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Most frequent referrals from tumor, infection and non-traumatic problems in the knee region 1. Meniscus tears 2. Cruciate ligament injury 3. Cartilage lesions (chondromalacia, joint mouse) 4. Plika syndrome Knee arthroscopy offers the opportunity to intervene in all of these problems without the need for open surgery.

Our feet are exposed to many traumas while carrying our weight. The heel pain that we see most often in the foot area may be a simple heel fat pad syndrome, or it may cause nerve compression in the ankle region. (tarsal tunnel) Apart from plantar fasciitis problems, nerve knots between the toes (morton neuroma), and nerve entrapments, there are dozens of joints that cause foot pain. Disruption of the foot arch are common reasons for flat foot or dome foot. Problems in the area called sinus tarsi can often be missed. This area, which is difficult to diagnose, achieves great success in arthroscopic intervention.

Physiotheraphy; It deals with all human movements and the structure of the skeletal musculature. It is one of the main treatment methods for those who have spinal problems, including those who suffer from back, waist and neck pain. We collect the physical therapy methods in our body under 4 main headings. 1. Range of motion exercises (ROM exercises) It is very important to bring the movements to their former extent in fixations after orthopedic treatments or after joint surgery. Movements that were previously passive assisted are developed over time to active and resistant exercises. It is very important for this treatment to be regular and efficient in the presence of a physiotherapist. Otherwise, permanent injuries and movement restrictions may develop. 2.Muscle Strengthening and Balance: Even if the joint range of motion is full, it should be very important to have a certain level of muscle strength that creates movement. Muscle atrophy and weakness negatively affect returning to daily life after orthopedic treatment. We practice these kinds of exercises gradually, by following certain programs, accompanied by a physiotherapist. 3.Walking Exercises Walking disorders can occur for various reasons. It is applied when it is necessary to gain normal walking style after orthopedic knee disorders or treatments. Gait analysis is a special test that makes it easy for us to find the cause of gait disorders and to treat the cause. 4. Return to Sports and Athlete Support Exercises Although joint width is provided after orthopedic treatment, bringing muscle strength to the level of daily life is not enough for athletes. Special training programs for returning to sports are carried out in the company of a physical therapy-sports physician and a physiotherapist.

Orthopedic problems in children are developmental disorders that occur with the disruption of skeletal development in any stage of the mother’s womb. In cases where there is no concomitant organ system insufficiency, early intervention can be achieved and recovery can be achieved without injury. Spine Problems (Scoliosis, Kyphosis) Joint Problems (Developmental Hip Dislocation, High Scapula) Dwarfs / Arm and Leg Deficiencies Foot Problems (Ekinovarus, Ekinus, Adduktus)

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.

Painless joint is freedom of movement. Stagnant life can lead to unexpected problems such as vascular diseases, internal organ failures, and stroke. The articular surface is smooth. Friction erodes the joint. Five main conditions can be put forward for the Working of the Joint. -Lubricity -Surface Compatibility -Lineup -Balance -Robustness The joint moves with the sliding cartilage surfaces. Injury on these surfaces, factors that disrupt the surface also disrupt the opposite side throughout the movement. Over time, both surfaces begin to erode each other. A groove of the width of the injury at a small point is revealed, the articular cartilage quickly disappears. Joints work in harmony with ball-socket, hinge structure. The axis of both surfaces should be the same, the covering areas should be the same. It carries our joints by distributing the weight of our body over large surfaces. Our weight is the strength of the joint that creates movement. With our joints, gravity is directed and the force of displacement is met. Harmonious joint surfaces should hold together in a balanced way. Joint ligaments complete the joint and provide balanced movement. (Compatible Joint) The joint also acts as a link. The main body is attached to the limbs. It is very important to have a balanced weight transfer and equal distribution to the joint surface, this is only possible with a good alignment. Even if a person with crooked legs has a compatible joint, bad alignment disrupts the harmony, causes different loads on the surface, injures the cartilage and wears the joint. Balanced load distribution is not just about sequencing. Our muscles balance the speed of the belt by meeting each other while opening and closing the joint. If this balance is not achieved, we cannot stand and injure the joint. The strength of the joint cartilage tissue depends on the buoyancy of the water it contains. If the water decreases, the strength and flexibility is lost, the tissue breaks down. Healthy joint tissue should hold a high rate of water in the cartilage bed. This rate is higher in young people. With aging, the rate of water in the cartilage bed decreases, and structures that hold less water take place in the tissue, and the joint tissue tends to break down by losing water. This situation can be prevented with treatment. Joint Cell Does Not Regenerate In case of injury to the joint surface, it is repaired immediately. Our body's repair ability is limited to 1mm, larger injuries; • If it creates friction on the surface • If the healing process risks damaging the counter surface • If it has resulted or will result in a poor healing, it must be treated arthroscopically. We Can Protect Our Joint Health Our joints get stronger and stronger as we move. A balanced diet rich in protein and regular exercises are beneficial. Excessive weight gain should be avoided. Sprained tarsi loading on the joint may be caused by weakness of muscle strength. Exercises to increase muscle strength should be done. The type of exercise should be appropriate for your level. It is inevitable that you will be injured while running on the treadmill if you have not walked on a straight track. If the items you use around you are in harmony (ergonomic) with you, it will reduce your risk of injury. Adapt your surroundings to yourself. Joint Injury Can Be Repaired Accurate diagnosis is possible with examination. When you have a joint injury, you should see an Orthopedics and Traumatology specialist as soon as possible. Radiological examinations performed after the physician's examination determine the level of injury and treatment method. Once the type of injury is determined, the rate of self-repair is understood. Apart from severe injuries, splint-plaster fixations, bandages, therapeutic drugs, painkillers are used that will allow the body to repair itself. Arthroscopic treatment is the gold standard in severe injuries. Joint immobility During injury, recessive treatments may be aimed at restricting the movement of the joint. The inactivity of a healthy joint can lead to a decrease in joint slipperiness and muscle melting. Therefore, the treatment is arranged so as to act as early as possible. Devices that provide passive movement of the joint surface without weight can be very effective in treatment. We get help from rehabilitation specialists and therapists for these types of treatments. (Continued Passive Motion) No matter how advanced and excellent the examination and radiological examinations are, Arthroscopy is the gold standard in the diagnosis of delayed joint injuries. Magnetic resonance imaging may be insufficient for cartilage lesions, plica tears and hardening. In this case, it is intervened before joint wear occurs. Meniscus tears and ligament ruptures can be treated with arthroscopic methods today with excellent results. Correct intervention and stepwise approach are very important when there is a joint injury Your joint may swell after injury, you will remain immobile and you cannot load. Do not panic, if you do not have a real health practitioner around you, a simple bandage, a temporary tesbt and a cold application is sufficient. Do not burden yourself with it, rest for a while and contact the health center as soon as possible. Your joint may swell after injury, you will remain immobile and you cannot load. Do not panic, if you do not have a real healthcare professional around, a simple bandage, a temporary tesbt and a cold application are all it takes. Do not burden yourself with it, rest for a while and contact the health center as soon as possible. Will the treatment affect your daily life and work life? Every person's daily life expectancy and business life differ. The physician's decision may vary from recessive treatments to arthroscopic surgical treatments while determining the rest and recovery time. Remember, your joints are the most important part of your life. Help may be needed to regain mobility after treatment We should definitely get physiotherapy help in arthroscopic treatments and long angle determinations performed after severe injuries.

Without denying Einstein's emphasis, "It is not the skeletal system that keeps man alive, but his beliefs and principles", the skeleton (Skeletal System); We can define it as a system consisting of bone-muscle-joint structures that enables us to stand. Skeleton; Derived from the Greek word skeleton - dried, mummified body. The skeletal system in humans is in the form of "endoskeleton" like most mammals. Some living things, which are invertebrates, contain "exoskeleton - exoskeleton", and when fossilized in this way, they can tell about their appearance in living form centuries later. The skeletal system in vertebrates is like the combination of the skeletons of living things (such as jellyfish, sponges, fish) at different stages of evolution. The human skeleton consists of 206 bones. The bone structure is interconnected by joints that allow movement, supported by ligaments and muscle structures. The main skeleton "Spine" is in the bearing position between the skull (cranium) and pelvis (pelvis) and extends to the coccyx. Spine; In addition to the central nervous system extension in the skull and the carrier feature surrounding the spinal cord, it is also a regulator that ensures the distribution of the nerves. While the surrounding skeleton is connected to the spine by the pelvis below, the more complex ribcage-scapula junction above is connected by a system. The lower peripheral skeleton is related to the muscular and ligament structures in the abdominal region, and the upper peripheral skeleton is related to the rib cage muscles. The main skeletal bones are composed of immobile-semi-mobile joint structures and bones connected to each other. These bones are in flat structures, rich in bone marrow, cell production storage, and contain stem cells. The surrounding skeletal system consists of long bones that are connected to each other by movable joints. The surrounding skeletal joints are complex structures supported by ligaments, meniscal structures, and cartilage. As the joints that provide the movement of the body go to the ends, they get smaller, contain more bones and become more complex; It is specialized as the hand on the upper side and the foot on the lower side. Hand and foot are specialized organs of the main skeleton in the last parts of the skeleton. Today, hand and foot mechanics have not been resolved and their details are little known. Long bones, like the flat bones in the main skeleton, have cell store bone marrow. All bones are a storehouse of calcium, phosphate and some minerals they contain. Bone is a living tissue and acts as an active organ in which the calcium-phosphate level of the body is controlled as well as its carrier feature. In this respect, a healthy body must have a healthy skeletal structure. The cartilage tissue with which the bones are in close relationship consists of cells covering the joint surfaces. It should be remembered that these cells come from the same origin as bone cells before they become specialized in cartilage tissue, and they are structures that can turn into both cells during injury-repair. The boiling tissue that occurs when the bone is broken has a similar character to cartilage and can turn into bone (abundant oxygen, pushing force) or cartilage (less oxygen-pulling force) tissue under different conditions. As a result, the skeletal system is a large tissue, even an organ, actively participating in body metabolism, as well as the connective tissue feature, which is a carrier.

We talked about important information for athletes in our pleasant interview with dear Ebru Eryener on waist health. How should we protect our waist while doing sports? First of all, let's assume that the building disk is the most injured when we say waist. Lumbar disc bursts after 400 newtons is loaded and the disease we call hernia occurs. It is one of the most serious injuries. The occurrence of this injury is dependent on the burden. The vector of the load-load changes depending on variables such as the force arm. Briefly, bending, axial loading and rotation are the conditions where the most load is placed on the disc. Strong muscles, correct alignment and correct movement reduce the load on the disc and the risk of injury is virtually eliminated. Therefore, it is of great importance to load a weight proportional to muscle strength, to do the movement correctly, to avoid rotation at the same time during loading. It should be known that the risk of injury is higher in combined movements (turning, bending and loading). During sports, I have students who say that my back hurts when doing movements such as kettlebell swing, superman, cat camel. (Although they do the movement correctly) and there are those who are afraid of this pain and do not want to do the movement. What pain is a sign that the back muscles are working in such a situation? And in what kind of pain should we really be afraid? First of all, the person should not have an alignment problem How do we know that? Hunchbacks, one shoulder low, meaning people with poor posture are at risk. In such athletes, standing movements such as kettlebell, swing or superman should not be given at the beginning, first the core muscles on the ground should be strengthened and in the second stage, the posture should be corrected a little and complex exercises should be started. Although there is no alignment problem in elite athletes, the duration and type of pain is important. If it does not decrease with rest or does not improve with weight reduction, this should not be done more than a muscle regeneration pain. Recently, I have encountered herniated disc in many people. Most of them are very advanced in the initial stage, although some do not require surgical intervention. What are the exercises that you would recommend and never do to these two groups? I would be glad if you explain this in a language that most of us can understand, not as described in medical language. We recommend that patients with lumbar hernia do sports. The back and abdominal muscles should be strengthened and the body-thigh stability should be ensured. We should avoid standing exercises and be content with floor exercises. It should be squat-assisted or it can be on the wall with the ball. If the patient who has undergone surgery has had a closed lumbar hernia surgery as I did, he can go to sports in 3 weeks. You can start on the floor and slowly do the same exercises with healthy people in 3 months. In open surgery, it takes 6 months to return to the gym (sports). Today, people who work at a desk are experiencing back pain and this has become routine. What can you recommend for people who work intensely and experience these pains? Desk workers are a complete catastrophe. There are all of the above. All of them have alignment problem, their muscles are weak, floor exercises must be at the forefront. Since their aerobic capacity is low, such people can be given heart rate tracking and then combined movements. A difficult group that lasted for months, good luck. There is also a stiffness of the waist that happened to me and that I encountered in a few other people. Why does this situation, which is very difficult and restricts the person to move, occur? Will it cause a hernia in the future? And is there anything we can do to avoid this? Your situation may be the type of injury we encounter in elite athletes. Generally, stresses are not on the disc but on the muscle groups carrying the spine (such as kettlebell swing, rupture), muscle-bone adhesion site enthesopathies. (Enthesopathy: It is an inflammatory or degenerative condition that occurs in the areas where the tendons attach to the bone.) The most difficult to heal enthesopathies. While in the other group, they can return to sports with exercise restriction and supports, while enthesopathy may last for months. The simple thing to do is to reduce the repetitions and weight of the injuring exercise and try to continue the exercise by preserving muscle mass and joint width, if not, the resting interval should be increased. My last question is a situation with my mother. One of the vertebrae in the lumbar region is congenitally missing. Would such a situation create a problem in the long term and training? In the case of sacralization, the load on the disc will increase because the force arm is shortened. In this type of athletes, the back and abdominal muscles should be extremely strong, in addition to being supported by the muscles we call spino pelvic (squat basic movement), soft squats can be done after floor movements. It is even possible to do deadlifts within months. An athlete who does a good deadlift will never get injured. The important thing is that regardless of the weight, it is close to the body axis and the shorter the force arm, the closer the center of gravity to the barbell, the less load on the disc. Balanced grip, opening of the feet is important. If one of them fails, the risk of injury will increase. It is said that the shuttle and crunch movement causes long-term lumbar hernia. Because the spine has a bending life. And every time we do this bending movement, it is said that we get a little closer to the hernia. I want to know your thoughts on this subject? Partially correct. With weak muscles, the load on the disc increases and even injury may occur. Disc wall repairs itself in mild injuries. We have a self-regenerating and healing mechanism. However, if the loading is done without full recovery, there may be a hernia from the weakened place.

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.

What is Osteoporosis? Consensus 93: It is a systemic disease characterized by low bone density and insufficiency of microstructures, which increases the fragility and fracture risk in bone tissue. What is Osteoporosis? Definition 2002 (USNIH): It is a skeletal disease characterized by an increased risk of fracture as a result of impaired bone strength. Bone strength is the reflection of two main components of bone: bone density and quality. Risk factors: Other risks: -General muscle weakness -Difficulty in balancing (neurological, vestibular, ophthalmological problems) -Vision defect -Slow walking -Disruption of heel-toe gait (arthrodeses etc.) Who should be made a risk inquiry? - Everyone over the age of 50 should be questioned -The main areas at risk of fracture (wrist, humerus, ribs, vertebra, pelvis and hip) should be examined in detail. Who should be taken for Osteoporosis tests? - Those with height shortening> 4 cm -Progressive kyphosis (hump) -Long-term steroid users -Those with low-energy post-traumatic fractures -Patients> 65 years old -Those under the age of 65 who have clinical risk should be included in the investigation. Who are at high risk? -The main skeletal fracture -Those who have developed kyphosis -With a shortening of height -One Major and two Minor factors detected -Those with low bone density have a high risk of fractures. What are the normal values ​​in bone density densitometry? -Normal BMD; T score according to the standard deviation of the mean bone density of young adults: those in the range of +2.5 - (- 1.0). -Osteopenia; T: (- 1) - (- 2.5) Grade-C -Osteoporosis; T <minus 2.5 Grade-B -Group A at risk of osteoporosis and fractures Who should be treated? -Those at high risk of fractures -Those taking glucocorticoid therapy for a long time -Those who had fractures and low bone density after low-energy trauma are treated immediately.

What is Plika? It is found in the natural structure of the knee, its medical name is "medial plica-meniscofemoral ligament", shortly referred to as plica. It is a structure like a skirt pleat on the inner front of the knee joint, passing under the kneecap and ending in the capsule higher. It is a structure that normally cleans the joint surface like a soft tulle like a squeegee and supports it during loading. Plika; Sprain of the knee, excessive stair climbing, squatting, running, cycling, repetitive overloading squats, and during heavy loads. After the injury, the knee swells, there is pain for a while and it heals. However, after its healing, a new scar tissue, which we call hard fibrotic, is formed. The contact of this hard tissue with the joint surface causes the cartilage to wear over time, even in daily life, and the groove-like collapses on the joint surface it touches. While the kneecap starts to wear due to this hard structure, the irregularity on the opposite joint surface starts to give pain over time. Killer of the Knee Joint, Hidden Enemy: What is the Plica? Patients with Plica syndrome experience pain when climbing stairs, cannot sit for a long time by bending their knees, and want to stretch their legs in places such as cinema or restaurants. When they drive for a long time, it is typical for them to limp off the vehicle, and cross-legged is painful. Most of the time, it is examined with the diagnosis of meniscus tear, after the tests are found to be normal, the pain is reduced with medications, but the Plika problem continues. In reality the situation is more grave and dangerous. During advanced examination methods such as plica and MRI, the diagnosis may be missed, especially if it is not taken into sections. The best diagnosis can be made during the examination. In case of delay, it is inevitable that it will cause deep cartilage losses and permanent disability as a result of abrasions on the articular cartilage surfaces. Plica syndrome Treatment is possible with arthroscopic methods. If possible, devices that cause little bleeding, such as radiofrequency, should be used without damaging other anatomical structures so that they are completely removed. In the same session, if there are cartilage problems caused by the plica, meniscus irregularities are also resolved. After a day of rest, it can be returned to daily life and it is recommended to stay away from heavy activities for 10-20 days. If you cannot sit with your knees bent for a long time and have knee pain while driving, you may have a hardened problem, do not neglect it.

I have a hernia. Can I exercise? According to the data of the World Health Organization, one out of every 4 people has to have bed rest until the age of thirties at least once in their life due to spinal pain (neck, back and waist). Half of those who suffer from spinal pain need medical treatment. Every year, one million of 9 million people who do not respond to medical treatment all over the world need severe surgical treatments (absolute treatment-elimination of the cause), while the remaining eight million seek a solution to spinal pain by restricting their activity with conservative treatments. This situation results in psychological destruction and unhappiness for those who live actively and make daily sports activities a lifestyle, and every year millions of people give up sports, that is, life. I Have a Hernia. Can I Exercise? Why is that? Open surgical procedures are often performed with certain medical indications. No physician will apply an initiative that will not further improve the quality of life of his patient. If open surgery is useless, it recommends activity restriction instead. Benefit-harm ratio is always considered in treatment. The problem is that the old physical activity cannot be guaranteed due to the damage to normal tissues while reaching the diseased area during surgical treatment. Therefore, terminal treatment with classical surgical interventions cannot be applied to the millions of active living people who suffer from paralysis and severe pain that cannot be treated, except perhaps the lucky one million patients. In the last two decades, surgeons trying to reach the relevant segment of the spine without damaging the normal anatomical structures laid the foundations of minimally invasive surgery. Previously, they used a thin steel tube and their tools among dangerous anatomical structures. Initially, the results were promising, but not very bright. However, with the development of endoscopic systems, this time they were able to project the area on the screen and enlarge it, and at the same time treat the affected tissues. Physicians who have been trained by authors such as Hijikata and Kambin over time have made it common to lift their inpatients all over the world by walking from the operating table without pain. Why? Minimally invasive treatment indication is centered on quality of life. Pain that requires bed rest more than three times a year requires treatment because the person may be out of work. Not being able to do sports or restricting daily activities is a reason for treatment, because health by definition; "it is a state of complete mental and physical well-being". There is no health without movement. How? Treatments are applied in sterile surgical settings (operating rooms). Appropriate equipment (endoscopic camera, endoscopic surgical instruments and fluoroscopy - simultaneous x-ray) support, trained spine surgeon should be available. It is imperative that the person to be treated is compatible and not overly obese. Because the intervention is performed under local anesthesia by percutaneous skin puncture through a 0.5-1 cm hole. The patient is fully awake, there is almost no blood loss, he can confirm that he has recovered during the surgery and terminate the procedure himself. It is possible to be discharged the same day or even sunbathe on the beach. Driving for a short time and doing sports can be prevented. However, patients can immediately return to desk jobs. In addition to the low duration of hospitalization and low cost, making the person productive immediately is a great contribution to the country's economy. Where? Minimally invasive spine surgery was born in America and has developed to form academies in Asia and Europe. Among hundreds of physicians who have undergone systematic training today, successful Turkish physicians have also started to implement these initiatives in our country, especially in the last two years. There are only specialized centers in the world for minimally invasive endoscopic spine surgery. In the near future, the centers mentioned with finger in our country will be out of the ordinary. Who? This intervention is applied by spine surgeons who have applied and know the classical methods of spine surgery (Orthopedics and Neurosurgery specialists), who have completed their endoscopic surgery training and have proven that they can perform appropriate minimally invasive surgical techniques with certificates. Do not forget; Medical treatment and recommendations should be made to ensure a better quality, happier and healthier life. Otherwise it's useless. Do you have a hernia, have you been excluded from sports? Do not be afraid there is a cure.