The Most Difficult Surgery for an Orthopedist: Ranking the Challenging Procedures in the Field

Choose the surgery you think is the most difficult!

Author: Gregor Krambs
Updated on Apr 18, 2024 06:41
Are you curious about the mind-boggling world of orthopedic surgery and the challenges faced by the experts in this field? Look no further! StrawPoll is hosting an exciting new ranking, "What is the most difficult surgery for an Orthopedist?" where you can dive into the intricate world of orthopedic procedures and cast your vote for the most complex surgery. Join thousands of other participants in uncovering the marvels of the human body and the incredible skills required to mend it. Can't find your favorite surgery on the list? Don't worry! You can suggest a missing option and share your insights with the community. So, what are you waiting for? Test your knowledge, learn something new, and help determine the most difficult orthopedic surgery by casting your vote now!

What Is the Most Difficult Surgery for an Orthopedist?

  1. 1
    This surgery involves the fusion of two or more vertebrae in the spine to eliminate motion between them. The surgery can be complex and require a high level of precision, as it involves the placement of screws and rods in the spine.
    Spinal fusion surgery is a surgical procedure performed on the spine to join two or more vertebrae together permanently. It aims to stabilize the spine, reduce pain, and improve function. During the procedure, bone grafts or synthetic materials are used to encourage the growth of new bone, which then fuses the vertebrae together. This limits the motion between the fused vertebrae and can alleviate symptoms caused by conditions such as spinal instability, degenerative disc disease, or spinal fractures.
    • Procedure type: Orthopedic surgery
    • Purpose: Spinal stabilization and pain reduction
    • Primary target condition: Spinal instability
    • Secondary target conditions: Degenerative disc disease, spinal fractures
    • Materials used: Bone grafts or synthetic materials
    Spinal Fusion Surgery in other rankings
  2. 2

    Joint Replacement Surgery

    Sir John Charnley
    Orthopedic surgeons must perform joint replacement surgeries with precision and care to ensure the replacement joint functions properly. The procedure requires the removal of damaged or diseased joint components and the insertion of an artificial joint.
    Joint replacement surgery is a surgical procedure in which an arthritic or damaged joint is replaced with an artificial joint called a prosthesis. This surgery is commonly performed for joints such as the hip, knee, shoulder, and elbow. The aim of joint replacement surgery is to relieve pain, improve joint function, and enhance the quality of life for individuals suffering from severe joint conditions.
    • Prosthesis Material: Metal, ceramic, or plastic
    • Surgical Approach: Minimally invasive or traditional open surgery
    • Anesthesia: General or regional anesthesia
    • Joint Mobility: Restores natural joint movement
    • Recovery Time: Varies, but typically several weeks to months
    Joint Replacement Surgery in other rankings
  3. 3
    This surgery is used to correct limb length discrepancies caused by injury or congenital conditions. Orthopedic surgeons must be highly skilled at bone lengthening and bone transport techniques.
    Limb Lengthening Surgery is a complex orthopedic procedure that aims to increase the length of a person's bones, particularly in the limbs. It is typically used to correct limb length discrepancies resulting from congenital conditions, trauma, or diseases like dwarfism. The surgery involves surgically cutting the bone, then gradually lengthening it over a period of time using an external or internal device. This stimulates new bone formation in the gap, leading to overall lengthening of the limb.
    • Surgical Technique: Minimally invasive
    • Device used: External or internal fixator
    • Duration of procedure: Several hours
    • Lengthening rate: Usually 1mm per day, can vary
    • Consolidation period: Several months
    Limb Lengthening Surgery in other rankings
  4. 4
    Hand reconstruction surgeries can be complex and require a high level of precision. Orthopedic surgeons must be skilled in microsurgery techniques to repair damaged nerves, blood vessels, and tendons.
    Hand reconstruction surgery is a complex orthopedic procedure aimed at restoring form and function to the hand following trauma, disease, or congenital abnormalities. It involves intricate reconstructive techniques to repair or replace damaged bones, tendons, ligaments, nerves, and blood vessels within the hand.
    • High precision: The surgery requires tremendous precision due to the intricate structures and delicate anatomy of the hand.
    • Multidisciplinary approach: Hand reconstruction surgery involves collaboration between orthopedic surgeons, plastic surgeons, hand therapists, and other specialists to achieve optimal outcomes.
    • Customized treatment plans: Every case is unique, and treatment plans need to be tailored to the specific needs of the individual patient.
    • Microsurgical techniques: Microsurgery is often employed to reconnect tiny blood vessels, nerves, and reposition tissues with extreme precision.
    • Use of advanced imaging: Preoperative imaging such as MRI or CT scans aid in understanding the extent of damage and planning the surgical approach.
  5. 5

    Arthroscopic Surgery

    Dr. Masaki Watanabe
    This minimally invasive surgery involves the use of a small camera to view and repair damage to joints. Orthopedic surgeons must be highly skilled in arthroscopic techniques to perform this surgery.
    Arthroscopic surgery, also known as arthroscopy, is a minimally invasive surgical procedure performed by orthopedic surgeons to diagnose and treat various joint problems. It involves the use of a specialized instrument called an arthroscope, which is a thin fiber optic tube equipped with a light source and camera. This allows the surgeon to visualize the joint and perform the necessary repairs or treatments through small incisions without the need for open surgery.
    • Minimally invasive: Requires small incisions compared to traditional open surgery
    • Visualization: Provides a clear view of the joint interior through the arthroscope
    • Diagnostic: Enables accurate examination and diagnosis of joint conditions
    • Therapeutic: Allows for various treatments like repairing damaged tissues, removing loose bodies, and reconstructing ligaments
    • Reduced scarring: Leaves smaller scars and reduces the risk of postoperative complications
  6. 6
    Orthopedic surgeons must be skilled in repairing complex fractures, which can involve multiple broken bones and significant soft tissue damage. These surgeries can be lengthy and require a high level of skill.
    Complex Fracture Repair Surgery is a highly challenging orthopedic surgical procedure aimed at restoring the structure and function of bones affected by complex fractures. It involves meticulous realignment and fixation of broken bones, often requiring the use of specialized techniques and implants.
    • Length of procedure: Varies depending on the complexity, but can range from 3 to 8 hours
    • Anesthesia: Most commonly performed under general anesthesia
    • Incision size: Varies depending on the fracture location and complexity
    • Imaging techniques used: X-rays, CT scans, and/or MRI may be used for preoperative planning and intraoperative guidance
    • Preoperative preparation: Thorough evaluation of the patient's medical history, physical examination, and imaging studies
  7. 7
    This surgery involves the replacement of the entire shoulder joint with an artificial joint. Orthopedic surgeons must be skilled in complex shoulder anatomy and have experience with shoulder surgery.
    Total Shoulder Replacement Surgery is a complex procedure performed by orthopedic surgeons to replace the damaged or diseased shoulder joint with an artificial joint. It involves removing the damaged parts of the shoulder joint and replacing them with prosthetic components.
    • Surgical Approach: Multiple surgical approaches can be used, including anterior, posterior, or superior approaches based on the surgeon's preference and the patient's condition.
    • Prosthetic Components: The artificial joint consists of a metal ball that replaces the humeral head and a plastic socket that replaces the glenoid cavity.
    • Indications: Total Shoulder Replacement Surgery is typically performed to treat severe shoulder joint arthritis, fractures, rotator cuff tears, and certain cases of shoulder instability.
    • Anesthesia: General anesthesia is commonly used, although regional anesthesia options like interscalene blocks may also be considered.
    • Rehabilitation: Physical therapy plays a crucial role in the recovery process, helping patients regain strength, range of motion, and function in the shoulder joint.
  8. 8

    Total Knee Replacement Surgery

    Sir John Charnley
    Orthopedic surgeons must be skilled in complex knee anatomy and have experience with knee surgery to perform this procedure. The surgery involves the replacement of the entire knee joint with an artificial joint.
    Total Knee Replacement Surgery, also known as total knee arthroplasty, is a surgical procedure performed by orthopedic surgeons to replace a damaged or arthritic knee joint with an artificial prosthesis. This procedure helps to alleviate pain, improve mobility, and enhance the quality of life for patients with severe knee joint conditions.
    • Purpose: To restore function and relieve pain in severely damaged knee joints
    • Anesthesia: General anesthesia or spinal anesthesia with sedation
    • Incision: Longitudinal incision about 8-12 inches in length
    • Implant: Artificial knee joint made of metal alloys, high-grade plastics, and polymers
    • Procedure: Damaged bone and cartilage are removed, and the prosthetic components are implanted
  9. 9
    Orthopedic surgeons must be skilled in complex foot and ankle anatomy and have experience with foot and ankle surgery. These surgeries can involve the repair of multiple bones, tendons, and ligaments.
    Complex Foot and Ankle Surgery is a specialized surgical procedure performed by Orthopedists to address complex foot and ankle conditions that require extensive reconstruction or repair. It involves the treatment of complex fractures, deformities, arthritis, and soft tissue injuries in the foot and ankle region.
    • Extensive Reconstruction: The surgery involves extensive reconstruction of bones, joints, ligaments, tendons, and soft tissues to restore and improve foot and ankle function.
    • Complex Fracture Management: The procedure includes the management of complex fractures in the foot and ankle, such as intra-articular fractures and fractures involving multiple bones.
    • Deformity Correction: Complex foot and ankle surgery aims to correct deformities such as bunions, hammertoes, flat feet, high arches, and ankle malalignment, improving the overall foot structure and alignment.
    • Joint Replacement: In cases of severe arthritis, the surgery may involve joint replacement procedures, such as ankle replacement or fusion, to alleviate pain and improve joint function.
    • Soft Tissue Repair: Repairing damaged or torn ligaments, tendons, and other soft tissues in the foot and ankle is an integral part of complex foot and ankle surgery.
  10. 10

    Hip Resurfacing Surgery

    Sir Derek McMinn
    This surgery involves the replacement of the hip joint surface with a metal cap, rather than a complete joint replacement. Orthopedic surgeons must be skilled in complex hip anatomy and have experience with hip surgery.
    Hip resurfacing surgery is a procedure that involves replacing the damaged surface of the hip joint with a metal prosthesis. Unlike a total hip replacement, this procedure preserves more of the patient's natural bone by only removing and resurfacing the damaged cartilage and bone at the hip joint's surface. It is typically recommended for younger, active patients with hip arthritis or other hip conditions that have not yet caused significant bone loss.
    • Patient population: Younger, active patients with hip arthritis
    • Bone preservation: Preserves more natural bone compared to total hip replacement
    • Procedure type: Partial hip replacement
    • Artificial joint material: Metal prosthesis
    • Joint surface resurfacing: Only damaged cartilage and bone at the joint surface are removed and replaced

Missing your favorite surgery?


Ranking factors for difficult surgery

  1. Complexity of the procedure
    The level of difficulty of the surgical technique, the need for specialized tools and equipment, as well as the involvement of multiple anatomical structures, should be considered.
  2. Duration of the surgery
    Longer surgical procedures can be more challenging due to the increased risk of complications, the need for sustained concentration, and potential fatigue.
  3. Anatomical location
    Surgeries involving areas with limited access, critical surrounding structures, or highly specialized tissues can be more difficult.
  4. Patient factors
    The overall health and well-being of the patient, including age, medical history, and comorbidities, can influence the difficulty of a given surgery. Patients with poor bone quality, obesity, or other health issues may present additional challenges.
  5. Precision required
    Some orthopedic procedures require a high level of precision, such as joint replacements, spinal surgeries, or surgeries involving small bones and joints. Greater precision demands greater skill and attention, thus increasing the difficulty of the surgery.
  6. Experience and skill level of the surgeon
    The surgeon's familiarity, comfort, and expertise with a particular procedure can influence its perceived difficulty.
  7. Potential complications and risks
    Surgeries with a higher likelihood of complications or adverse outcomes, either during the procedure or in the postoperative period, can be considered more challenging.
  8. Team coordination
    Complex surgeries often require a diverse and highly skilled surgical team, which can consist of multiple surgeons, anesthesiologists, and nurses. The ability to effectively coordinate and communicate among team members is essential to success.
  9. Technological advancements and innovations
    The constant evolution of orthopedic surgery techniques, tools, and materials can influence the difficulty of a specific procedure. Surgeons must stay up-to-date with the latest advancements and be adaptable to new methods and technologies.

About this ranking

This is a community-based ranking of the most difficult surgery for an Orthopedist. We do our best to provide fair voting, but it is not intended to be exhaustive. So if you notice something or Operation is missing, feel free to help improve the ranking!


  • 178 votes
  • 10 ranked items

Voting Rules

A participant may cast an up or down vote for each Operation once every 24 hours. The rank of each Operation is then calculated from the weighted sum of all up and down votes.


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More information on most difficult surgery for an orthopedist

Orthopedic surgery is a specialized branch of medicine that deals with the diagnosis, treatment, and prevention of conditions affecting the musculoskeletal system. Orthopedic surgeons are trained to perform a wide range of surgical procedures, from simple joint replacements to complex spinal surgeries. However, some surgeries are considered more challenging than others due to the complexity of the procedure and the potential risks involved. When it comes to orthopedic surgery, one of the most difficult procedures is often considered to be joint replacements, particularly for the hip and knee. These surgeries require precision and expertise to ensure proper alignment and positioning of the prosthetic joint, as well as minimizing the risk of complications such as infection and blood clots. Other challenging orthopedic surgeries may include spinal fusion, shoulder arthroscopy, and reconstructive surgeries for complex fractures. In any case, orthopedic surgery requires a high level of skill and experience, as well as a thorough understanding of the underlying anatomy and physiology of the musculoskeletal system.

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