The Beauty of Bones and Joints

Going beyond the bare bones of the issue

January 21, 01:01 PM

Dr. Mohd Rusdi Abdullah attained his medical degree from the International Islamic University Malaysia (IIUM) and undertook his Masters in Orthopaedic Surgery at the Universiti Kebangsaan Malaysia (UKM) – National University of Malaysia. Upon graduation, he worked with several Malaysian Ministry of Health tertiary hospitals. By mid 2013, Dr. Rusdi enrolled in a fellowship programme sub-specialising in arthroscopy & sports surgery. Through this well-regarded fellowship, Dr. Rusdi had opportunities to learn and work with world-renowned orthopaedic surgeons from Hospital Kuala Lumpur, the Technical University of Munich (TUM), Germany and the Instituto Ortopedico Rizzoli in Bologna, Italy.
Upon his return, Dr. Rusdi culminated the fellowship in Hospital Selayang and continued to practice there as a Consultant Orthopaedics, Sports and Trauma Surgeon until July 2017. Not one to rest on his laurels and as a doctor who believes learning and improving never ends, he further undertook a Fellowship in Trauma Surgery at a teaching hospital of Harvard Medical School in Massachusetts, USA.  
Dr. Rusdi is now a Consultant Orthopaedic Surgeon with a sub-specialty in Arthroscopy and Sports Surgery at the Subang Jaya Medical Centre. In this article, the erudite and tireless bone and joint expert speaks of his passion for orthopaedic surgery and the treatments and procedures he specialises in.
 
Dr Mohd Rusdi Abdullah
How did your love for orthopaedics begin?
My passion for orthopaedics began when I was just in my teenage years. Not only did I find joy in repairing and constructing, I loved sports and constantly made it a point to maintain an active and healthy lifestyle. Furthermore, it has always been my nature to care for people and work with various mechanical tools and instruments. As such, there was no doubt that orthopaedic surgery was to be my future path. Apart from its clear-cut approach where diagnosis and outcomes are objective in nature, it also requires artistry and creativity as there’s no one solution for every problem. In summation, patients can enjoy and take advantage of its improved curative interventions that neither requires too many diagnostic differentials nor prolonged medical care. In short, despite being a difficult discipline to master, orthopaedic surgery doesn’t have pigeonholed solutions as there are no rigid barriers. 
In my humble opinion, this fraternity requires doctors to continuously learn and hone their craft. It’s an ongoing educational journey and through this process, I’ve had opportunities of meeting and befriending amazing people and colleagues who’ve spoke of their ideas, philosophies and experiences. 
What are orthopaedic surgery’s commonest challenges?
While orthopaedic surgery has been very rewarding, it isn’t without its challenges. Firstly, not all doctors will qualify for its training programme and if one wants to pass with flying colours, trainees have to show initiative, work tirelessly and be well prepared for all tasks and responsibilities. Secondly, learning never ends. I consistently update my knowledge on anatomical and biomechanical function as well as be further versed in the many available surgical techniques, instruments, implants and treatment solutions. Next and because we’re required to be on call, and sometimes perform long surgeries at odd hours, and appropriately handle life-threatening situations including emergencies and disasters, personal fitness and maintenance of healthy lifestyles should remain a priority. In addition, orthopaedic surgeons must constantly think on their feet as complications like infections or implant failures are unfortunate possibilities. Last but not least, we have a responsibility to the people supporting us and therefore, ought to prioritise good relationships with not only colleagues but also the working team and staff too. 
Degenerative knee joint can be treated with realignment osteotomy or knee replacement surgery
What treatments and procedures do you mainly perform?
I can say that the bulk of my cases are divided into trauma, sports injuries, degenerative joint diseases, overuse injuries and even deformity correction. Trauma cases are commonly motor vehicle collisions and industrial accidents. Sports injuries however, are most times correlated to the knees and shoulders. Such knee injuries include anterior cruciate ligament tears, multiligament injuries, cartilage and meniscus injuries. When the shoulder is concerned, patients generally present with acute or recurrent dislocations, instability, muscle and tendon tears, impingement syndrome, frozen shoulder and osteoarthritis. Sports patients may also complain of pain and instability in the elbow and ankles too. 
The commonest presentation of knee related pathology is swelling, pain, instability, locking and being unable to perform normal activity. In my opinion, should patients experience any of these symptoms, it’s best they consult with a surgeon immediately owing to the fact that the earlier problems are diagnosed, the higher the possibility for a better treatment outcome. Patients must understand that delayed treatment may cause easily treatable injuries to turn irreparable, which may necessitate complex and prolonged treatment. 
In general, all sports injuries require immediate rest – especially in the affected region – cold compression, bandaging or splinting and anti-inflammatory medications.  Physiotherapy and activity modifications may also offer amazing benefits in some cases. Other conservative treatments may include regenerative and therapeutic injections to the affected area. PRP (Platelet Rich Plasma) injections can be efficacious on poorly healing tissue.  
Should all other treatments fail or present with severities that necessitate surgery, I may recommend minimally invasive or arthroscopic (keyhole) procedures if possible. Ultimately, surgeons understand that invasive procedures may not be for everyone and therefore will only recommend operations after all other non-invasive techniques have failed. Nonetheless, patients shouldn’t fear surgery as medical and technological developments have given birth to reparative and reconstructive methods that both constitute open techniques or minimally invasive surgery with fewer risks and produce good results.
Degenerative diseases – like sports injuries – can be treated via conservative therapies at early stages. Take osteoarthritis for instance. During the disease’s early stages, surgeons may advise activity modification, weight loss and physiotherapy. In addition, there are other treatments like hyaluronic acid injection and even stem cell therapy. 
However, in cases where patients present with advanced degenerative changes, surgeons may initially suggest conservative treatments, but should such recommended options fail, we’ll have no choice but to advocate joint replacement surgeries. 

What do you find most satisfying about orthopaedics and what are your personal philosophies?
The most gratifying aspect about being a surgeon is helping patients return to normal activity and function and seeing them experience improved quality of life. My personal philosophies are to not only maintain good relationships with patients, but colleagues as well, as it’s important to work together in order to accomplish desired goals and optimal treatment results. Moreover, my personal principles involve providing patients with adequate information regarding their conditions, diagnosis and treatment options because not all methods befit every problem. At the end of the day, patients can rest assure that I’ll continuously apply my skills, judgment and knowledge to each unique case in the interest of securing only the best possible outcome. 
 
Dr. Mohd Rusdi Abdullah
• Consultant Orthopaedic Surgeon at Subang Jaya Medical Centre (SJMC)
• Speciality: Arthroscopic Surgery, Knee Surgery, Shoulder Surgery, Hip Surgery, Sports     Injury, Soft Tissue, Joint replacement, Trauma
• National Specialist Register No. 129110
• Malaysian Medical Council No. 39637
Qualifications
• MBBS, International Islamic University Malaysia, 2002.
• Master of Surgery (Orthopaedic), National University of Malaysia, 2011.
• Fellowship in Arthroscopy & Sports Surgery, Ministry of Health, 2013 – 2016.
• Fellowship in Arthroscopy & Knee Surgery, Instituto Ortopedico Di Bologna, Universita Di Bologna, Italy, November – December 2014.
• Fellowship in Orthopaedic Sports Surgery, Klinikum Rechts Der Isar, Technical                  University of Munich (TUM), Germany, January – July, 2015.
• AO Internantional Trauma Fellowship, BIDMC, Harvard Medical School Teaching             Hospital, USA, 6 – 31 March, 2017.
• Certified Medical Impairment Assessor, Malaysian National Institute for Occupational Safety and Health, 2011.
• Advanced Trauma Life Support, 2013.
Membership
• International AO Trauma Foundation.
• International Society of Arthroscopy, Knee Surgery & Orthopaedic Sports Medicine.
• European Society for Sports Traumatology, Knee Surgery & Arthroscopy.
• Asia Pacific Knee, Arthroscopy & Sports Medicine Society.
• Malaysian Arthroscopy Society.
• Malaysian Orthopaedic Association.
• Malaysian Medical Association.

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