Written by Dr. Omar David Hussamy

Orthopaedic surgery involves a series of clinical judgments made before, during, and after an operation. In medical malpractice litigation, these decisions are often examined closely to determine whether care met the applicable standard. Evaluating surgical decision-making requires more than reviewing the outcome; it requires understanding the clinical reasoning behind each step of care.

Standards of care in orthopaedics are not rigid formulas. They reflect what a reasonably prudent orthopaedic surgeon would do under similar circumstances, considering the information available at the time. When I evaluate a case, my focus is on the decision-making process rather than hindsight. This includes assessing diagnostic workup, timing of intervention, choice of surgical technique, and post-operative management.

Pre-operative evaluation is often a key issue. This stage includes patient history, physical examination, imaging studies, and consideration of non-operative options when appropriate. In joint replacement cases, for example, proper patient selection and surgical planning are critical. Factors such as anatomy, comorbidities, implant choice, and alignment strategy all play a role in surgical outcomes.

Intra-operative decision-making is another frequent area of scrutiny. Orthopaedic surgery requires technical execution as well as the ability to respond to unexpected findings. Surgical reports, implant records, and operative notes provide important insight into what occurred during the procedure and whether those actions were consistent with accepted practice.

Post-operative care and follow-up are equally important. Many orthopaedic complications arise not during surgery, but afterward. Infection, hardware failure, stiffness, and delayed healing must be recognized and addressed in a timely manner. Evaluating these cases involves reviewing follow-up visits, imaging, rehabilitation plans, and the response to evolving clinical findings.

It is also important to recognize that not all adverse outcomes indicate substandard care. Orthopaedic surgery carries inherent risks, and complications can occur even when care is appropriate. A key part of my role as an expert is to distinguish between known risks and true deviations from accepted standards.

Clear explanation of these issues is essential in litigation. Judges and juries benefit from understanding not only what happened, but why certain decisions were made and whether they were reasonable based on the clinical circumstances at the time.

Learn more at https://www.hussamyortho.com/