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Wear of the Hip Joint; The hip joint consists of the thighbone (Femur) and the hip joint socket (Acetabulum) as the largest joint of our skeletal system. In cases where the ball-shaped head of the thigh bone is not fully compatible with the joint socket, the joint wears out rapidly. Wear of the Hip Joint Can Be Prevented By Arthroscopy! The original name of this incompatibility hip impingement syndrome = hip joint incompatibility disease (Femoro - acetabular syndrome) is briefly defined as "FAS". This situation, which is frequently encountered in our society, can be missed without the use of advanced examinations and special examinations. Hip pain that begins at ages when joint movement limits are challenged or when development is about to be completed, damages the cartilage due to friction and compression. FAS can occur in two ways with the simplest classification. 1. Head being of a different size than the nest (Often being big) (CAM): In this case, it causes wear on the parts by forcing the edges of the head joint socket. 2. Increased coating surface of the joint socket or geometrically different axes of the joint head and socket (Pincer = pincer syndrome). This is the most difficult type of hip impingement syndrome to diagnose. For example, the head, which is not completely round, rotates in a spherical slot as if it was held with a pincer at the limit of movement and wears the joint inside. Pincer and Cam lesions are often observed together. After the joint socket problem is corrected in arthroscopy, harmonious movement of the head is provided. In this case, arthroscopic treatment performed in the early period in order to ensure joint harmony can be corrected for the excessive head that is incompatible. The footprint of the joint socket can be reduced. Tears of the edge lips that fix the joint on the joint surface and the joint we call the labrum can be repaired. As the joint surface is compatible and slippery, wear will stop and the pain that occurs during insertion and compression is eliminated immediately..

ONE TIME IN EVERY HUMAN LIFE CAN EXPERIENCE Regardless of the type of injury, cartilage and joint problems can be recovered in a short time without leaving a scar. Sprains can cause injuries at different stages from stretching of the ligaments to rupture. Severe sprains can cause fractures, ruptures of cartilage, and ruptures of muscles and tendons. WHAT ARE THE MOST COMMON INJURIES? Ligament strains and ruptures are the most common injuries. In severe stretching and ruptures, the ligaments elongate and heal and create a tendency to sprain in the ankle. In this case, joint structures, cartilage surfaces begin to wear, their surfaces become irregular as a result of ruptures and cause calcification. In habitual sprains, when the injured cartilage tissue forms a raised structure from the surface as a result of healing, it causes a pain in the form of pressure in the joint with movement. This situation mostly occurs in the front outer corner of the joint, in the rear corners. Because of the sudden stinging pain during walking or doing sports, you cannot be loaded and the balance is disrupted. Especially in situations that require sudden jumping and relocation such as goalkeeping, basketball, volleyball and defensive sports, the balance may be lost and the match may be lost. Read More

Before giving information about Musculoskeletal System Tumors, let’s briefly touch on the subject of tumor. Definition: Tumor: It means swelling-mass. What should be in a tissue is the excessive growth of a cell or a cell that does not belong to that tissue. By occupying space, the mass may impair or weaken the function of the bone or skeleton and cause fractures by eliminating the load bearing feature. Classification: Tumors usually grow painlessly, but all tumors of a certain size cause pain by creating a compression effect or tissue damage. Skeletal system tumors are one of the most feared and disabling oncological problems as they cause loss of limbs from time to time. Tumors are simply divided into two 1-Good-natured (benign) 2-Malignant (malignant) The more gentle the treatment of benign tumors, the more comprehensive the surgical approach to a malignant tumor. 1-Benign tumors: It is called as osteoma, chondroma, myoma, neuroma, which is slightly differentiated from the normal cell and proliferates in the tissue to which it belongs, without exceeding the tissue borders. When this tissue is removed, it usually does not recur. Recurrent tumors are usually tumors originating from multinucleated cells different from the tissue to which they belong. They do not spread distantly, but as aggressive benign tumors, surgical treatments can spread as wide as malignant tumors. Rarely, radiotherapy, physical agents such as nitrogen or surgical treatment can be combined with drugs. Tumors that occur with the proliferation of cells different from the tissue they originate form masses in the bones. A different cell growth in the soft tissue is called “Hamartoma”. Such benign structures replace bone cells in tissues such as bone and weaken bone. It can be cyst-like or soft tissue consistency. If these tumors are removed from the bone or tissue with their borders, the treatment is completed. (Fibroma, Angioma are simple bone cysts) 2- Malignant tumors Tumors originating from bone tissue: It consists of cells that are completely differentiated, having an unlimited tendency to proliferate, regardless of whether they belong to the tissue they are located or not. If the cell source is epithelial, it is called carcinoma, and connective tissue (mesenchymal) is called sarcoma. They can spread to distant tissues through lymph or blood, re-colonize in organs and cause death by disrupting body functions. This percentagen kötü huylu tümörler, evreleme yapıldıktan sonra geniş cerrahiler ile tüm kompartman çıkartılarak tedavi edilmek zorunda kalınabilir. Uzuv kaybına sebep olabilirler. Tumors that metastasize to the bone: Tumors with sarcoma characteristics that occur in the organs can spread to the bone tissues. They cause painful lytic lesions and mostly occur in the last stage of the disease. Diagnosis: After a good physical examination, tumors are determined by blood tests (whole blood, biochemistry), urine analysis, and radiological methods. Direct radiography is very valuable in revealing the bone structure in orthopedic tumors. Methods such as ultrasound and doppler are used in cases of soft tissue and vascular origin. Magnetic resonance imaging is very valuable in soft tissue tumors and staging. Bone scintigraphy is effective for determining areas with tumor activity, as well as very valuable for the definition of benign / benign aggressive / malignant. The final stage of tumor diagnosis is revealed after cell analysis by biopsy. Biopsy can be performed before surgery by removing the cell taken from the area with a needle, or it can be revealed after the entire mass is removed during surgery. Mostly, in benign tumors, the entire tumor is removed without preoperative biopsy and sent to pathology. Rarely, a second surgery may be required for benign tumors. Treatment of Tumors: Growth rate and loss of function are taken into account in the treatment of benign tumors. Some tumors may remain painless and unnoticed without affecting the bone’s carrying function. Although these incidentally detected tumors are frightening, they can be followed up radiologically without biopsy, considering the location. In cases where a definitive diagnosis cannot be made, pathology is revealed with needle biopsy and treatment is arranged. It is sufficient to remove benign tumors from the marginal border to the normal tissue junction. In cases where cells remain, the rate of cancer is determined according to the biopsy result. In this case, the treatment is similar to the malignant tumor treatment approach. In aggressive benign tumors, the mass is removed by passing to the normal tissue border, but this does not exceed 1-2 cm. In the treatment of malignant tumors, the tumor should be removed with a 5 cm normal tissue circumference. If there are satellite-satellite lesions in the same compartment, the border will go beyond them. When the entire compartment needs to be removed, if limb salvage methods are not sufficient, amputations and the patient’s life are tried to be saved without metastasis spread. In malignant tumors, chemotherapy-radiotherapy treatments may be required before and after surgery, depending on the staging. Tumors are tried to be eradicated with a multidisciplinary approach.

What is Cellular Therapy? In the field of orthopedics, cellular therapy is widely used in general. The concept of cellular therapy is a broad concept. however, the use of cells prepared under laboratory conditions mostly includes cartilage, fibrocyte and platelets. In use, the source can be bone marrow (stem cell), Plasma (Plasma enriched platelet) or directly the cell itself. Bone marrow and plasma can be put into use in a short time after being subjected to special treatments and filtered. However, for cell production, a production time is required under special culture and laboratory conditions. In general terms, the treatment is called “cellular renewal therapy”. ​ Why are they doing where they were left? Cellular therapy is applied in tissues that do not have the ability to regenerate themselves. The ability of the cartilage cell itself to proliferate is suppressed within the tissue. Therefore, it cannot compensate for the tissue loss in the cartilage. However, the cell sample can be activated outside and reproduced and transplanted to the defect area and healing is prevented with tissues that do not have the quality of cicatrix-cartilage. Thus, organ or limb function is not impaired. ​ How and where are these cells prepared? We first decompose the forehead cells. This is done with various processes in the form of filtration-centrifugation and healthy cells are selected under a microscope. It is then reproduced in suitable media. This reproduction is then continued by providing a certain distribution on a skeleton that we call matrix. When the appropriate volume is obtained, the tissue is ready for delivery. ​ What kind of preparation is made in the region to be given? The area where the tissue will be transferred is prepared adjacent to healthy cells, well-blooded and easy to detect. Dead cells are cleaned, space is opened up to healthy tissue and blood supply is provided. ​ How long does it take to fulfill its new tasks? If the tissue is a person’s own cell, it functions as long as it maintains its vitality without entering the remodeling process, and the cartilage matrix can begin to reproduce within 24-72 hours. The attachment of the tissue will take place in a period of 3-12 weeks, depending on the region it is located in. At the end of 2 years, the tissue skeleton is completely renewed and its continuity with other neighboring cells is ensured. The situation is very different in foreign cells. If cell rejection occurs, the cells are enveloped and killed within 72 hours, leaving only the matrix left behind and leaving cells that mimic cartilage called fibrocytes.. ​ Is it on the agenda to use it in other places? It is possible to use it in all joints, it has come to the fore to use cellular treatment in fractures with super adhesives. ​ How do you think the future of treatment? In the future, we will do all the treatments using cells. Even the nervous tissue that cannot be regenerated will be treated in this way.

12. MISS Summit 2019 Date: 23-24 August 2019 Venue: Aichi, Japan - Aichi Spine Hospital Website: http://missummit.com/ Program http://missummit.com/e/program.html President Fujio Ito (Genel Müdür - Aichi Spine Hospital) Permanent Members of Turkey Tarik Yazar University of Ankara,Faculty of Medicine Orthopaedic and Traumatology, Turkey Murat Erguven StateHospital Orthopaedi Department SpineSection, Japan Ayhan Comert Ankara University Faculty of Medicine Tolgay Satana Avrupa Safak Hospital Istanbul and International Hospital, Turkey Sekreterya Aichi Spine Institute

How will we be protected from hump? Standing upright, not bending over, self-confidence is perceived in our culture as an expression of arrogance and even challenge. So much so that the correct posture and walking are described as the expression of beauty in the expression of femininity. The paintings of Frida, the famous female painter with a splintered spine, while writhing in pain, worry that she will not be beautiful again. If you say to a little girl, “Come on be ugly to me,” it will be complementary to the resentment - repulsion on her face, even the ugly expression on her face, while moving her shoulders forward and slightly tilting her head forward. So, if we do not have a congenital defect, we can make our appearance more impressive or ugly by using our spine correctly. A proper spine structure provides a balanced weight distribution of the main skeleton and is necessary for the harmonious functioning of the movement system. The concave alignment, which we call lordosis in the neck and waist region, is located in the convex area, which we call kyphosis in the back and coccyx region. Note that Lordose is a mechanical requirement for weight bearing and weight distribution of kyphosis in bipedal creatures. The definition of "BIPED" in English, which means bipedalism, also means a living being that can perceive biological intellectual philosophy, a well-footed vertebrate stance is also an expression of intelligence, consciousness and is used to express affect easily. Beautiful and intelligent people can express this with their posture. This is why we take our hunch out when we are troubled, or when we are crushed, when we ask for forgiveness, we hump ourselves while expressing ourselves. When breast development begins in young girls, the tendency to increase humpback by highlighting the shoulders created by the feeling of embarrassment is also a voluntary hunchback choice. If we can manage the hump in our back, how should we fight against it? If we have a structural (spinal wedging, fractures), developmental (growth cartilage problems) or congenital (dwarfism, cartilage and muscle diseases) spinal problem that causes curvature, scoliosis is one of them, which is the most common with rotation. treatments will be required. Since congenital humpbacks are often seen together with rheumatic diseases, dwarfism, and metabolic problems, they first face the treatment of the main disease at an early age. Scoliosis - kyphosis cases, which we call idiopathic, generally refer to the physician with one shoulder down and the hump is noticed from the outside. Kyphosis without scoliosis in the back area, which is true humpback, is mostly due to posture disorders. In the developmental age, wrong posture, carrying heavy bags, weak muscle structure, and shy posture in girls are the most common causes. The use of desktops, laptops and smartphones in adulthood seriously affects the spine posture and triggers hunchback. The back spine alignment, which transfers loads to the shoulders and arms or connects the load on the arms to the main skeleton, is closely related to the arms. With the shoulder coming forward, the hump increases. The dorsal vertebrae can increase humpback, similar to the relationship between the neck and the head. The flattened neck spine of a person working by approaching the computer screen is balanced by a hunchback on the back. If you have a neck hernia, a hump may develop on our back. The flattening that occurs in the lumbar region will again change the alignment of the back vertebrae in the direction of the hump. In cases of inequality between your legs, the spine alignment changes in the direction of the hump. All this is a tendency to get into some sort of steady state other than mechanical balancing. The main skeleton responds to stress and disorder by increasing its hump, and if this is not temporary, the hump takes a permanent shape. You can visualize this form of defense by thinking about the state a cat takes when it gets caught in a corner. We get a steady state by removing our hump. However, this is not healthy. In daily life, the fact that young and mature people do not associate themselves with the shortening and hunchback that occurs with aging may also delay their taking precautions. The most common cause of curvature is bone loss and wedging of the vertebrae, which occurs in later years. However, this situation can be eliminated by proper nutrition that will strengthen bone metabolism at a young age or by being under the control of a physician during menopause. Humpback that occurs with aging can turn into a progressive deformity, a serious health problem that narrows the rib cage, apart from a posture disorder. This situation creates a domino effect that disrupts health, such as the decrease in lung capacity, the tendency of the tissues to degenerate permanently without oxygen, deterioration of the vessel function and the deterioration of circulation. So if the hump is progressive it can cause fatal organ and system ailments. How will we be protected from hump? First of all, correct posture training is the first condition, all kinds of daily activities that are not ergonomic should be avoided or restricted. For example, we should catch the correct posture at the computer and our spine should be disciplined in this direction. Activities to strengthen the back muscles of children: Activities using hands such as archery, yoga, basketball, handball should be encouraged. Regular exercises such as pilates and yoga are the most valuable investment to prevent humping despite bone loss in advanced ages. Let's not forget that our skeletal health depends on the correct alignment of our spine, where alignment is maintained with solid bones and strong muscles. Correct posture is essential for a healthy and happy life and is the most effective way of self-expression for a beautiful woman. SLet's use our spine correctly for weepy smiles.

Suprascapular Nerve Entrapment shows signs of pain, loss of sensation, mainly in the back and shoulder area, weakness in overhead and shoulder movements, especially in external rotation. What is Supraskapular Nerve Entrapment? The suprascapular nerve is the nerve that runs behind the shoulder blade (scapula) and transmits the sense of touch in the back area as well as working the back muscles. In case of entrapment under pressure, the functions of the supraspinatus-infraspinatus muscle (shoulder rotators) deteriorate and may lead to paralysis. Patients complain of shoulder and back pain and weakness in overhead arm movements. Volleyball is common in basketball players. The mechanism of injury is traction or falling directly onto the shoulder. Can also occur in heavy sports, crutches users. What are the Symptoms of Supraskapular Nerve Entrapment? Back and shoulder pain, loss of sensation, weakness in overhead and shoulder movements, especially in external rotation, are the main symptoms. How is Suprascapular Nerve Stress Treatment Performed? The suprascapular nerve is pinched in two places (proximal and distal). In the proximal type, the suprascapular nerve passes behind the scapula through a groove on the bone. This groove is closed like a hole with the transverse ligament. The trap occurs as a result of the narrowing of the groove after the trauma or the thickening of the ligament and pressing the nerve. The nerve is relaxed by cutting the transverse ligament. Distal type impingement is more common. After passing through the groove and giving the suprascapular muscle branch, the infrascapular s-branch divides into the glenospinal hemisphere under the teres minor muscle. Cysts created by untreated intra-shoulder injuries such as SLAP tears in this area often cause entrapment neuropathy by compressing the nerve. The nerve is relaxed by removing the cyst and repairing the SLAP tear. Loosening is done in two ways: open surgery and arthroscopic. In open surgery, the muscles are cut to reach the area, it is very difficult to reach the nerve. The transverse ligament is cut with special retractors, but most of the time the nerve cannot be seen. Arthroscopic treatment is the gold standard. It is mandatory to investigate SLAP with distal type joint arthroscopy. We definitely perform shoulder arthroscopy for proximal impingement. If there is SLAP rupture, we make sure that the glenospinal stalemate is excised, if any, the bursa-pseudo-cyst and visualized the nerve branch and loosened. Subsequently, we do SLAP repair. Again, this time after bursectomy in the subacromial region, we view and protect the nerve before cutting the transverse ligament that lies next to the coronoid ligament attachment, and remove the trap by opening the ligament. How Long Does Supraskapular Nerve Entrapment Arthroscopy Take? The standard duration of shoulder arthroscopy is 60 minutes. Since nerve compression is a delicate procedure that requires effort, it can take up to 2 hours. What Should the Patient Do Before Arthroscopy? Arthroscopy preparation should be done in the hospital. What is the Recovery Process After the Surgery? In open surgery, the arm is suspended for 6 weeks, it is not possible to return to sports before 6 months. After arthroscopic surgery, you can return to daily life the next day. Exercises are started immediately. The arm sling can be used between exercises for 2-3 weeks. You can return to active sports within 6-12 weeks. Will It Repeat After Surgery? There is no question of proximal recurrence. Rarely, post-traumatic cases of the distal type have been reported. How Much is the Surgery Fee? It is planned according to the patient's budget.

History: 04-07 July 2019 Place: Raipur, Hindistan Website: http://tssula.com/ MISSION SPINE FOUNDATION FACULTY Dr Satishchandra Gore Dr Shirazahmed Munshi Dr Bhupesh Patel Dr S N Madhariya Dr S Palanikumar Dr Sunil Nadkarni Dr Anand Kavi Dr Janmejay Jamdar Dr Sujit Vidiyala Dr S Namboothiri Dr Malcolm Pestonji Dr Lavkush Pandey Dr Sunil Raghav Dr Ravindranath Dr Sai Sudarshan Puduru MGM HOSPITAL ENDOSCOPIC SPINE UNIT Dr (Lt. Gen.) K. R. Salgotra Dr Alfven Vieira Dr Nilesh Vishwakarma Dr Sarabjit Kohli Dr Shaival Chauhan INTERNATIONAL FACULTY Dr Tolgay Satana (Turkey) Dr Tunc Koc (Turkey) Dr Michael Schubert (Germany) Dr Hyeun-Sung Kim (South Korea) Dr Kangtaek Lim (South Korea)

What is Hip Replacement? / What is Hip Arthroplasty? - Arthroplasty / Joint prosthesis means the renewal-replacement of the joint surface by using metal or similar materials. It is performed when the cartilage on the joint surface is completely eroded and joint movements are restricted and painful loss of function occurs. Shortness and rotations can be eliminated if there is malalignment while the joint is renewed. Two methods are commonly used in hip joint prostheses. 1. Resurfacing 2. Total joint / Partial joint prostheses In resurfacing surgeries, joint surfaces are covered with metal / ceramic structures. It is applied to patients who do not have malalignment and have sufficient coverage in the joint socket. It has become widespread in recent years, especially in patients under 60 years of age whose muscle strength is balanced. Total joint and partial joint prostheses have been widely used since the second world war. In total prosthesis, both joint surfaces (socket and head) are usually replaced partially. Partial prostheses are often applied after fractures. While the head is fixed with a handle extending into the bone marrow, it may consist of 4 parts together with the head by adding a ceramic or polyethylene surface on the metal coating to the nest part. What is Hip Replacement? / What is Hip Arthroplasty? If adhesive is used in prosthetic surgeries or the patient's bone stock is sufficient, if there is no osteoporosis in the bone, weight can be given immediately with the help of crutches. It may be necessary not to press for a while under the supervision of the physician for prostheses that we call cementless, that is, in cases where we do not apply adhesive. Prosthetic surgery gives very good results when done at the right time and to the right patient. It is possible to return to normal life, except for certain restrictions, especially when the recovery is completed.

In pursuit of immortality, Gilgamesh is that the brutal real death he encounters in search of the herb of immortality cannot be stopped. Humanity, which has been pursuing immortality like Gilgamesh for thousands of years, is still in pursuit of the healing it has lost to the snake. The discipline of medicine, on the other hand, ironically symbolizes the snake, exalted as it cures the diseases that cause death. While humanity survived by hoping for empirical treatments was protected against diseases, on the other hand, it was inevitable that it was defeated by aging and death. Today, local physicians define death as a chromosomal program that develops at the cellular level with the concept of “apoptosis” and even genetically triggered it, creating the concept of stopping aging. It’s like everyone had a biological clock that suddenly all cells were ordered to die. There must have been a grass that stopped this clock. Speaking of the cell, the chromosomal structure is detailed. DNA and ribosomes encode, progenitors chase the clock. The result is hopeless for now. But genetic engineering was born, and tissue engineers were also waiting at the door. The cure for immortality would be found. Genetic science and human genetic mapping, cloning made the masses believe that the utopian dreams in the Jules Verne novels were real. So much so that science fiction scenarios are almost the most interesting ones; There were those who evoked immortality and demonstrated the convincing and possible results of recent scientific advances. The experiments for the unethical scenarios of the rich people who cloned themselves in the movie Ada are based on a sheep named Dolly, which was cloned in 1996. The idea that humanity could replicate itself, and even the idea that this copy could be perfect, created another nightmare that was more terrifying than the serpent in seeking immortality. In Hollywood scenarios, the “terminator” icon was immediately cloned, in Galactica the Cylons were conceived as clones of common intelligence, and even an esoteric god was created with the Avatar. So much so that the opinion of the public began to be inaccessible, expensive, imaginary and even immoral treatments. Cellular therapies are banned and restricted in many countries. In reality, what was done in the health field was not very inaccessible. Genetics and tissue engineering continued to evolve rapidly. Masses circulating between us in multiple babies that have become commonplace like IVF (invitro fertilization = in vitro fertilization) technology, those who come back to life with stem cells taken from bone marrow, and those who live with their sibling’s organs have always been among us. Organ donations were encouraged, and those who came back to life with organ transplants continued to make headlines in the newspapers. Another hope arose for Gilgamesh, who lost the weed when cloning was banned before it could replace the herb of immortality; “Stem cells”… but they too faced serious resistance, starting empirical treatments that would cause public controversy. Because the treatment success was low, the behavior of cells was unpredictable, it could be associated with cancer, and failure was brutally criticized. Those who were investigated were those who were dismissed from the profession. Cloning is not legally possible today. The use of stem cells is restricted or prohibited in many countries. However, by producing tissue, treatment can be performed without straining ethical limits. Tissue production can be autologous or allogeneic. The basic principle is that living cells are similar or identical to the characteristics of the original tissue and are placed in the host’s relevant tissue or in an environment where it can survive. Since the person’s own tissue is produced and applied to himself, it can be easily applied in medical treatments within the limits of ethical rules. The cell source may be stem cells. However, the process of differentiation into muscle, cartilage, nerve or any tissue to be developed from stem cells is a very expensive and long process. Pluripotent (multipotent differentiation) cell sources can be used for cells that form nerve and muscle tissue that have completed their differentiation. Such cells decrease gradually as the bone marrow ages and it is very difficult to enrich. The richest source of pluripotent stem cells is in cord blood and blood taken from the embryonic side of the placenta. Taking and keeping these cells is very important in this respect. The cells that complete their differentiation (muscle and nerve cells) cannot multiply by dividing and cannot be renewed by the body when damaged. The obstacle to the production and regeneration of cartilage from cells that have partially completed their differentiation but have the ability to transform into another cell is due to their inactivity in different matrix structures. The ability of bone, fibrous tissue and epithelial cells to renew themselves rapidly may be a hope for immortality. When it comes to epithelium, not only skin and organ surfaces should come to mind. Hormone and enzyme-supplying glands that have highly differentiated proliferative abilities but cannot be reproduced in the body are also of the same origin as epithelial cells. For example, pancreatic islet cells are of ectodermal origin, such as dopamine secreting cells that play a role in the formation of Parkinson’s in its absence, and epithelial cells of the adrenal glands. Today, tissue engineering seeks to differentiate these cells and produce them from stem cells or to reproduce them directly. The relatively problematic tissue in the musculoskeletal system, other than muscle, is cartilage tissue. The reproduction of the cartilage cell is possible by removing it from the lacunae in which it is imprisoned and placing it in an environment where it can be fed again. When the appropriate matrix structure is provided according to the cartilage structure to be produced, there will be a ready-to-use cartilage tissue. After the source cell (ear, joint surface) from which the cartilage tissue will be produced is taken from the donor area, production is started. Since the appropriate medium will also be the tissue to be transferred, the matrix will give the character of the tissue. The tissue produced according to the type of cartilage must bear the character of the tissue to which it is transferred as much as possible in order to maintain its vitality during the remodeling process in the body. Otherwise, the cells may be removed during remodeling and leave their places to non-functional fibrous tissues, which we can call “wildcard”. That is why one of the most important issues that tissue engineering focuses on is “biocompatibility”. Well, we produced your texture, everything is ready and can we apply it to you? The answer to this question will reveal the concept of “host suitability”. In this case, your biological clock should be at times to adapt the new tissue to your body. The young cells that are transferred cannot survive alongside the old cells that surround them whose metabolism has fallen. In the area to be transferred, it should be biologically active and at a level to remove high metabolism. At this level, the snake is in the hands of the clinician. Ensuring that the host is suitable for cellular therapy will perhaps be more challenging than producing cells. Technological developments, tissue engineering will bring many developments in the future. We will surely find and even find the herb of immortality, but the important thing is to know how to use it without getting caught by the snake.

Our stance plays an important role in revealing our personality in social life. The spine, which forms our main skeleton, is the basis of this posture. For this reason, spine health is much more important. How Should a Normal Posture Be? The spine architecture is designed for standing. Our main skeleton is a structure consisting of joints, muscles and ligaments above the face. This particular architecture is the center of gravity that counteracts gravity; It can perform weight bearing, weight distribution and balancing functions in a certain sequence. This alignment is the basis of our stance. In the abbreviation of B.I.P.E.D, the intellectual infrastructure, which distinguishes the bipedal creature from vertebrate creatures in terms of content, reveals the spine stance. Spine Health This is why the reflection of personalities and moods in our posture is observed. Spinal stance is considered in three dimensions and evaluated in two plans. Our spine is straight in the foreground and background. In the lateral plane, the carrier, balancing function areas are located in the form of concave (Lordose), distribution-balancing regions as convex (Kyphosis), array. Neck Vertebrae: Lordosis Back vertebrae: Kyphosis Lumbar Vertebrae: Lordosis Coccyx and pelvis (pelvis structure): Kyphosis and anterior sloping (Inclination) Humpback and Scoliosis (Spine Health) It is a spinal malalignment disorder, an increase in kyphosis on our back. In fact, although the humpback is a unidirectional deformity (kyphosis) in Turkish, it is the definition of humpback, severe back deformity curvature caused by Scoliosis and the resulting pelvis and shoulder axis imbalance. In this respect, the most important cause of hump is SCOLIOZ disease. Scoliosis is a rotational 3D deformity of the spine. It can develop congenitally and later. Congenital scoliosis may require early surgical intervention, depending on the type, because the bones of the vertebrae do not dissociate. Developmental scoliosis is controlled during growth and its increase is tried to be prevented without surgery. The earlier the age of onset and the faster its progression, the earlier it is to decide on surgical treatment. Surgery is rarely performed below 30 degrees. 40 degrees is an adequate correction angle for surgical decision. During rapid growth, adolescence, follow-up should never be neglected. Posture Disorder (Spine Health) Our body is balanced on a straight axis formed by our spine. The lines between the shoulders and the hips are located together with this axis. When the spine axis is disrupted, it will not be possible to balance walking or to use arm power efficiently. It is inevitable that the misuse of devices that cause non-ergonomic posture, such as the plague of our age, causes not only spinal problems, but also impairment of walking and dexterity, even vital functions such as vision, eating, sleep and breathing. Back Pain Is A Consequence Spinal pain can also occur as a reflection of internal organ disorders, except for situations caused by the imbalance of the movement system. In this respect, heart, digestive system and urogenital disorders can cause back and low back pain, as well as back hernias can manifest as internal organ pain. Back hernia can mimic a heart attack or an ulcer. Apart from that, our spine is a system of joints. A complex vertebra and facet joint contents with synovial and disc contents are susceptible to joint injuries and inflammatory consequences of rheumatic diseases. Muscle-ligament and ligament problems will cause pain as they are supported by intense muscle groups. In this respect, the source of the pain is too important to eliminate the presence of pain, which cannot be neglected. Ergonomic Precautions Our spine continues to carry and balance the weight of our body while standing, sitting or lying. A healthy spine alignment is normal, supported by ligaments and muscles that balance this alignment. Every movement against gravity is designed to be balanced on the side of our spine. Incorrect sitting, posture and habits or inappropriate seat, vehicle use disrupts the functions of the spine and makes it vulnerable to injury. If the Source of Neck, Back and Low Back Pain is the Spine; Assessing Priority Sequence Accurate diagnosis is possible with examination:Spinal alignment should be evaluated in an upright and lying position with orthoroentgenographic evaluations, with films taken from feet to the skull. If the problems detected in static standing radiographs indicate spine malalignment, bending radiographs, if necessary, dynamic evaluations should be performed. It is inevitable that short legs and gait disturbances affect the dynamics of the spine. Flatfoot and rotational problems impair spine function. Any joint disease (meniscus, ligament ruptures, hip pincer lesion, varus-valgus) that makes the gait limp should be corrected with treatment. If there is no misalignment: The cause of spinal pain, especially the pain and loss of strength reflected on the arm and leg, and numbness is the "hernia" disease. Hernia occurs due to the displacement of the pillow called the disc between the vertebrae, tearing and compression of the nerve. In cases where hernias do not resolve with medication-rest and physical therapy, they may need to be removed. As long as the pressure on the nerve continues, loss of strength and sensation disorders may become permanent and surgical treatment cannot be benefited. Surgical treatment of Neck-Back and Lumbar Hernia:Hernias that are delayed to heal with medication or physical therapy or that require rest at least three times a year should be treated surgically. Surgery will be planned immediately if nerve damage has occurred. Surgical treatment can be applied by open or closed methods. Closed or Minimally Invasive Endoscopic Disc surgery is the first option in our practice. Closed surgeries are superior to open surgery in terms of reaching the hernia area directly with a 7 mm camera and preserving the disc structure and removing only the herniated part. This surgical technique, which is becoming more and more widespread, will allow the abandonment of open surgical methods over time. If the hernia cannot be removed by closed methods ... Open surgical methods can be used. Closed endoscopic surgeries may be insufficient in complex cases that move to the middle regions or are adhered to the environment. In this case, open surgery is preferred. Will the treatment affect your daily life and work life? Every person's daily life expectancy and work life differs. The physician's decision may change from recessive treatments to minimally invasive closed endoscopic surgical treatments, while determining the rest and recovery time. Remember! The spine is the axis of our body and it keeps us alive. It takes a very short time to regain the old mobility after the treatment. Closed surgeries create surgical wounds through small incisions. Your recovery period requires you to continue your daily life by limiting some of the activities with the recommendation of a doctor, even if you get up immediately. Immediately returning to your busy work life may cause serious situations such as discitis that require bed rest again.

Dislocations are very common in the shoulder joint, which is the most mobile joint in our body. What is Shoulder Dislocation? How is Shoulder Dislocation Surgery and Treatment Performed? You can find out all about Shoulder Dislocation in this article. What is Shoulder Dislocation? It is when the shoulder joint comes out of its socket. In reality, the shoulder joint does not have a seat. Instead of a slot covering the sphericity of the shoulder head, the labrum lip of approximately 1 mm, which acts as a suction cup on a flat structure that we call the gleonoid, and the capsule, ligament and muscles covering it, can keep the shoulder joint in place. This allows the shoulder to rotate nearly 360 degrees, allowing it to function as the most mobile joint of our body. In Which Situations Is Arthroscopy Preferred For Shoulder Dislocation? Treatment of shoulder dislocation is immediate placement in the first 6 hours and fixation with a bandage. Detection should not be less than 6 weeks. Although this period of recurrent shoulder dislocation is reduced to 3 weeks, 6 weeks is recommended as a safer period in our clinic. The diagnosis of "habitual dislocation" (Habituel) is made in people who have shoulder prolapse more than three times. The ligament and labrum structures of the shoulder should be repaired in the habitual shoulder dislocation and primary (first) shoulder dislocation with tears in the anterior region of the labrum. Arthroscopic shoulder dislocation repair is the gold standard. Today, open surgery is very rare and cannot be performed. How is Shoulder Dislocation Arthroscopy Performed? It is like standard shoulder arthroscopy. If the width of the labyrinth tear is large, an additional portal can be opened. Stitches placed in the labraum are repaired and shoulder stability is checked. If necessary, the capsule can be intervened in the same session. How Long Does Shoulder Dislocation Arthroscopy Take? The optimal time varies between 30-60 minutes. What Should the Patient Do Before Shoulder Dislocation Arthroscopy? Preparation for shoulder arthroscopy is done in the hospital. What is the Recovery Process After the Surgery? After arthroscopic shoulder dislocation surgery, rehabilitation and movement are started immediately. First of all, after pandular movements, joint range of motion is actively provided. After 3 weeks, passive, active resistive exercises can be started in the presence of a physiotherapist. The rehabilitation period may vary depending on the patient's location and profession. Will It Repeat After Surgery? It is not expected to reappear in sedentary life. It is possible for the shoulder to dislocate after a new trauma that pushes the shoulder limits, but in daily life, it is not seen as a spontaneous or habitual dislocation. How Much is the Surgery Fee? It is determined according to the options suitable for the hospital and the patient's budget.