reconstructive surgery--and implications

[Victor Steinbok]

MWOLD lists "reconstructive surgery" going back to 1943. OED only has
one entry for reconstructive (but includes both a noun and an adjective).

> Relating to, concerning, or occupied with reconstruction.

Although the meaning is a bit generic, there are two quotes included the
mention "reconstructive surgery"--one of them antedating MW's limit.

> 1928 /Amer. Jrnl. Nursing/ *28* 1209/2   These patients, unlike most
> others, are not reduced in strength by illness; reconstructive
> surgery, in most cases, is not gone on with until the patient is in
> good condition.
> ...
> 2004 /Breast Reconstruction/ (Breast Cancer Care) (rev. ed.) 21   It
> is just as important to be breast aware after reconstructive surgery
> as before.

There are, I believe, two types of reconstructive surgeries. One matches
the listed sense--it includes using plastic surgery to restore or to
create an appropriate shape for an organ, including, but not limited to,
mammaries (post-excision), genitals (usually gender changing), facial
features (including cleft palate, post-burn ear, nose, mouth, etc.),
skin (including regrowth from transplanted patches). The second type
originates from sports medicine and includes arthroscopic procedures,
repair and regrowth of ripped, broken or damaged cartilages and
ligaments, particularly involving implantation of pieces taken from
other parts of the body, regrowth and reshaping of broken or damaged
bones, etc. Structurally, these are very different types of surgeries
although both kinds may involve implantation or transplantation. The
first type is reputed to be a skill-based surgery, the second type is
more of a high-tech operation (although, obviously, also involves a high
degree of skill).

IMO both have a very narrow and well defined meaning for
"reconstructive" that should be taken out of the generic definition. And
"reconstructive surgery" certainly earns a separate spot.

These surgeries also have consequences. Of course, the procedure is not
only referred to "reconstructive surgery", but also as "X
reconstruction" (where X is the respective organ or joint). Then X
itself is referred to as "reconstructed X" (particularly in reference to
knees, ankles, elbows and breasts). Neither of these is in the OED with
this particular meaning--I presume, both are currently understood to
fall under the generic definition.

> 1. The action or process of reconstructing something.
>  a. The rebuilding of something natural, artificial, or abstract.
>  b. spec. The rebuilding of an area devastated by some process, esp.
> war; the restoration of economic stability to such an area. Also in
> extended use.
>  c. U.S. Usu. with capital initial. The process by which the
> Confederate states which had seceded during the Civil War were
> reorganized and restored to the Federal system of government. Also:
> the period during which this process occurred. Now hist.
>  d. Business (orig. Brit.). The reorganization of a limited company by
> (voluntary) liquidation and transfer of assets to a newly-formed
> company under similar ownership, usually in order to redistribute
> capital or liability.
>  e. Linguistics. The action of deducing the structure or nature of a
> protolanguage, or of an individual form or feature within such a language.
>  f. In accident and criminal investigations: the action of recreating
> the scene or circumstances of an accident or crime as an aid to
> discovering the cause, perpetrator, etc.

Given d., e., and f., it would be odd to force "knee reconstruction"
under b. Medical definition of reconstruction--both of them,
really--deserves a call-out. Reconstructed 2. (a. and b.) is linked to
reconstruction 1.c. But the main definition is, again, very generic:

>  1. That has been reconstructed (in various senses).

Again, it would seem odd to stick "reconstructed knee" under this
category. It would seen even more odd to stick something that is
"constructed" rather than "reconstructed" (i.e., cleft palate or
transgendered genitals) as something "that has been reconstructed"
(although the adjective still applies).

It's just a thought--take it or leave it. Other dictionaries (AHD, MW)
do have separate lemmas for medical reconstructive terms. I think, the
OED should as well.

     VS-)

PS: The hook for this diatribe was the mention of Tom Brady's
"reconstructed knee" in one of the ESPN articles on him.

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