An orthopedic surgeon is a doctor who specializes in diagnosing, treating, and performing surgery on the bones, joints, muscles, ligaments, and tendons that make up your musculoskeletal system. These specialists handle everything from broken bones and torn ligaments to joint replacements and spinal conditions. While the word “surgeon” is in the title, a significant portion of their work involves non-surgical treatments like physical therapy, bracing, injections, and medication management.
What Orthopedic Surgeons Treat
The musculoskeletal system includes over 200 bones, roughly 360 joints, and more than 600 muscles, along with the tendons and ligaments connecting them all. Orthopedic surgeons treat problems anywhere in this system. Common reasons people see one include fractures, arthritis, back pain, sports injuries like torn knee ligaments or rotator cuff tears, carpal tunnel syndrome, osteoporosis, and bone tumors.
Many orthopedic surgeons also treat conditions that develop gradually over time. Degenerative disc disease in the spine, osteoarthritis that wears down joint cartilage, and tendinitis from repetitive motion all fall within their scope. They see patients across every age group, from children with scoliosis or growth plate injuries to older adults needing hip or knee replacements.
General vs. Subspecialty Practice
Some orthopedic surgeons maintain a general practice, treating a wide range of musculoskeletal problems. Others complete additional fellowship training (one to two years beyond residency) to focus on a specific area of the body or patient population. The most common subspecialties include:
- Sports medicine: Injuries to ligaments, tendons, and cartilage, often using minimally invasive arthroscopic techniques
- Joint replacement (arthroplasty): Replacing damaged hips, knees, shoulders, or other joints with artificial implants
- Spine surgery: Conditions like herniated discs, spinal stenosis, and spinal deformities
- Hand and upper extremity: Problems from the fingertips to the shoulder, including nerve compression and fractures
- Foot and ankle: Bunions, Achilles tendon injuries, fractures, and reconstructive work
- Pediatric orthopedics: Musculoskeletal conditions specific to children, including clubfoot, limb deformities, and fractures involving growth plates
- Trauma: Complex fractures, dislocations, and injuries from accidents or falls
- Orthopedic oncology: Bone and soft tissue tumors
If your primary care doctor refers you to an orthopedic surgeon, asking whether the surgeon subspecializes in your particular problem can help you find the best fit.
Training and Education
Becoming an orthopedic surgeon requires one of the longest training paths in medicine. After completing a four-year undergraduate degree and four years of medical school, a doctor enters an orthopedic surgery residency lasting five years. Those who pursue a subspecialty then complete an additional one to two years of fellowship training. In total, an orthopedic surgeon typically trains for 13 to 15 years after high school before practicing independently.
Board certification from the American Board of Orthopaedic Surgery (ABOS) requires passing both a written and an oral examination. Surgeons must also demonstrate ongoing competency through continuing education throughout their careers. While board certification isn’t legally required to practice, most hospitals require it for staff privileges, and it signals a verified standard of training.
Surgery Isn’t Always the First Option
Despite the title, orthopedic surgeons spend a substantial amount of their time recommending and managing non-surgical treatments. For many conditions, surgery is considered only after conservative approaches have been tried. A patient with knee arthritis, for example, might first be guided through physical therapy, weight management, anti-inflammatory medications, and corticosteroid or lubricant injections before joint replacement is discussed.
When surgery is recommended, the approach varies widely depending on the problem. Arthroscopic procedures use small incisions and a camera to repair torn cartilage or ligaments, often allowing patients to go home the same day. Joint replacements are larger operations typically requiring a hospital stay of one to three days, followed by weeks of rehabilitation. Spinal surgeries range from outpatient disc procedures to complex fusions requiring months of recovery.
Recovery timelines depend heavily on the specific procedure. A simple arthroscopic knee surgery might have you walking within days and back to full activity in six to eight weeks. A total hip replacement generally takes three to six months for a full return to normal activities, though most people feel significantly better within weeks. Your surgeon should give you a clear timeline for what to expect at each stage of recovery, including when you can drive, return to work, and resume exercise.
Orthopedic Surgeons vs. Similar Specialists
Several other types of doctors work on overlapping problems, which can create confusion about who to see. Rheumatologists treat joint and autoimmune conditions like rheumatoid arthritis and lupus but do not perform surgery. Physiatrists (also called physical medicine and rehabilitation doctors) focus on restoring function through non-surgical methods. Podiatrists specialize in the foot and ankle and can perform surgery in that area, though their medical training follows a different pathway than orthopedic surgeons.
Sports medicine physicians are another source of overlap. Some are orthopedic surgeons with sports medicine fellowship training, while others come from primary care backgrounds and treat sports injuries non-surgically. If you need a procedure, the orthopedic sports medicine surgeon is the one who operates.
Neurosurgeons also perform spine surgery, creating one of the most common points of confusion. Both orthopedic spine surgeons and neurosurgeons are trained to operate on the spine. The historical distinction (neurosurgeons focused on the spinal cord and nerves, orthopedic surgeons on the bones and discs) has blurred considerably, and both types now perform many of the same procedures. For most spinal conditions, either specialist is qualified.
What to Expect at Your First Visit
A first appointment with an orthopedic surgeon typically starts with a detailed history of your symptoms: when they started, what makes them better or worse, and what treatments you’ve already tried. The surgeon will perform a physical exam of the affected area, testing range of motion, strength, stability, and pain response. Bring any imaging (X-rays, MRIs) you’ve already had done, as this saves time and avoids unnecessary repeat scans.
After the evaluation, the surgeon will explain their diagnosis and lay out a treatment plan. This might be as simple as a brace and physical therapy referral, or it might involve scheduling further imaging, trying injections, or discussing surgical options. If surgery is recommended, you should expect a clear explanation of what the procedure involves, the expected recovery timeline, the success rate, and the risks. Getting answers to all of these questions before agreeing to any procedure is a normal and expected part of the process.