Orthopedic Surgery
Orthopedic Surgery is one of the most instrument‑intensive and technically demanding specialties in the operating room. CSTs in orthopedics support procedures involving bones, joints, ligaments, and soft tissues, using power tools, implants, traction systems, and arthroscopy equipment. This specialty requires precision, strong anticipation skills, and deep familiarity with orthopedic sets used in trauma, total joints, sports medicine, and spine crossover cases.
Role of CSTs
- Prepare orthopedic instrument sets, power tools, implants, and specialty trays for trauma, total joints, and sports medicine cases.
- Assist with patient positioning, traction setup, prepping, and draping for open and arthroscopic procedures.
- Maintain sterile technique during high‑volume, high‑instrumentation cases involving bone cutting, drilling, and implant placement.
- Anticipate surgeon needs during reduction, fixation, reaming, drilling, and implant assembly.
- Manage implant systems, including plates, screws, nails, anchors, and prosthetic components.
- Operate and troubleshoot orthopedic power tools, arthroscopy towers, and fluid management systems.
- Support intraoperative imaging workflows with C‑arm, navigation systems, and robotic‑assisted platforms.
- Assist with specimen handling, implant tracking, and accurate surgical counts during complex multi‑set procedures.
Essential Skills
- Proficiency with orthopedic power tools, reamers, drills, saws, and drivers.
- Strong understanding of bone anatomy, fracture patterns, and implant systems.
- Ability to anticipate surgeon needs during reduction, fixation, and implant assembly.
- Skilled in handling large, heavy, and multi‑component instrument trays.
- Familiarity with arthroscopy equipment, fluid pumps, and camera systems.
- Competence with traction devices, limb positioners, and fracture tables.
- Ability to support intraoperative imaging workflows and maintain sterility around C‑arm equipment.
- Effective communication with surgeons, anesthesia, radiology, and nursing teams.
Common Procedures
- Total hip arthroplasty (THA)
- Total knee arthroplasty (TKA)
- Shoulder arthroscopy and rotator cuff repair
- ACL reconstruction
- ORIF (open reduction and internal fixation) of fractures
- IM nailing of long bones
- Carpal tunnel release
- Hand and wrist reconstruction
- Ankle fracture repair
- Meniscectomy and meniscus repair
- Hardware removal
- Joint arthroscopy (knee, shoulder, hip)
Instruments & Equipment
Instruments
- Basic orthopedic sets (large bone, small bone, hand sets)
- Power tools (drills, saws, reamers, drivers)
- Reduction instruments (bone clamps, reduction forceps)
- Screwdrivers and plate systems
- IM nail systems and targeting devices
- Arthroscopy instruments (biters, shavers, probes)
- Retractors (Hohmann, Bennett, Chandler)
- Osteotomes, mallets, and rasps
- Suture anchors and arthroscopic fixation devices
Equipment
- Orthopedic power tool systems
- Arthroscopy towers and fluid management pumps
- C‑arm fluoroscopy
- Traction tables and limb positioners
- Tourniquet systems
- Navigation or robotic‑assisted surgery platforms
- Implant trays and sterilization containers
- Suction and irrigation systems
- Specialized positioning devices for extremity and joint procedures
Workflow & Case Progress
- Room setup with orthopedic instrument trays, power tools, implants, and positioning devices.
- Patient positioning using traction, limb holders, or fracture tables as required.
- Prepping and draping with attention to extremity isolation and tourniquet placement.
- Initial exposure using retractors and specialty instruments.
- Reduction of fractures or preparation of joint surfaces.
- Drilling, reaming, cutting, and implant placement using power tools.
- Verification of alignment and fixation using C‑arm imaging.
- Irrigation, hemostasis, and closure with layered suturing.
- Final counts, dressing application, and safe transfer to PACU.
Sterile Technique Considerations
- Maintain sterility around power tools, cords, and irrigation lines.
- Protect the sterile field during frequent C‑arm movement and imaging.
- Manage large, heavy trays without contaminating the field.
- Maintain sterility during high‑fluid arthroscopy cases with active irrigation.
- Handle implants and hardware with precision to avoid contamination.
- Ensure sterile technique during long cases with multiple instrument exchanges.
Career Pathways
- Orthopedic Surgical Technologist
- Trauma Orthopedic Technologist
- Arthroscopy Specialist
- Joint Reconstruction Specialist
- Orthopedic First Assist (with additional training)
- Orthopedic device representative or clinical specialist
- OR educator for orthopedic instrumentation and workflows
- Navigation or robotic‑assisted surgery technologist
How to Prepare
- Study bone anatomy, fracture patterns, and common fixation methods.
- Learn implant systems, screw types, and plate configurations.
- Practice handling orthopedic power tools and understanding their components.
- Review arthroscopy workflows and camera system setup.
- Observe orthopedic trauma and joint replacement cases to understand pacing.
- Build strength and endurance for handling heavy trays and long procedures.
- Review sterile technique for imaging‑heavy cases involving C‑arm movement.