How did orthopaedic surgery begin?

Pat Lester
Nursing Program Coordinator, Unit 7-1 Orthopaedics/Neurosurgery

When I began thinking about one of my favorite topics—orthopaedics—my mind naturally turned to “How did we get here?”

In the mid-1800s, people with orthopaedic disabilities and diseases were considered incurable. There were only about 150 hospitals in the United States; surgery was not an option due to the high mortality rates of this time period, and anesthesia was in its infancy. Instead, people with orthopaedic disabilities or diseases relied on the charity of family and friends to survive.

James Knight believed children with these “afflictions” could be rehabilitated with braces, exercise and prayer. In 1863, Dr. Knight opened his Manhattan home to 28 children, and his home became known as the Hospital for the Ruptured and Crippled.

When Dr. Knight passed in 1887, the institution was turned over to Virgil Gibney, a doctor who believed the hospital should provide surgery in addition to rehabilitation. The number of surgical procedures increased rapidly. The first adult ward opened in 1903, and four years later the polio epidemic filled the hospital to capacity. The Hospital for the Ruptured and Crippled continued to grow, adding classrooms so children could keep up with their education while hospitalized. After several years and moves, Dr. Knight’s hospital became the Hospital for Special Surgery.

In 1955, the average length of a patient’s hospital stay after orthopaedic surgery was 25 days! Total joint replacements and arthroscopy were just beginning to be performed. Today, patients can expect to be in the hospital for only a few days—demonstrating great progress in surgical techniques, pain management and overall care.

To learn about orthopaedic services, visit

Kahn, B. A. (2005). “The Evolution of Orthopaedic Nursing at the Hospital for Special Surgery: The First Orthopaedic Institution in the United States.” Orthopaedic Nursing, 24 (5), 343-348.

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