The specialized orthopedic centers and specialized wards of the largest and internationally accredited hospitals in Istanbul, Turkey offer their patients all kinds of classic joint replacement surgeries according to internationally recognized standards, as well as uniquely applied techniques by highly qualified medical professionals.

The combination of extensive professional experience of surgeons in applying invasive interventions, modern technical base (high-resolution CT and MRI, 3D surgery planning, endoscopic equipment), high-quality prostheses and individual rehabilitation schemes ensure a high quality of life for patients and life expectancy of the used prostheses up to 15-25 years.

Indications for a need of joint replacement surgery
Joint replacement surgeries are used only in case of ineffectiveness of conservative methods of treatment and orthopedic rehabilitation practiced.

When replacing joints, doctors take into account:

• Maximum delay of joint replacement surgery
• To preserve the patient's bone tissue with the help of gentle techniques for replacement of superficial joints and partial endoprostheses
• To choose an individual prosthesis with a high quality of life after surgery.

The list of applications for arthroplasty includes:

• Osteoarthritis (stage III-IV disease with severe pain)
• Rheumatoid arthritis (disease III-IV with severe pain)
• Avascular necrosis of the head or femur of the femur, osteonecrosis elsewhere
• Congenital hip dislocation or clinically significant hip dysplasia
• Serious traumatic joint injuries, including articular cartilage injuries
• Joint stiffness and joint dysfunction caused by other diseases

Knee replacement surgery
In most patients, knee replacement surgery is performed by one of the classic methods with proven effectiveness:

General or complete joint replacement surgery involves replacement of the articular components of the femur and tibia, intra-articular cartilage and, if necessary, replacement of the patella. Taking into account the high requirements for the function of the knee joint, the components of the prosthesis are in most cases fixed with the help of bone cement.

Partial or unipolar replacement surgery most often involves the replacement of the medial (inner) part of the knee. As a rule, joints and cartilage are not affected. Due to the small scope of the operation and the relatively small size of the prosthesis, the intervention can be performed endoscopically.

Patella replacement surgery (patellofemoral arthroplasty) involves replacing the medial patella in its isolated lesion. Patellofemoral arthroplasty is indicated in the complete absence of signs of arthritis or other pathological process in other joint components.

In addition to the classic surgical techniques for joint replacement, a less invasive intervention is offered, namely tibial osteotomy. This technique is used for unilateral knee lesions. The surgeon reshapes the tibia to redistribute the load on the joint. As a result, the affected part of the knee is mainly in a state of functional rest.

Hip replacement
Hip replacement surgery is the mainstay of treatment for hip fractures, especially in the elderly. At the same time, this type of arthroplasty can often be recommended to young, physically active patients. To best meet the needs of patients of all ages, orthopedic surgeons use two fundamentally different methods of treatment. They include:

General or complete joint replacement surgery involves the replacement of the head and neck of the femur, the inner surface of the acetabulum, and the articular cartilage. A plastic spacer is placed between the components of the prosthesis, which protects the joint components from premature wear.

The economical superficial surgery of the hip joint is the best choice for young patients and patients with a high level of physical activity – active athletes. In this case, the surgeon preserves the head and neck of the femur, replacing only the damaged joint surface. This is important for patients who potentially need revision, as the service life of even the highest quality prostheses does not exceed 20-25 years. Arthroplasty creates favorable conditions for subsequent implantation of the total or new superficial endoprosthesis.

Shoulder joint replacement
In the case of shoulder replacement, surgery has two anatomically different types of arthroplasty, which include:

Physiological replacement surgery, which can be complete or partial, depending on the degree of damage to the components of the shoulder joint. In physiological arthroplasty, the shape of the prosthesis completely mimics the shape of a normal shoulder joint. This type of surgery is used in patients with normally functioning rotator cuff muscles.

Hemiarthroplasty involves replacement of the shoulder head, while total surgery involves replacement of the shoulder and glenoid cavity.

In the case of reverse replacement surgery, the supporting surfaces of the joint change places – the spherical head is placed on the shoulder blade, while the cup of the shoulder is placed on the shoulder. Such a non-standard prosthesis is suitable for patients with damaged rotational cuff muscles who are unable to use classic prostheses. The reversible design allows patients to make movements in the joint only with the help of the deltoid muscle.

Orthopedic rehabilitation and follow-up
Regardless of the underlying disease and the type of arthroplasty, treatment always ends with orthopedic rehabilitation. The rehabilitation program begins at the hospital the day after the arthroplasty. All exercises are performed under the full guidance of a qualified instructor.

After discharge from the hospital, the patient continues to perform the recommended set of exercises at home or visits a specialized center for physiotherapy and simulator exercises, which include the following activities:

• Exercises to strengthen the muscles of the body and the operated limb
• Physiological load of the operated limb with intensity modulation
• Passive joint development or CPM therapy
• High intensity laser therapy or HIL therapy
• Extracorporeal shock wave therapy
• Massage
• Electrical stimulationAnd when necessary, psychotherapy.

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