WHAT IS ARTHROSCOPY?
Arthroscopic surgery is called ‘closed surgery’ among the people. In this surgical procedure, the inside of the joints is visualized and treated with fiberoptic devices.
In the 1970s, arthroscopy was used only in the diagnosis of diseases, but today, diagnosis and treatment can be performed simultaneously.
The aim of arthroscopic intervention is to solve the problem in the joint without opening it. It is one of the most used orthopedic methods for treatment for the last thirty years.
Which Diseases Can Be Treated With Arthroscopy?
- Hip joint
- Labrum tears
- Glutes impingement
- Synovia
- Ligamentum teres injuries
- Structural defects in the femur and pelvis
- knee joint
- Meniscus tears
- Ligament injuries
- Cartilage injuries
- Synovia
- Shoulder joint
- Tendon tears
- recurrent joint dislocations
- Shoulder impingement syndrome
- Freezing of the shoulder joint
- Acromioclavicular joint problems
- Suprascapular nerve entrapment syndrome
- Ankle joint
- Cartilage injuries
- Synovia
- Anterior and posterior impingement syndrome
- joint freezing
How Is Arthroscopic Surgery Performed?
Arthroscopy surgery can be performed with local or spinal anesthesia. It is entered into the joint by making approximately 0.5 cm incisions. A fluid is given to visualize the inside of the joint. The camera can be advanced and the image can be enlarged 4-6 times. It can also be viewed from various angles. Therefore, the viewing angle of the surgical site is quite high. This makes it possible to make a detailed diagnosis.
Making small incisions shortens the recovery time after surgery and enable patient to feel less pain.
The duration of arthroscopy surgery may vary depending on the type. This period is between 30 minutes and 2 hours.
How Does the Process Proceed After Arthroscopy Surgery?
After performing arthroscopic surgery, the patient is discharged on the same day. There may also be cases where a stay in the hospital for a few days is required. The patient should regularly take painkillers prescribed by the doctor.
After the surgery, a drain is placed to drain the fluid inside the joint. This drain is removed at the next dressing. It is possible for the patient to take a bath 2 days after the stitches are removed.
How Does the Process Before the Lengthening Surgery Work?
Before performing the lengthening surgery, the patient is taken to multiple scans. This scan is carried out physically and psychologically. Patients and their relatives are informed in detail about the surgery and recovery process. Consent is obtained from the patient and then the preparations for the surgery are launched.
Medications such as blood thinners and diuretics are stopped before the surgery. In addition, the doctor should be informed about the drugs used.
How is Length Extension Surgery Performed?
Lengthening surgery is mostly performed under general anesthesia.
While performing the lengthening surgery, osteotomy is performed in the first stage. This process is the cutting of the bone that is desired to be lengthened in two, transversely. In the next stage, the leg is stabilized with the help of fixation devices. After this stage, the distraction osteotomy begins. The bone separates very slowly from the inserted device. The reason for doing this is to allow the cut bone to elongate. By operating the pins on the device 4 times a day, a total elongation of 1 mm is achieved. The body switches to the production of tissue to fill the gap that occurs as the bones separate. With this method, 7 to 10 cm of elongation is recorded at the end of 2 months.
Stabilizer devices can be used to prevent misalignment. During this time, the patient walks with the help of crutches.
The first stage after lengthening surgery is consolidation. At this stage, the bone hardens and healing is achieved. At this stage, the elongation is stopped and the ossification of the elongated part is expected for approximately 3-4 months. If it is thought that the healing has taken place completely, x-rays are taken and the fixation device is removed.
Insertion and removal of the fixation device are also performed by making small incisions. The operation takes approximately 2-2.5 hours.
What is Precice Stryde?
Precice stryde is the most advanced form of preciceII and it is the safest, most successful and most comfortable lengthening method. The patient, who chooses the Precice stryde method, gets the opportunity to be treated with tailor-made nails using advanced technology. This allows the patient to walk without support by putting a load on the leg during the consolidation phase. With this application, mobility and load carrying potential can be increased to much higher levels.
Lengthening is carried out by controlling with external magnetic field. With this method, a total elongation of 8 cm is recorded. An elongation of 7 cm can be achieved within 70 days. The surgical process is similar to other surgeries.
There is no need for dressing and blood thinners in the post-operative period. With this application, which has a very low risk of infection, less pain is felt compared to other methods. Since the closed method is used, no traces are seen outside. This situation greatly increases the level of satisfaction with the aesthetic results.
What is the Process After the Lengthening Surgery?
After the lengthening operation, the patients are discharged after staying in the hospital for 2 days. Recovery time varies according to the type of surgery and the amount of lengthening. The recovery process of the patient who is given physical therapy, is accelerated with mineral supplements such as calcium. The patient should go through the doctor’s examination at intervals of 10-14 days.
It is possible to return to ordinary life standards and work 15-20 days after the operation.
WHAT IS DEFORMITY CORRECTION?
Deformity is an orthopedic term that refers to existing disorders in the anatomy of bones such as the spine skeleton, limbs and pelvis.
Deformity cases may be congenital or may occur later. Congenital deformities are caused by the wrong existence of the tissue drafts of the baby in the mother’s womb for various reasons. Subsequent deformities may occur as a result of metabolic disorders, polio, malunion of fractures, osteomyelitis and similar disorders.
Some types of deformity are as follows:
- rickets-related disorders
- “O” or “X” leg
- hip dislocation
- rotational problems
- flat-footedness
- Clubfoot
- Hallux valgus
Deformities that occur at an early age can negatively affect the life of the individual in the following years. The patient may experience posture problems and dysfunction, and his mobility may decrease. Existing deformities may cause a secondary deformity to occur over time and may completely disrupt the patient’s biomechanical balance. Therefore, early diagnosis and treatment are very important in order to maintain the quality of life.
Deformity correction treatments differ depending on the severity of the deformity, the age of the patient, and the presence or absence of a second deformity. Each surgery should be organized to be specific to the patient. If the deformity has spread, complex surgery may also be required.
Which Methods Are Used in Deformity Correction Surgeries?
- Deformity correction with the help of fixators: One of the safest ways to correct leg deformity is to apply external fixators. This method allows gradual correction of the deformity after surgery. After the operation, the patient can walk by putting weight on his foot. Fixators, which are attached to the bone with nails and wires and located outside the body, are devices that are worn to support the healing bones. External fixators can also be used to lengthen the bone.
- Correction of the deformity with the help of intramedullary nails: With careful planning and measurement, the deformity can be completely eliminated with the help of intramedullary nails inserted into the bone.
- Deformity correction with the help of plate-screw: Correction with a plate in the deformity around the knee can be done if the patient’s conditions allow. Approximately 1.5 months after the plate application, the patient becomes able to bear weight on the leg. This method can be preferred in order to prevent the formation of arthrosis.
With the advancement of medicine and technology, it has become possible to achieve more ideal results by using smart fixator systems.
Following the deformity correction surgery, tracking the patient, applying physical therapy and taking good care of the wound are also of great importance for rapid healing.
WHAT IS KNEE REPLACEMENT SURGERY?
Knee replacement surgery is a method used for the treatment of serious diseases such as traumas or calcifications in the knee.
Carrying the entire body weight, aging, rheumatic diseases, wear and tear of the cartilage, traumas can cause many problems for the knees. Among these, problems such as difficulty in walking and difficulty in climbing stairs significantly affect the life of the person.
As a solution to all these problems, knee replacement surgery helps to increase the quality of life of patients. This surgery, whose success rate can be as high as 98%, has started to become widespread.
There are three types of knee replacement:
- Standard total knee replacement
- Half knee prostheses
- Mini knee prostheses
Expert orthopedists are the authority that decides which of these prostheses can be used for the patient.
What is the Process Before Knee Replacement Surgery?
Before the knee replacement surgery is performed, the use of blood thinners should be discontinued and the doctors should definitely be informed about the drugs used by the patient.
Before the operation, food and drink should not be consumed and the patient should not smoke in the last 8 hours. If the patient has a disease that carries the risk of infection, such as influenza, at the time of the operation, the doctor should be informed about the subject. Because this may require the postponement of the surgery.
If the patient’s body shows an allergic reaction to metal jewelry, a skin test can be performed. In the presence of chronic infection, cultures are taken to prevent the risk of knee replacement infection.
It is recommended to take a bath without a pouch and without using lotion the night before the surgery. Female patients should be without make-up and nail polish. There should be no metal on the patient during the operation, and if there is a dental prosthesis, it should be removed.
How is Knee Replacement Surgery Performed?
Knee replacement surgery is an operation that is generally performed under epidural anesthesia with open surgery method. First, the worn surfaces at the end of the bone are cleaned. Then the prosthesis is placed in this area. Prostheses are anti-allergic devices that adapt quickly to the organism.
The pre-operative preparation process takes 1 hour. The operation takes approximately 1-1.5 hours.
How is the Process After Knee Replacement Surgery?
The patient, who is taken to the room after knee replacement surgery, does not feel any pain and is able to talk comfortably. The patient, who is recommended to spend the day of the operation lying down, is up and walking the next day.
When the patient is taken to the room, a catheter and a drain are attached, and antiembolic stockings are put on his legs. The patient is discharged after 2 to 5 days.
In this process, embolic stockings should be continued to be worn, and if a needle was provided, it should be used. Painkillers prescribed by the doctor can be taken in case of pain.
The doctor should examine the patient 15 days after the knee replacement surgery. The stitches are removed, but the patient can take a shower 2 days after the stitches are removed. It is necessary to wait 6 weeks to use the Turkish bath, sauna and bathtub. If necessary, physical therapy applications are also initiated.
Patients who work in heavy jobs can return to work after 10-12 weeks, and patients who do office work after 2 weeks. The patient can start sportive activities after 6 months. Sexual intercourse can be carried out under certain conditions after 4 to 6 week. To drive, the patient must wait 6 weeks.
Two weeks after the knee replacement surgery, the patient becomes able to let go of the walker. However, if he does not feel well enough to walk unassisted, he can use a walking stick. The patient does not need to use it after 6 weeks.
The presence of the prosthesis becomes imperceptible 3-6 months after knee replacement surgery.
After the operation, a scar of approximately 15 cm remains. The expiry time for knee prostheses is 20-25 years. Due to that reason, a regenerative surgery can be performed for the prosthesis, which has expired.
WHAT IS HALLUX VALGUS SURGERY?
The bony protrusion on the inner part of the big toe is called hallux valgus. It is more common in women aged between 25-40. The patient may feel pain when walking. Aesthetically it may be unappealing.
In the occurrence of hallux valgus problem, reasons such as trauma, flat soles, wrong shoe preference as well as genetic factors can be effective.
How is Hallux Valgus Treatment Performed?
Surgery is not considered unless the condition is severe. Patient is relieved by means of toe spacers, insoles, night splints but the use of these orthotics do not truly correct the deformity, which can only be achieved by surgery.
What is the Process Before Hallux Valgus Surgery?
Patient is thoroughly examined before surgery. Hallux valgus is inspected with weight on and off the foot and analyzed with simple x-ray.
How is Hallux Valgus Surgery Performed?
Various methods can be utilized for surgery. Specialized orthopedists determine the best method for the surgery. General or local anesthesia may be used. In the operation, incisions are made on the bone and an angle of 11 degrees is formed between the two bones.
Operation takes approximately 1,5 hours.
What is the Process After Hallux Valgus Surgery?
The patient may have to stay at the hospital for 1 to 2 days after Hallux Valgus operation. After 3 to 4 days, patient is allowed to walk. Big toe is supported with cast, bandages and brace. Dressing is used if the doctor deems it necessary. Recovery time is reduced with the use of antibiotics and blood thinners.
Full recovery takes approximately 6 weeks. A special shoe is worn during this time period. Leg elevation is advised to prevent swelling.
The patient will be able to do sports after 2 to 3 months.
WHAT IS HIP PROSTHESIS SURGERY?
Hip prosthesis surgery is done for treating the osteoarthritis of the hip joint. This surgery is very common in orthopedics.
Below are the conditions treated by hip prosthesis surgery:
- Hip fractures
- Slipped growth plate in hip
- Hip dislocation
- Tumors
- Rheumatic diseases
- Infectious sequelae
Hip prosthesis last up to 20 years.
How is the Process Before Hip Replacement Surgery?
Doctor examines the patient and determines the surgery date. Patient is required to lose weight if needed and takes break from blood thinner medication.
No eating or drinking is allowed starting from the night before surgery. Living space after surgery is recommended to be organized for extra comfort and ease of use for the patient.
How is Hip Replacement Surgery Performed?
General or local anesthesia may be used depending on the conditions. The hip joint is replaced with a prosthetic implant which can be cemented or uncemented. Operation takes approximately 1-3 hours.
What is the Process After Hip Replacement Surgery?
After surgery, patient is taken to the recovery room to be monitored for a couple of hours. Usually patient is wanted to lie on the back. Patient may have to stay at the hospital for 1 to 2 days considering the overall condition or be discharged in the same day.
To prevent blood clots, patient is made to walk with the help of crutches the next day.
During recovery period, patient should refrain from lying down and bending. It is allowed to get assistive care. It is beneficial for the patient to keep commonly used items and objects close since mobility will be limited.
Patient may take a bath after 2 weeks, may use alla turca toilet after 6 months, may cross legs after 2 months, may have sexual intercourse after 6 weeks and may drive a car after 1 month.
Full recovery occurs in 6 to 12 months. Doctor examines the prosthesis after 6 and 12 weeks. In time patient can swim, walk and ride a bicycle but high tempo sports like basketball are not recommended.
WHAT IS OSTEOMYELITIS?
Osteomyelitis is an infection in a bone. Disease emerges with the infection of the bone marrow. Bacteria and fungi are usually the cause. Bones may be exposed to microorganisms directly after an injury or a surgery or indirectly through the blood stream from another part of the body. This situation causes infection of the bone.
Signs and symptoms usually include:
People with the mentioned symptoms should immediately see a doctor.
Osteomyelitis usually affects hip, feet and shoulder bones in adults. In children it affects arm and leg bones. Diabetes, kidney diseases, etc., are risk factors for bone infection.
Early diagnosis and treatment is important to keep infection from becoming a serious threat.
How Is Osteomyelitis Treated?
Osteomyelitis has long been thought to be uncurable. However advancements in medicine made it possible to treat it with good results. Treatment varies by the severity of the disease. Mild cases can be cured with antibiotics whereas worse cases may require surgical procedures. Extreme cases can lead to amputation.
How Is Osteomyelitis Surgery Performed?
Infected area is opened up first, accumulated pus and fluids are drained from the infected area. Next, infected bone and tissues are removed. Cavities are then filled with tissues taken from the body via a technique called injection. Removed tissues are sent to a lab for biopsy for further diagnosis in order to determine the pathogen causing the disease. This allows to choose the best antibiotics for treatment. Intravenous therapy is used to administer antibiotics.
Treatment usually takes 4 to 6 weeks.
WHAT IS SHOULDER PROSTHESIS (SHOULDER REPLACEMENT) SURGERY?
Shoulder prosthesis surgery is done for treating the shoulder joint that is damaged for varying reasons such as rheumatoid arthritis, trauma or osteoarthritis.
Shoulder prosthesis last up to 20 years.
There are three types of shoulder prosthesis:
- Standard Anatomic Prosthesis
- Surface Coating Prosthesis
- Reverse Shoulder Prosthesis
Cemented and uncemented options are also available. The type of prosthesis should be selected carefully according to the patient’s overall condition and specific needs.
What is the Process Before Shoulder Replacement Surgery?
Doctor examines the patient, inspects the condition of the shoulder. Blood tests, MRI, x-ray, bone scan may be requested if needed.
How Is Shoulder Prosthesis Surgery Performed?
There are different methods for the shoulder prosthesis surgery. Doctor determines the exact method and the type of prosthesis that is going to be implanted. Damaged section of the shoulder is replaced with the prosthesis.
Shoulder prosthesis surgery usually takes 2 to 3 hours.
What is the process after shoulder prosthesis surgery?
Shoulder immobilizer is used for the first ten days after surgery. It is recommended to use shoulder immobilizer at nights for 4 weeks.
On day 10, patient starts doing passive arm movements. On week 3, patient starts doing active arm movements. Simple activities such as eating can be done after 2 weeks.
Stitches are removed after a couple of weeks. During this time period, the area of surgery have to be bandaged and should not contact water.
Driving is not recommended for 2 to 4 weeks.
Strengthening the muscles by doing the exercises given by the physiotherapist is very important for quick recovery. Doctor prescribed painkillers may be taken if needed.
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