I have been on the orthopedic surgery rotation for the past two weeks and have learned so much about orthopedics in that time! One of the interesting things about being a fourth-year veterinary student is that you get to see cases that you wouldn’t always see in a private practice somewhere. For orthopedic surgery, this comes in the form of complications from previous surgeries, and patients with difficult hurdles to jump.
Just the other day, a patient with a luxating patella was referred to us after his previous surgery failed, for what we call a “re-op,” or a surgical revision of a previous surgery. As any veterinarian or veterinary student knows, many procedures are fraught with complications, and orthopedic surgery is no different. Even the most well-meaning and well-trained surgeons don’t always get things perfect on the first try. This is why it is so important to know your strengths and weaknesses as a veterinarian or surgeon. In this dog’s case, the first surgery may have worked if he was a normal dog, but he wasn’t. He had a curvature of the lower part of his femur that made patellar luxation repair very difficult. Part of his re-op involved straightening the lower part of his femur by taking out a wedge of bone and securing the two cut pieces with a plate and screws. Talk about exhausting and complicated! While it sounds “doable,” the precision with which you have to cut the femur in order to make the bone straight in the end is very difficult and tedious to actually achieve.
Luckily his surgery went well, but it was a good reminder to always plan for every possible outcome, and not to feel inadequate if a surgery is more complicated than you are comfortable performing! I hope to be able to perform many surgeries and procedures as a general practitioner, but I will always keep in mind the complications in case I do not have the surgical help, equipment, or means to practice the best medicine. As veterinarians, we never like to admit when we struggle with something, but sometimes, the gold standard of care is to refer.