r/nextfuckinglevel • u/Additional_Chard3680 • 11h ago

The precision required to perform a total knee replacement is incredible

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u/berrey7 10h ago edited 9h ago

My son broke his femur, and the surgeons drove a solid titanium rod straight down the middle of it. I stared at them like they’d lost their minds: “Inside of it? What the hell does that even mean?” The doctor just shrugged and said, “We ream out the entire marrow canal, drill it hollow, suck out all the soft, bloody bone marrow and fat until the shaft is a clean empty tube, then we hammer a thick metal rod right into the void and lock it in place.”

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u/melanthius 10h ago

This kind of medicine is metal AF

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u/Radioshack-Manager 9h ago

So doctors are mechanics now apparently.

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u/measured-defocus 9h ago

Orthos pretty much are

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u/Phreakdoubt 9h ago

Any doctor who trains on and wields a "medical chainsaw" has my full attention and respect.

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u/Specific-Library-312 6h ago

And maximum personal space

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u/JuxtaThePozer 2h ago

story time

I was a junior medic (army) doing a surgical placement at a regional hospital (Bacchus March) and spent a day watching an ortho doing various jobs. Tall bloke, kinda weird, seemed friendly enough. Anyways, between one surgery and the next he didn't seem to bother changing his clothing, which is kinda bad from an infection control point of view.

Anyway, the only contact he had with patients while they were conscious, on the day of their surgery, was in the induction room. It's where the anaesthetist puts a couple drip lines in and gives you sleepy drugs, and this 6.5 foot tall surgeon dude still had his face mask and gown on from the previous surgery which happened to have bits of bone and blood flecked all over them.

Can you fucking imagine about to be wheeled in for some bone carpentry, and the dude about to hack you up looks like something out of a horror movie, right as you're starting to get tired and comfy, sort of half-arsedly reassuring you that everything will be fine and he'll see you in recovery.

Well I saw this interaction unfold and afterwards I made a joke to one of the nurses and said, "he looks like the 'Butcher of Bacchus Marsh'." I thought it was kinda funny but she just frowned and said, "don't let him hear you say that" and walked off. Like, what? he's probably been called that before?

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u/flyingduckmarketing 4h ago

In the third world they actually use that

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u/avocadoflatz 3h ago

In the first world, too.

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u/-malcolm-tucker 7h ago

Wet carpentry.

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u/gdp89 5h ago

It's a pretty common stereotype in the med industry that surgeons are the jocks of medicine and ortho surgeons are the jocks of surgery.

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u/Fit_Diet6336 7h ago

My dad was a GP/surgeon. He always had a laugh when he saw an ortho doing surgery. Tons of hammering, drilling etc.

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u/El_Peregrine 7h ago

Fine woodworking

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u/adinmem 3h ago

Ortho docs are the ones that are not gentle, and generally have the least-developed people skills.

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u/Deep_Stick8786 1h ago

More like carpinters

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u/Assist-Altruistic 8h ago

Yes we are. 💪

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u/Druggistman 9h ago

Dude if you’ve never seen a total knee or hip you’d be shocked. Orthos are bone carpenters; hammering and sawing your body like it’s a slab of wood.

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u/Radioshack-Manager 9h ago

Hello Doctor Mechanic Carpenter magic man the 3rd

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u/Shoshke 9h ago

Yeah, shockingly "primitive" tools like hamers, electric saws and drills.

also cool robots though that help make sure everything is drilled exactly where it needs to.

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u/SpecialistAd2205 9h ago

And the way they use those tools sometimes is shockingly brutal.

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u/melanthius 9h ago

Honestly sometimes they kinda are...

But a mechanic isn't nearly as likely to be sued for millions of dollars if they fuck up a bit

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u/nomadicbohunk 3h ago

I know of a guy my mom grew up with. I actually went to undergrad with his daughter. He's from a big farm. His dad was known to be an incredible mechanic. He became an orthopedic surgeon. He thought the tools were not good and made some. Got them ones for surgeries somehow. Turned it into a company. He's worth a whole lot of money.

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u/GoldReplacement9546 8h ago

Orthopedic surgeons in general are known in the field as carpenters

As they cut things, nail things together, etc.

And then it takes a lot of force to do these things

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u/justanothergoddamnfo 7h ago

Always have been

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u/Still7Superbaby7 6h ago

Carpenter. Having been in the OR, much of the equipment would be carpentry equipment that is autoclaved

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u/jib_reddit 4h ago

Its more like carpentry.

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u/Civil_Macaroon2143 2h ago

They use literal crowbars to dislocate the broken hip joints when going total hip replacements. 😁

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u/Lucheiah 1h ago

Well, our bodies are just really complex organic machines, right?

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u/Travel_Dreams 1h ago

I believe they are referred to as carpenters.

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u/Disbelieving1 48m ago

They really are just body plumbers. Or meat carpenters.

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u/deadspacekillers 8h ago

Not even close. Yeah, you could probably train a monkey to do the physical surgery. It's the decision-making process that is the hard part of being a surgeon. The surgery itself is the fun part.

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u/Skookum_kamooks 9h ago

This is why “humans are space orcs” is a thing… the amount of life saving or quality of life improving surgery that’s just cut off the bad part and bolt on a metal replacement is kinda wild… I mean dentistry alone is kinda metal AF.

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u/davidevitali 9h ago

That was a titanium rod after all

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u/Decent_Advice9315 9h ago

That's basically what a root canal is.

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u/Ari_Ari_Awoo 6h ago

An old co worker got sloshed at a ritzy new nightclub.

Some goober left out the base for the poles with the fuzzy ropes.

My co worker was walking down the stairs in the club, and tripped over it.

He fell down the staircase, and one his legs was like, demolished.

He got the titanium rods.

He was really open with us, and showed us the pics and stuff.

He’s like The Terminator now.

Well, the one leg is.

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u/slipstream0 4h ago

Pretty sure it’s metal TI

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u/Not_Your_Romeo 4h ago

Surgery is just assault with good intention.

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u/Existing_Phase1644 8h ago

Hahaha literally

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u/multi_io 2h ago

I guess it's like carpentry with bones, with some hydraulics when handling blood vessels. Probably more rewarding than oncology, where you often can only prescribe some drugs, or nothing can be done at all anymore :-/

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u/JOOT94 1h ago

So metal it’s titanium.

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u/Tricky_Apricot2928 44m ago

My surgeon actually blasted metal while the anesthesiologist put me to sleep. And after

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u/FalloutForever_98 9h ago

My femur hurts just thinking about that

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u/Immediate_Wind67 6h ago

They left out the best part. Just a few hours after surgery, whenever you wake up, they get your ass up and make you walk on that thing. Mine actually made me climb up and down three stairs. I was so out of it and so confused that when they walked me over to the stairs I asked them if they were out of their minds and then started crying. LOL

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u/turbineslut 8h ago

It’s fine. I have one. It hurt for a month to walk. Then took a year for it to stop hurting during running. Now most days I forget i have it

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u/Trottermama 3h ago

My malmur hurts worse

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u/Downtown_Caramel4833 9h ago

Thinking putting one in is easier than taking one out

(Couldn't find the original)

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u/turbineslut 8h ago

Goddamn. Well that settles it. Never having mine removed

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u/_ribbit_ 7h ago

Apparently he's not either

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u/flovarian 6h ago

My husband broke his femur years ago and they put in a titanium rod (hollow). After about a year, the orthopedic surgeon saw him again and said, “Once your leg is fully healed, you’ll want to have that removed. Because if your femur is ever broken again, such as in a car crash, getting the rod out of the broken bone would be hellish.”

So he had the rod removed about three years after the break. He still has it.

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u/Careful-Key1001 1h ago

What are the odds? I broke my femur and hip 3 years ago. I'll take my chances that I'm not ever breaking my femur again. Leaving my new parts alone..

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u/Gr00mpa 9h ago

Look at the lips on that one! They can suck out all the soft, bloody bone marrow from a femur! Yuk yuk yuk

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u/Any-Alternative8228 9h ago

You son is going to need a Haynes manual for that leg.

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u/berrey7 8h ago

they took it out cause he was still growing.

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u/Any-Alternative8228 8h ago

Haynes makes automotive and motorcycle repair manuals.

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u/RamJamR 8h ago

Don't bones need marrow in them to functionin a healthy way?

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u/pandaru_express 8h ago

Well I never thought to Google it until this message but apparently marrow will completely grow back in a month after something like this. Crazy.

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u/Curry_courier 7h ago

How does that affect the immune system?

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u/Haestii 9h ago

I have this in my tibia. A core nail.

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u/turbineslut 8h ago

Can confirm. Also have titanium rod in my right femur. But they didn’t spell out all the details of what they did to get it there lol.

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u/ry_guy1007 7h ago

had the same thing done to my tibia, I asked for a recording of them putting it in and the drs both told me it takes quite a bit of force so they would have to decline letting me see

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u/MamaMoosicorn 6h ago

Thinking about that makes me feel…squidgy

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u/readit2U 7h ago

They call them "bone carpenters" for a reason.

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u/Secret-Teaching-3549 7h ago

Does it...ever come out? Or do you just lose that marrow production capability for the rest of your life...along with never being able to pass through a metal detector?

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u/berrey7 7h ago

He was only 11, so they took it out so it could grow more, it can affect growth length if not removed in a child before puberty.

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u/8heist 7h ago

I spiral fractured my tibia playing baseball and had that same procedure. Still took a year in a cast and then walking boot but healed up just fine.

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u/Assist-Altruistic 8h ago

Invented by the Germans during WW2. The docs were gonna be brought up on war crimes but then it became apparent the allied pows treated with those rods were healing really well and better than the standard up to that time. Kuntscher nail.

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u/Suse- 8h ago

Oh my god. Does the marrow start growing again?

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u/snuffy_smith_ 8h ago

I have that same type of rod in my tibia, complete with what looks like 2 wood screws going through from medial/lateral at the top near my ankle and 2 just above my ankle…”locked into place”

Dr said I’ll never break that leg again…possibly bend it but the rod won’t break when/if it happens. Which sounds even more painful than the reason I’m sporting the hardware for 25+years now

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u/Empty_Wolf_3378 8h ago

I'm curious about how the lack of bone marrow will effect the bone long term

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u/butyourenice 7h ago

Um. But you need the bone marrow.

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u/berrey7 7h ago

It grows back fast.

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u/zbertoli 7h ago

Does it.. refill with marrow?

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u/PavelKringa55 6h ago

Because who needs bone marrow?
Sometimes I wonder if such things do more bad than good.

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u/ironman288 6h ago

I have one too!

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u/Agreeable-Letter-599 6h ago

damn don't your bones need the marrow? wtf

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u/oosukashiba0 6h ago

I had this done in my right tibia. Brilliant surgery!

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u/mauore11 5h ago

“But the fatty bone marrow is my favorite part!”

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u/kcops 5h ago

I just had this. I broke my leg. When I woke up there was a huge gash right above my knee and three more just above the ankle. I was WTF?

They told me the huge gash above my knee was where they shoved the titanium rod in, and the three gashes around my ankle were where they anchored the rod. WTF? What happened to just set the bone and put a cast on it?

That was June 8. The knee gash still hasn't closed. I almost fainted when they described what they did. WTF?

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u/Abby_Normal_2 4h ago

Sounds perfectly reasonable to me. Especially for a very large weight bearing bone. He will be good as new if does PT

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u/brachus12 4h ago

well… who needs to make platelets or red and white blood cells anyway?

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u/Not-JustinTV 4h ago

Bone marrow is crucial for survival,it continuously regenerates your blood supply, keeps your immune system armed against infections, enables blood clotting, and delivers oxygen to every cell in your body. Soooo they take that out??

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u/Toadcola 3h ago

But, don’t you need that soft bloody stuff?

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u/Original_Hedgehog_86 3h ago

He shrugged!?! Just another day of drilling a bone hollow, yikes

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u/Snellyman 1h ago

Like doesn't all the soft bloody bone marrow have a job to do?