Arthroscopy is the imaging of the inside of the joints with a pen-sized camera using small incisions of one centimeter. It was used only for diagnostic purposes in the seventies and today it is used for both diagnosis and treatment thanks to developing technology and special tools. It has been widely used in the treatment of diseases involving the shoulder, ankle, wrist, elbow and hip joints, most commonly the knee joint.
Arthroscopy is performed under anesthesia and operating room conditions. Simple diagnostic procedures can be performed under local anesthesia, but regional or general anesthesia is used for therapeutic arthroscopy. The inside of the joint is inflated using a liquid to provide the image, which is discharged at the end of the procedure. During surgery, the structures within the joint are enlarged 4-6 times to provide an image so that a detailed diagnosis is possible. A complete diagnostic procedure can be performed, as the camera can also display areas that are not easily accessible during open surgery. Once the diagnostic examination is completed, the treatment of problems detected within the joint can be performed using mechanical, motorized, or thermal energy (radiofrequency or laser) instruments, also placed through small incisions.
At least two small incisions are used for arthroscopic surgery, the number of these incisions can be increased to reach different areas. Processing time ranges from 20 minutes to 2 hours. In some cases, arthroscopic surgery may be performed in conjunction with open surgery. In these cases, the joint part of the procedure is performed by arthroscopy and the part outside the joint is performed by open surgery.
The length of hospital stay after arthroscopic procedures depends on the complexity of the procedure. While some procedures may be discharged on the same day, in some cases hospitalization may be necessary for several days.
Total knee prosthesis is the formation of an artificial joint by covering the worn joint surfaces with special parts made of metal and polyethylene designed for painless joint movement. The knee prosthesis, which was first applied in 1968, has been developed with the help of surgical techniques, materials used and design advances and has become a more successful treatment method today.
Who is the total knee replacement for?
Although knee pain is uncontrolled, daily life activities such as walking, stair climbing are severely restricted and advanced cartilage damage is present in total knee prosthesis, although rest, drugs, physical therapy methods, cane use and intraarticular injections have been applied. The patient is preferred to be between the ages of 60 and 80 years, but in some special cases, such as rheumatoid arthritis and osteonecrosis, prosthesis may be performed at an earlier age.
How is total knee replacement performed?
After appropriate anesthesia, the knee joint is reached with an incision made in front of the knee. The worn cartilage tissue on the contacting faces of the three bones (femur, tibia, and patella) forming the joint is cut with a thin layer of bone, then the selected prosthetic fragments of appropriate size are prepared using a filler called bone cement (polymethyl methacrylate) surfaces.
Thus, the joint faces are re-coated with parts made of metal and plastic. Surgery lasts between 1-2 hours. Epidural or intravenous pain pumps are often used for postoperative pain control. The next day, the knee movements begin and help is to stand up. When you are able to walk comfortably in the room and hallway, you can be discharged from the hospital. This period varies from 3 to 7 days, although varies greatly from patient to patient.
Total hip replacement is an operation to replace the damaged joint with an artificial joint in patients with severely damaged hip joint. The hip prosthesis consists of main parts made of cobalt chrome or titanium and plastic, metal or ceramic spacers where they are jointed.
The hip replacement can be attached to the bone in two ways. In elderly patients with poor bone quality, the prosthesis is fixed to the bone with a filler called bone cement. This type of prosthesis is called cemented hip prosthesis. In younger patients with good bone quality, the prostheses covered with a porous material are placed very firmly in the bone, and then the bone of the body moves into the pores on the prosthesis to provide fixation. This type of prosthesis is called cementless hip replacement.
Due to the design changes made in the size and geometric structure of the joint parts of the hip prosthesis, the risk of dislocation of the prosthesis is reduced. This resulted in the elimination of some of the limitations of the old design hip replacement during daily life activities.
In the past, interventions with much larger incisions and damage to large muscle groups can now be made by taking care of smaller incisions and soft tissues around the hip. This facilitated the return to daily life activities after surgery. Postoperative hospital stay was shortened due to improvements in postoperative pain control.
Who is the total hip replacement suitable for?
Hip arthroplasty is applied in patients who are severely damaged due to arthritis, hip dislocation, fracture or vascularity, if other treatment methods (drugs, physical therapy, intra-articular injections, cane use) are not obtained.
Hip replacement is the best treatment option in cases of severe pain, limitation of movement and shortness that prevent daily life activities. It is preferable that the patient is over 60 years of age, but may also be administered in younger patients if necessary (rheumatoid arthritis).
Hallux Valgus is a common orthopedic disease of the big toe. It refers to the bone protrusion on the inner side of the big toe. If this condition is not treated in time, it can cause loss of labor, quality of life and aesthetic problems with symptoms that may concern not only the thumb but the whole foot. Especially someone with a family history of Hallux Valgus should take precautions at an early age due to its genetic predisposition. The first physical manifestation of the big toe bone, which is projected outwards, facilitates the diagnosis of the disease. Depending on the degree of hallux valgus formation, preventive or surgical treatment is decided.
The anterior cruciate ligament is one of the structures that connect the femur and tibia bones together in the knee joint. This ligament, which is very important for the knee to function normally, is the most important structure that prevents the tibial bone from moving abnormally forward.
Anterior cruciate ligament injuries take the first place among injuries that occur during sports and cause athletes to stay away from sports for more than 4 weeks. Anterior cruciate ligament injuries are followed by internal meniscus and internal lateral ligament injuries. In the United States, approximately 200,000 anterior cruciate ligament injuries occur annually. It is expected that this frequency will increase with the increasing interest of society in sports. Although there are no healthy data in our country, it is estimated that approximately 3,000 anterior cruciate ligament injuries occur annually.
How do anterior cruciate ligament injuries occur?
Anterior cruciate ligament injuries usually occur during sudden rotational movement on the fixed foot. It often happens during an athlete’s own movement. More rarely, anterior cruciate ligament injuries may occur following direct impacts from the knee, traffic accidents, fall from height and industrial accidents. In this case, injuries of the posterior cruciate ligament, lateral ligaments and meniscus can also be added to the anterior cruciate ligament injuries. Because of the structural characteristics of female athletes, anterior cruciate ligament injuries are more common than male athletes. In adults, injuries can be as the rupture of the ligament from the body, while in children, the injury may occur as a part of the ligament ruptures from the bone.