4. Treatment techniques in orthopaedics

In orthopaedics, the treatment spectrum is broad. The surgical treatment is part of this, but despite the vastly increased surgical options, the non-surgical (‘conservative’) treatment is still very important. Conservative treatment may include an explanation of the complaints to the patient, advice on how to handle them, physiotherapy, cast treatment, use of braces, prescribing painkillers and administering local injections. However, there are many other forms of treatment. A considerable number of these treatment options have an empirical basis, which sometimes leads to conflicting insights. In recent years, scientific research has shown that a number of previously applied treatments are ineffective or no better than a placebo. The best-known of these are various physical therapy modalities, including cryotherapy, thermotherapy, ultrasound and electrotherapy. Glucosamine tablets for osteoarthritis have also proved to be ineffective. Of the surgical treatments, arthroscopic rinsing of an osteoarthritic joint has turned out to be no better than placebo surgery.