a surgeon to make a three- to five-inch incision in the shoulder and detach the shoulder muscle to gain access to the tendon for repair. It’s then stitched back to the humus upon completion of the repair.

4. Spinal Surgery

Our spines get a workout every day, so it’s no surprise that a number of problems can surface. Medication or physical therapy may be able to solve for some issues, but often surgery is required to improve function and ease or eliminate pain. Incisions can be relatively small, just enough to get at a particular vertebra, or can run the length of the back, depending on how much spinal work is needed. The most common orthopedic spinal surgeries are as follows:

  • Laminectomy. Also known as decompression surgery, laminectomy enlarges your spinal canal by removing lamina—the back portion of a vertebra—to relieve pressure on the spinal cord or nerves.

  • Diskectomy. A surgical treatment involving the removal of part of failing or damaged spinal disks. This relieves pressure on nearby nerves and reduce low back pain and sciatica (pain stemming from the lower back that affects the legs).

  • Fusion. Essentially a welding process, spinal fusion involves fusing together two or more vertebra so that they heal into a single, solid bone.

5. Ankle and Wrist Surgery

Our feet consist of 26 bones and our hands do them exactly one better, with 27 bones; both have an even greater number of joints. Because of the complexity of these structures, a number of problems can arise that require surgical treatment, including overuse injuries, rheumatoid arthritis, stress fractures, and sprains. Incisions may be less than an inch or up to about 2 inches depending on the problem, but, especially in the case of hands which are almost always uncovered and visible, many people can be self-conscious of scarring.

Closing Wounds Following Orthopedic Surgery

No matter how invasive a surgery may be, each requires some form of closure, and surgeons have been limited to four traditional methods, each presenting its own set of unique challenges.

  1. Sutures. Stitches can causes needlestick injuries, scarring, and infection. They’re also time-consuming to sew in and sometimes require a return visit to take out.

  2. Staples. These leave an unsettling appearance in the minds of many patients and result in scarring; they also often require a return visit for removal.

  3. Glue. Difficult to apply and often very messy, glue also requires the skill to closely approximate skin edges.

  4. Adhesives. Gummy and known to release prematurely, adhesives are also weakened by moisture.

Today, surgeons have another option: BandGrip. The latest development in wound closure technology, BandGrip Micro-Anchor Skin Closures offer a quick, intuitive, and non-invasive closure option for surgeons. Resembling a typical adhesive bandage, BandGrip’s patented micro-anchors grip the skin tightly and hold wound edges together to facilitate a secure closure offering many advantages:

  • Faster and easier application versus sutures and staples

  • Eliminates the risk of needlestick injuries

  • Can be applied by a nurse or physician’s assistant

  • Results in less scarring than sutures or staples

  • Supports better mobility due to its smooth, water-resistant surface

  • Does not require a return visit for removal, saving surgeon’s time

Want to experience wound care 2.0 for yourself? Request your free sample now.

Advanced Wound Closure