Description

Orthopedics and Traumatology

Arthroscopy  is a Latin word that means looking at the joint. Today, it is the method of diagnosis and treatment
applied by the Orthopedics and Traumatology branch. After the joint is
inflated with water, an average of 4 mm. thick devices are placed in the
joint through the skin. It is an advantageous method compared to open
surgery in terms of reducing the duration of hospital stay, the risk of
infection, the amount of postoperative pain and poor cosmetic appearance due to
the small size of the skin incisions and little damage to the
tissues. Training and special surgical equipment are required for the method to be applied.

Knee Arthroscopy Knee arthroscopy is the most common area where arthroscopic
surgery is applied today, due to the high number of diseases in this region and
the anatomical ability of the knee to allow arthroscopic surgery. With
this method, in the knee; Almost any tissue such as meniscus, cartilage,
ligament, bone and soft tissue can be easily accessed and treated. Also,
with this method, intra-articular fractures can be intervened.

Shoulder Arthroscopy Shoulder disorders are usually the conditions caused by
inappropriate or excessive use of the shoulder. It can also be seen after
sports injuries. The method is preferred in cases that have been
rehabilitated after shoulder discomfort but have not achieved satisfactory
results. Thanks to the method, evaluation and treatment of the shoulder
joint, cuff surrounding the joint and soft tissues are easily provided.

Ankle Arthroscopy Although ankle arthroscopy is used in a more limited area than knee and shoulder
arthroscopy, it provides the chance to intervene in many cartilage, bone and
soft tissue disorders in the ankle. The treatment of cartilage lesions,
especially in athletes, is easily provided by using the advantages of
arthroscopic intervention.

Cartilage Injuries  Cartilage injuries usually occur in the joints exposed to trauma in the form of
non-healing tears of the cartilage surface or fractures with the bone
beneath. In middle and elderly patients, it may occur due to aging and
overuse. Also, cartilage patients develop in all age groups with the
effects of drugs and toxic substances. It usually manifests itself as
swelling, pain, snagging sensation or severe movement limitation in the
knee. In these types of injuries, the surgical method is chosen
considering the age of the patient, active life expectancy, width and depth of
the injured area.

Micro fracture: This method is performed arthroscopically
to clean the damaged cartilage area and to revitalize the healthy bone tissue
at the base by piercing.

Mosaicplasty (Mosaicplasty): It is the process of
removing the damaged area and moving the healthy cartilage and bone tissue from
the area that does not carry the load in the joint. The vast majority of
the method is done arthroscopically. It partially requires open surgery.

Cartilage Cell Transplantation (Auto log Chondrocyte
Implantation): It is applied in young patients with very large damaged
areas. Treatment is carried out in two stages. In the first stage,
the surgical procedure is terminated by taking a cartilage tissue sample from
the patient and the patient is sent home. The cells in this removed cartilage
tissue are produced in a laboratory environment enough to repair the damaged
area. When sufficient tissue is obtained, the patient is reoperated, and
this produced cartilage is implanted and expected to recover.

Anterior Cruciate Ligament Tears 
The anterior cruciate ligament and posterior cruciate ligaments
are important ligaments in the knee that fix the knee movements. The
anterior cruciate ligament primarily prevents the leg from slipping forward
under the knee, in addition, it prevents excessive turning outward. We
perform many movements in our lives in a comfortable manner based on the
stabilizing effect of the ligament. (Running and sudden stops, dance, cross
running, movements that enable us to rotate on the knee in skiing, football and
basketball …) Because it is one of the most important ties in all these
movements, it is the most common in the body. It is the ligament that is
injured. When it is torn, swelling in the knee due to the bleeding inside
the knee, pain and a feeling of insecurity in the load on the leg may
occur. If there are no accompanying cartilage and meniscus injuries, the
knee will be able to handle daily movements, often in 3
weeks. Unfortunately, despite the rehabilitation applied, some people may
continue to have ailments that affect their daily life or sports
activities. The feeling of spinning and idle in the knee may
occur. Surgical treatment can be arranged in order to increase the quality
of life of this group of patients, to prevent cartilage and meniscus injuries that
may occur in every ejaculation and calcification problems that may occur in the
long term. Traditional anterior cruciate ligament surgery is based on the
liberation of the tissues in the proximal parts of the body, transplanting and
fixing them as a single bundle between the two main bones that form a knee, the
leg bone (tibia) and thigh bone (femur). Today, this surgical application
is performed by many orthopedists with a closed surgery technique called
arthroscopic technique. With this technique with faster recovery and less
damage, the patient can be discharged home on the same day. The success
rates of traditional Anterior cruciate ligament surgery are around 85%.

Rotator Cuff Tear It  is a tear of the muscle group that allows the shoulder joint to remain
in a certain position to make its movements. It may develop traumatic or
age-related. Complaints of pain in the shoulder and inability to lift his
arm up develop. Initially, he may often benefit from physical therapy and
rehabilitation. Arthroscopic examination and treatment options are
available for ongoing pain and complaints. As long as the tear is of
repairable size, it can be treated arthroscopically. In case of very large
muscle ruptures, the joint that remains immobile with open tendon transfers can
be mobilized with the help of another muscle.

Recurrent Shoulder Dislocation  It is the loss of the relationship and strength between the upper
part of the humerus, which are the 2 main bones of the shoulder joint, and the
side joint end of the scapula. The resistance of the shoulder joint, which
holds these two bones together, may have decreased forward-downward or in all
directions. In this way, the patient can remove his shoulder spontaneously
while swimming, lying up or even turning in bed at night. Treatment is
usually by rest and rehabilitation in the first dislocations. Surgical
intervention is required to repair the ligaments that are torn due to reasons
such as discomfort and pain caused by recurrent dislocations. Surgical treatment
is carried out in 2 basic ways in our clinic. If severe bone damage has
occurred in the joint that has been damaged by recurrent dislocations, another
bone fragment is moved from the same area. And the injured area is
repaired. Bone damage is not dominant, Arthroscopic repair of the
damaged ligaments is possible only in cases where a ligament tear (bankart
lesion-capsular tear) is dominant. It is possible to visualize the joint
and stitch the area to which the torn tissues belong again with 3-4 1 cm
incisions opening to the shoulder. After the operation, shoulder straps
are used for 3-6 weeks and rehabilitation is provided. Returning to daily
life is around 4-8 weeks, returning to sports takes around 4 to 6 months.