Orthopaedic Clinics Bayrampasa

Knee arthroplasty is a surgery performed in order to relieve pain and enhance quality of life for patients with severe pain secondary to knee arthritis. Those patients are usually characterized with past medical history of long-term non-surgical therapies (i.e., oral drugs, intra-articular injections, activity regulations, physical therapy) that do not actually help relieving the pain. Broadly, there are two types of knee prosthesis. One is the conventional procedure that is also known as total knee replacement, and the other is the partial knee replacement that is performed with minimally invasive approach. Both methods have been used for a long time worldwide and have very good outcomes.​​

Hip arthroplasty is a surgical method with pretty good outcomes, which is performed to eliminate pain secondary to hip arthritis. Arthroplasty is regarded as last option, after all non-surgical methods are tried out for arthritis. It is seen that the success rate is above 90% in patient groups who are followed-up for minimum 10 years. In hip arthroplasty; the main procedure is to remove arthritic cartilage and bony segments and to replace them with new joint surfaces that are formed of metallic parts and durable polyethylene. Patients are hospitalized for approximately one week and discharged after patient is mobilized and given training on daily routines. It is recommended that the patient walks with crutches or walker for 4 to 6 weeks postoperatively, and patient is allowed to walk independently thereafter. Many surgical methods are developed for hip arthroplasty to enhance comfort of the patient and many different metallic, ceramic or polyethylene materials are used to extend durability and lifetime of the system. Decision about best surgical method or best material should be based on patient factors and surgeon's education.​

Ervus medianus, one of the two main nerves responsible of the hand/fingers movements and sensation travels along with nine tendons underneath a bridge called ‘’transvers carpal ligament’’. This bridge and bones on the bottom create a tunnel called ‘’carpal tunnel’’. For any reason if median nerve represents nerve symptoms such as numbness and/or motor inabilities this is called ‘’carpal tunnel syndrome’’. Although the reason for nerve compression cannot be found in most cases, hormonal changes, pregnancy, rheumatoid diseases, masses in the tunnel etc.. could ease to show up the symptoms. First symptoms can be felt mostly at nights. Numbness in thumb, index, long and (half of)ring fingers, clumsiness, pain(in the late stages) are main complains of the patients. In late cases, the muscle bulk between palm and thumb base lost its prominence. In time, the symptoms expand to whole day. The syndrome is generally diagnosed by physical examination and electrophysiological studies(electromyography - EMG). In cases which are doubtful about their etiology(the reason of the disease) additional radiological methods are required to reveal previous fractures or possible masses. In some cases wrist splints may lessen the symptoms. Steroid injections may decrease swellings around the nerve and help for diminishing the symptoms. Surgery is the treatment of choice for patients whose symptoms last more than 2-3 months despite conservative methods. The roof of carpal tunnel is opened to relieve compression to the median nerve. Some severe cases need neurolysis (releasing nerve sheet under microscope)as well. Endoscopic carpal tunnel surgery (closed method)may be applied in selected cases. Patients should know that all symptoms may not be eliminated in some severe and delayed cases.