Information resources for patients regarding orthopaedic problems on the internet
We are at a stage in history where we have easy and instant access to complex information and are often times overloaded with it. We now can have access to huge amounts of data within a few seconds with the tap of a few keyboard keys. Google is the most popular search engine that majority turns to with a query.
It is important to know how Google gives us the information and places the information in the order given in the search. The order is not necessarily in the order that you as a patient would like it to be or we as surgeons would like it to display to us. While some websites may be very relevant, some, however, are not so relevant and could potentially mislead you. This list of websites is an endeavor to guide you to accurate patient information for common Orthopaedic conditions.
Having said that, information given by individual countries is primarily aimed at the local population. While the behaviour of most of the Orthopaedic conditions is similar in most countries, their presentation may differ and some conditions are more common in India compared to western countries e.g. Tuberculous joint and spine infections. One should keep in mind that all diseases, medicines and operative procedures may not behave exactly the same in all countries due to racial, cultural, dietary, behavioural and climatic differences.
There may be differences among people within the same country depending on their comorbidities (associated medical problems) and other factors. Hence, one should discuss the issues involved with their respective doctors before deciding what is best for them. For example, poor result of Total Knee Replacement in a neighbour or friend does not necessarily mean that one, as a patient, will also experience the same result. As information is available, one can research about their conditions to make assisted decision making with the help of the doctor.
Compounding this is the fact that there are a number of different techniques to achieve the same result and two surgeons may operate using different techniques or equipment to attain the same end result. So their post-operative management of the patient may not necessarily be the same. It is important to get the postoperative management of orthopaedic conditions from the operating surgeon. A growing number of surgeons have their own websites to better guide their patients, giving the rehabilitation protocols they prefer in these websites in addition to information on the conditions they treat and the contact details. For the reasons given above, the advice given by doctors should be heeded as they are equipped with local knowledge and experience of dealing with the condition locally.
Trauma & Orthopaedics is broadly divided into sub-specialties. The vast majority of surgeons that practice in India and even in the western countries include more than one sub-specialty. Some surgeons prefer to restrict their practice to one sub-specialty for a variety of reasons.
The sub specialties include: Adult Reconstruction (deals mainly with joint replacements), Paediatric Orthopaedics (Orthopaedic problems in Children), Trauma (deals with fractures and dislocations), Foot and Ankle, Shoulder and Elbow surgery (sometimes included under Adult Reconstruction), Limb Reconstruction (deformity corrections), Arthroscopy and Sports Medicine, Spine surgery, Hand and Wrist surgery, Musculoskeletal Oncology (Orthopaedic tumours) and Peripheral Nerve Injuries. Allied and closely related specialties include - Rheumatology, immunology and Metabolic disorders, Plastic Surgery and Neurosurgery. Physiotherapy is a supportive service of Orthopaedics.
The following are some of the useful websites for orthopaedic conditions on the internet. The list is very brief, giving access to professional information to patients which is reliable. More websites will be made in the future. One should make an effort to find the accuracy and authenticity of a website before going through the information as it may be very confusing to alter the information once gathered in our memories and can also lead to mistrust between a doctor and a patient.
1. www.orthoinfo.org - Patient information
A part of American Academy of Orthopaedic Surgeons (AAOS), this is an excellent site for patients seeking information on a range of topics in orthopaedics. Most of the physiotherapy exercises that your doctor prescribes are available at this site.
2. https://www.nice.org.uk/ - Medical guidelines and devices
NICE (National Institute for Care and Health Excellence) is a UK based website which gives very useful information about latest news in health, consultations on health policies, guidance and pathways for health care providers and sets quality standards for healthcare providers in the UK. It has useful information for patients on a range of health issues from all specialties.
3. http://mohfw.nic.in/index.php - Ministry of Health and Family Welfare, India official website
Any policy matter about health and family welfare in India can be accessed from the Ministry of Health and Family Welfare website.
4. https://www.aofoundation.org - AO Foundation (Trauma)
A Switzerland-based organisation which pioneered fixation methods in fractures in the later part of the last century and early this century. It is a well-organised site mainly for orthopaedic and trauma surgeons for information on trauma. Patients may be able to get information about traumatic conditions.
5. http://ghr.nlm.nih.gov/handbook/hgp/genome - Genetic and chromosomal disorders
This is a service maintained by U.S. National Library of Medicine (NLM) giving information on all Genetic disorders on record. Information on Human Genome Project and other Genetics news is available here (http://ghr.nlm.nih.gov/Resources). Information on a wide range of pediatric and pediatric orthopaedic genetic and chromosomal conditions can be found here.
6. http://www.tbcindia.nic.in/ - Tuberculosis
An excellent site for information on Tuberculosis in India. It is maintained by the Directorate General of Health Services, Ministry of Health and Family Welfare,India. You can get information on RNTCP (Revised National Tuberculosis Control Programme) here.
7. National Joint Registries
National Joint Registry of UK reports on the results of Joint Replacements done in the UK on a regular basis (http://www.njrcentre.org.uk/njrcentre/default.aspx).
Australian Joint Registry - https://aoanjrr.dmac.adelaide.edu.au/
American Joint Registry - http://www.ajrr.net/
ISAR - International Society of Arthroplasty Registries - http://www.isarhome.org/directory - Gives information and links to joint Registries of most countries.
The Indian counterpart of Joint Registries is based at Ahmedabad and is yet to get a website of its own. The data is generally handled by ISHKS (Indian Society of Hip and Knee Surgeons - http://www.ishks.com/)
It is useful to get information regarding joint replacement implants from these registries which provide a summary of results of popularly used individual commercially available implants at regular intervals.