Gɛnɛgɛnɛ kolotuguda .

01. Kolow sigicogo cogoya .

E Gɛnɛgɛnɛ kolotuguda bɛ kɛ kolo 4 ye: senkɔni, senkɔni, patella ani fibula.

A bɛ Kɛ dakun 3 ye: Tibiofemoral dakun cɛmancɛ, Tibiofemoral yɔrɔ lateral, ani patellofemoral compartment, ani 3 dakunw bɛ sinkɔrɔkɛrɛdimi yɔrɔ kelen na.

02.Joint sigicogo .

A suguya: Joli-sira-joli .

Gɛnɛgɛnɛ bɛ ni joli 3 ye: tibiofemoral joli cɛmancɛ, tibiofemoral joint ani patellofemoral joint.

Tibiofemoral joint bɛ distal senkɔni ni senkɔni cɛ, ani distal femur tapers ka kɛ senkɔni cɛmancɛ la ani senkɔni kɔkanna na. Tibia bɛ kɛ fɛn ye min bɛ kɛ fɛn ye, nka meniscus inclined bɛ a to a ni senkɔniw kɔnɔna na, minnu bɛ bɔ kɛnɛ kan.

Senkɔniw bɛ Bɔ ɲɔgɔn na ni fɛnɲɛnamafagalanw ye minnu bɛ Weele ko intercondylar fossa, o min bɛ Weele fana ko femoral groove walima femoral talus.

Patella ye kisɛ kolo ye min bɛ don a la quadriceps muscle kɔnɔ ani a bɛ kɛ joli ye ni trochanteric groove ye.

A bɛ baara kɛ walasa ka quadrices farikolo ka nafa bonya masin na. Fibula kunkolo bɛ sɔrɔ gɛnɛgɛnɛkisɛ kɔnɔ nka a ka ca a la a tɛ baara kɛ i n’a fɔ farikolo girinya min bɛ girinya. Femoral condyles ani tibial plateau bɛ kɛ joli sira ye.

03. Joli sabatili .

Gɛnɛgɛnɛ kolotuguda sabatili bɛ mara ni farikolo yɔrɔ nɔgɔlen suguya caman ye minnu fana bɛ kɛ sababu ye ka farikolo tanga joli ma.

Tibia ni senkɔniw bɛ datugu ni hyaline cartilage shock-absorbing ye gɛnɛgɛnɛ kolotuguda kɔnɔna na.

-Diski-cogo la lateral ani medial menisci bɛ shock absorption wɛrɛw di ani fana ka fanga tila gɛnɛgɛnɛ kan joli bɛɛ la.

-Kɔrɔsi sanfɛla (ACL) ni kɔfɛla kurukuruni (PCL) bɛ ɲɛfɛla ni flexion-extension mouvements sabati.

-The medial colateral ligament ani lateral colateral ligament bɛ gɛnɛgɛnɛ sabati u ka planw kɔnɔ.

-Jɛgɛkɛnɛw bɛ jɔ cogo wɛrɛ minnu na, olu ye iliotibial bundle ye ani kɔfɛla kɔkanna-yɔrɔ dɔ.

04. Bursae ni cystic structures .

Sisitiki fɛn caman bɛ sɔrɔ ka caya gɛnɛgɛnɛ lamini na, i n’a fɔ senkɔniw sirilanw ni sinjiw. Tendon sheath cysts ye fɛnɲɛnamafagalanw ye minnu bɛ kɛ ni fɛnɲɛnamafagalanw ye minnu bɛ ɲɔgɔn cɛ ani nɔgɔ bɛ u la.

Popliteal cyst (o kɔrɔ ye ko Baker ka kuru) ye sinji ye min ka ca farikolo la. A bɛ Bɔ bursa la gastrocnemius muscle cɛmancɛ cɛmancɛ ni semimembranosus tendon cɛ. A ka ca a la, popliteal cysts tɛ taamasiɲɛ ye nka a ka ca a la u bɛ tali kɛ gɛnɛgɛnɛ kɔnɔ banaw la.

Bugun naani bɛ sɔrɔ gɛnɛgɛnɛ ɲɛfɛ. Suprapatellar bursa bɛ gɛrɛ gɛnɛgɛnɛ kapisi la ani a bɛ sɔrɔ kɔnɔbara basigilen ni a senkɔni cɛ, ani a ka taama ni gɛnɛgɛnɛ joli ye baliku fanba la. Bursa min bɛ kɔn ka na, o bɛ ɲɛfɛla dɔrɔn de la. Bursa infrapatellar infrapatellar sanfɛla bɛ sanfɛla la ka taa ɲɛda fan yɔrɔjan fɛ ani tibial tuberosity, k’a sɔrɔ infrapatellar bursa juguman bɛ sɔrɔ ka taa a fɛ patellar tendon distal yɔrɔ ni kɔnɔbara basigilen tuberosité cɛ. Sanfɛla bursa bɛ se ka funu ni baara kɛli ye kojugu walima ni a bɛ mɔgɔ tɔɔrɔ, i n’a fɔ gɛnɛgɛnɛ janyalen, ka sɔrɔ ka gɛnɛgɛnɛw janya baara caya, o bɛ se ka kɛ sababu ye ka bursa jugumanba funu, i n’a fɔ ka panpan walima ka boli siɲɛ caman.

Gɛnɛgɛnɛ cɛmancɛ fan fɛ, goosefoot bursa, semimembranosus bursa ani suprapatellar bursa de bɛ o yɔrɔ cɛmancɛ la. Goosefoot bursa bɛ sɔrɔ tibial stop de lateral tibial collateral ligament ni distal fusion tendons la suture, fin femoral ani semitendinosus muscles. Semimembranosus bursa bɛ semimembranosus tendon ni medial tibial condyle cɛ, ani suprapatellar bursa ye bursa belebele ye gɛnɛgɛnɛ joli la ani a bɛ sɔrɔ patella sanfɛ ani a jugumanba kan.

05 Jogindaw lamagacogo .

Walasa ka gɛnɛgɛnɛ jiginni jateminɛ, a bɛ banabagatɔ bila a ka a jɔyɔrɔ ta ani ka gɛnɛgɛnɛ wuli ka ɲɛ walasa a senkɔni ka surunya gluteal groove la cogo min na; Flexion (flexion) ka normal (kɔrɔlen) bɛ Taa 130° ɲɔgɔn na.

Walasa ka gɛnɛgɛnɛ janya jateminɛ, banabagatɔ bɛ sigi yɔrɔ la ani ka gɛnɛgɛnɛ janya caya. Gɛnɛgɛnɛ janya sen tilennen kɔfɛ walima a jɔyɔrɔ neutre (0°) la, o bɛ kɛ banabagatɔ dɔw la nka a bɛ fɔ ko hyperextension. A ka ca ni 3°-5° ye ka tɛmɛ a hakɛ kan, o ye jiracogo ye min bɛ kɛ ka ɲɛ. hyperextension ka tɛmɛ nin hakɛ in kan, o bɛ wele ko gɛnɛgɛnɛw ka retroflexion ani a jiracogo tɛ kelen ye.

Homas sɛgɛsɛgɛli bɛ quadrices ni hip flexors ka sɛgɛsɛgɛli kɛ.

Ni kɔkiliw ka sɔgɔli bɛ kɛ, finimugu duguma dafɛla cɛmancɛ bɛna kɛ sanfɛla la sanni ka a ko walima ka jigin ni sɛgɛsɛgɛli tabali ye.

Cɛsirilan min sirilen bɛ sɛgɛsɛgɛli tabali la, o bɛ a jira ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ ko a bɛ se ka kɛ.

Ni quadrices tightness bɛ yen, drape sen duguma bɛna a ɲɛsin sɛgɛsɛgɛli tabali ma. Angle min bɛ sɔrɔ sen duguma draping fɛ ni dugukolo plumb layini ye, o bɛ quadriceps tension hakɛ jira.

06. Joli sabatili jateminɛ .

kɔfɛla sɛgɛsɛgɛli - kɔfɛla sɛgɛsɛgɛli bɛ kɛ ni banabagatɔ ye a da la, a kɔkili bɛ wuli ka se 45° ma, gɛnɛgɛnɛ bɛ wuli fo 90°, ani sen min bɛ a sen na . Sɛgɛsɛgɛlikɛla bɛ banabagatɔ ka senkɔni gɛrɛgɛrɛ minɛ ni a bolo fila ye ka a sɔrɔ a bɛ a bolo fila bɛɛ bolokɔniw bila tibial tuberosity kan. O kɔfɛ, kɔfɛ fanga dɔ bɛ Kɛ senkɔni-kɔnɔ-yɔrɔ la. Kɔnɔbara kɔfɛla jiginni min ka ca ni santimɛtɛrɛ 0,5-1 ye ani kɔfɛla jiginni min ka bon ni kɛnɛya fan ta ye, o bɛ gɛnɛgɛnɛ kɔfɛla kurukuruni dɔ walima a dafalen jira.

Quadriceps active contraction test - A bɛ banabagatɔ sen sabati (a ka ca a la a sigilen bɛ sen kan) wa a bɛ a ɲini ka sen sɔgɔ ka taa ɲɛfɛ sɛgɛsɛgɛli tabali kan (sɛgɛsɛgɛlikɛla bolo kɛlɛli), o manɛw bɛ kɛ sababu ye ka kirinnan farikolo tigɛ, o min bɛna kɛ sababu ye ka tibia jiginni kɔrɔ ni a dɔgɔyalenba ye 2mm ye a kɔfɛla la.

Tibial external rotation test - Tibial external rotation test bɛ kɛ ka kɔfɛla lamini joginw dɔn ani ka kɔfɛla kurukuruniw sɔrɔ. Tibia bɛ wuli ka bɔ kɛnɛma 30° ni 90° gɛnɛgɛnɛ jiginni na. Sɛgɛsɛgɛli bɛ kɛ ni a fan min bananen don, o bɛ wuli ka tɛmɛ 10°-15° kan ka tɛmɛ fan kɛnɛman kan. Ni a bɛ sɔrɔ gɛnɛgɛnɛ 30° la ani ni a tɛ 90° la, o bɛ PLC joginni nɔgɔman jira, wa a bɛ sɔrɔ 30° ni 90° fila bɛɛ la, o bɛ a jira ko joginda bɛ sɔrɔ kɔfɛla kurukurulen kɔfɛla la ani kɔfɛla la.

07. Periarticulaire ligaments .

Joli kapisi ligaments .

Patellar ligament, medial patellar ligament, lateral patellar ligament .

Ligaments intracapsular .

Kɔnɔbara basigilen ɲɛfɛla la, kɔkolo kɔfɛla la .

Ligaments extracapsular .

Ligament collateral medial, ligament de cololaté latérale, ligament oblique oblique popliteal, ligament de collaterale fibular .

08. Jogindaw ka innervation .

Neurovasculaire ka baarakɛcogo .

Neurovasculaire bundle min kɔnɔ popliteal artery, popliteal vein ani tibial nerve (a continuation of the sciatic nerve) bɛ taa kɔfɛ dɔrɔn ka taa gɛnɛgɛnɛ kolotuguda la.

Peroneal nerve min ka teli ka sɔrɔ, o ye sɔgɔsɔgɔninjɛ kɛrɛfɛla ye.

09. A ni farikolo yɔrɔw bɛ ɲɔgɔn na .

ɲɛfɛla lateral .

Quadriceps ye rectus femoris, vastus medialis, vastus lateralis ani intermedius femoris ye.

Kɛrɛfɛ fan fɛ .

Hamstrings .

a bɛ biceps femoris, semitendinosus ani semimembranosus kɔnɔ;

Gastrocnemius.

Anteromedial .

Tibialis ɲɛfɛla.

Fasa minnu bɛ gɛnɛgɛnɛ kolotuguda sabatili sabati, i n’a fɔ kɛrɛ naani, sutura farikolo, senkɔniw, senkɔniw farikolo yɔrɔ finmanw, biceps femoris, semitendinosus ani semimembranosus.

10. Farikolo sɛgɛsɛgɛli .

1. Sɛgɛsɛgɛli yelen .

Aw bɛ gɛnɛgɛnɛ kolotugudaw lamagacogo ni u simetri kɔlɔsi banabagatɔ fan min bananen don ani banabagatɔ fan dɔ fɛ, ani aw bɛ aw janto a la ni funu bɛ sɔrɔ yɔrɔ la, ni fari kulɛri tɛ kelen ye, ani ni taamacogo tɛ kelen ye, a ɲɔgɔnnaw 3.

2. Palpation .

Aw bɛ dimi ni funu yɔrɔ lajɛ, a juguya, a bonya ani a cogoya, banabagatɔ fan min tɔɔrɔlen don, o bɛ lafiya yɔrɔ la min bɛ se ka kɛ.

3. Mobilizasiyɔn .

Aw bɛ gɛnɛgɛnɛ joli lamagacogo lajɛ banabagatɔ ka baara kɛcogo ɲuman ni a ka baara kɛcogo la.

4. Sumani .

Aw bɛ bolokɔni yɔrɔ kelen-kelen bɛɛ janya suman ka fara bolokɔni janya bɛɛ kan, a lamini, a lamagacogo hakɛ, a farikolo fanga, a farikolo yɔrɔ bɔnɛnen, a ɲɔgɔnnaw, ani ka sɛbɛnw ni taamasiyɛnw kɛ.

5. Sɛgɛsɛgɛli kɛrɛnkɛrɛnnen .

 - Aw bɛ patella sɛgɛsɛgɛli kɛ min bɛ wuli : Aw bɛ a kɔlɔsi ni a bɛ sɔrɔ banabagatɔ gɛnɛgɛnɛ kolotuguda la.

Ka taabolo sɛgɛsɛgɛ .

Suprapatellar bursa sɔgɔli kɔfɛ walasa ka ji lajɛ, ni ji bɛ gɛnɛgɛnɛ joli la, patella bɛ digidigi nɔgɔya la ni bolokɔnincinin ye, ni degun bɔra, patella bɛ pan ka taa sanfɛ ji wulilen fanga kɔrɔ, ani ni degun bɛ bɔ, patella bɛna kɛ ni popping walima flotting sensation ye ka da a kan buoyant force ka da a kan.

- drawer test : k'a lajɛ ni tiɲɛni bɛ kurukuruli la.

Aw bɛ ɲɛfɛla sɛgɛsɛgɛli kɛ: Banabagatɔ dalen bɛ a ka dilan kan, a gɛnɛgɛnɛ bɛ 90 °, a senw bɛ kɛ fla ye dilan kan, aw bɛ to ka lafiya. Sɛgɛsɛgɛlikɛla min bɛ banabagatɔ senw na walasa a ka jɔ, bolow bɛ gɛnɛgɛnɛ joli dakun minɛ, ka misiden sama ka taa ɲɛfɛ, i n’a fɔ senkɔni ɲɛfɛla jiginni ka tɛmɛ 5mm fan kɛnɛman kan, o b’a jira ko joli kurulen sanfɛla joginni (kɔlɔsili: lachman sɛgɛsɛgɛli ye gɛnɛgɛnɛ jiginni sɛgɛsɛgɛli ye 30 °).

kɔfɛla sɛgɛsɛgɛli : Banabagatɔ dalen bɛ a kɔ kan, a bɛ gɛnɛgɛnɛ biri 90° la, a bɛ gɛnɛgɛnɛ kɔfɛla bolo fila da, ka bolokɔni bila a fan fɛ, ka misiden laban gɛrɛgɛrɛ ani ka a sama ka segin kɔfɛ, ani senkɔniw bɛ taa kɔfɛ ka a kɛ a senkɔniw ye, o min bɛ a jira ko kɔkili kurulen bɛ a fan dɔ la.

- Grinding Test : Ka a ɲɛfɔ ni tiɲɛni dɔ bɛ gɛnɛgɛnɛ meniscus la.

Gɛnɛgɛnɛ kolotuguda sɛgɛsɛgɛli: Farikololajɛ fɛɛrɛ min bɛ kɛ ka gɛnɛgɛnɛ kolotugudaw lajɛ ani ka gɛnɛgɛnɛ kolotugudaw jogin.

Banabagatɔ bɛ a cogo la ni a gɛnɛgɛnɛ min bɛ a la, o bɛ wuli 90° la.

1. Aw bɛ wuli ka wuli sɛgɛsɛgɛli la .

Sɛgɛsɛgɛlikɛla bɛ misiden digi banabagatɔ cɛmancɛ kan, ka a senkɔni minɛ ni a bolo fila ye walasa ka misiden kɔrɔta misiden janya sira kan, ka sɔrɔ ka kɔnɔna ni kɛnɛma jiginni lamaga; Ni dimi bɛ sɔrɔ gɛnɛgɛnɛ fan fila bɛɛ la, a bɛ kɛ ko a bɛ kɛ joginda lateral collateral ligament joginni ye.

2. Aw bɛ sɛgɛsɛgɛli kɛ ni wuli ye .

Sɛgɛsɛgɛlikɛla bɛ a bolokɔni minɛlen sen minɛ ni a bolo fila ye, walasa a gɛnɛgɛnɛ min bananen don, o bɛ wuli 90° la ani misiden bɛ jɔ cogo la min bɛ jɔ ni sen ye san fɛ. O kɔ, aw bɛ gɛnɛgɛnɛ kolotuguda sɔgɔ ka jigin ka sɔrɔ ka misiden wuli ka taa a kɔnɔ ani ka taa kɛnɛma waati kelen na. Ni dimi bɛ gɛnɛgɛnɛ kolotuguda kɔnɔna ni a kɛnɛma fan fɛ, o b’a jira ko kɔnɔna ni kɛnɛma menisiki tiɲɛna.

Ni gɛnɛgɛnɛ bɛ wuli kojugu, kɔfɛla meniscus karili bɛ siga la; Ni a bɛ 90° la, a bɛ siga ko cɛmancɛ kari; Ni dimi bɛ sɔrɔ ni aw bɛ gɛrɛ a jɔyɔrɔ tilennen na, a bɛ kɛ ko a ɲɛfɛla bɛ tiɲɛ.

- Lateral stress test : ka banabagatɔ kɔlɔsi walasa ka a tiɲɛ ka a sɔrɔ a bɛ a lateral collateral ligament.

Gɛnɛgɛnɛ degun sɛgɛsɛgɛli ye farikolo sɛgɛsɛgɛli ye min bɛ kɛ ka gɛnɛgɛnɛ kɔkanna kolotugudaw lajɛ.

JAABI: Banabagatɔ dalen bɛ sɛgɛsɛgɛlikɛlan kan, ka a tigi bolo minɛ ka a tigi minɛ nɔgɔya la walasa a ka se ka a sen duguma min bananen don, o ka bila dilan kɔfɛ.

Joli jɔyɔrɔ : gɛnɛgɛnɛ bɛ bila a jɔyɔrɔ la min janyalen don kosɛbɛ ani a bɛ se ka wuli 30° la.

Fanga waleyali : Gɛnɛgɛnɛ jɔyɔrɔ fila sanfɛ, sɛgɛsɛgɛlikɛla bɛ banabagatɔ sen duguma minɛ ni a bolo fila ye, ka degun kɛ a cɛmancɛ ni a kɛrɛfɛ fanw na, walasa gɛnɛgɛnɛ kolotuguda ka minɛ cogo la min tɛ kɛ ka a minɛ walima ka a kɛ fɛn ye, n’o ye valgus ni valgus sɛgɛsɛgɛliw ye ani ka a suma ni fan kɛnɛman ye.

Ni dimi bɛ sɔrɔ gɛnɛgɛnɛ kolotuguda la degunw tali senfɛ, walima ni a sɔrɔla ko inversion ni eversion angle bɛ bɔ a cogo kɔrɔ la ani ko popping sensation bɛ yen, o b’a jira ko spraine walima kari ka kɛ lateral collateral ligament ye. Ni kɛnɛma jiginni degun sɛgɛsɛgɛli ye ko ɲuman ye, a b’a jira ko sira tilennen cɛmancɛ tɛ sabati, wa a bɛ se ka kɛ ko joginda bɛ se ka kɛ a cɛmancɛ la kolilama ligament, medial meniscus ani joint capsule Ni kɔnɔna jiginni degun sɛgɛsɛgɛli kɛra koɲuman, a b’a jira ko sira tilennen tɛ sabati, wa joginw bɛ se ka sɔrɔ kɛrɛfɛ menisisi walima joli siraw sanfɛla kolotugudaw la.

11. Gɛnɛgɛnɛ ja .

1. Sɛgɛsɛgɛli min bɛ kɛ ni X-ray ye .

A bɛ kɛ ka a lajɛ ni a karilen don ani kolotugudaw tiɲɛni. Girinyali (min bɛ jɔ) Aw bɛ gɛnɛgɛnɛ joli ɲɛfɛla ni kɛrɛfɛla lajɛ filimu bɛ se ka kolo, gɛnɛgɛnɛ kolotugudaw ani a ɲɔgɔnnaw kɔlɔsi.

2. Tomografi jatebɔlen (CT) .

CT scans bɛ se ka dɛmɛ don ka kolo gɛlɛyaw ni kari nɔgɔlenw sɛgɛsɛgɛ. CT scan suguya kɛrɛnkɛrɛnnen bɛ se ka gout dɔn ka ɲɛ, hali ni joli ma funu.

3. Ultrason .

A bɛ mankanw Kɛ walasa ka ja dɔw Bɔ waati yɛrɛ la gɛnɛgɛnɛw jɔcogo la gɛnɛgɛnɛ kɔnɔ ani a lamini na. Ultrason bɛ se ka bana caman yeli ye i n’a fɔ kolotugudaw la, kolotugudaw la, kolotugudaw tiɲɛni, sinji, joli bɔli la, popliteal fossa fununi, ani meniscal bulging.

4. Magnetic Resonance Imaging (MRI) .

Nin sɛgɛsɛgɛli in bɛ dɛmɛ ka farikolo yɔrɔ nugulenw joginw sɛgɛsɛgɛ, i n’a fɔ senkɔniw, senkɔniw, kolotugudaw ani farikolo yɔrɔw.

Laboratowari ka sɛgɛsɛgɛliw : Ni dɔgɔtɔrɔ bɛ sigasiga banakisɛ walima funu na, joli sɛgɛsɛgɛli ani tuma dɔw la jolilabanaw °, fɛɛrɛ min bɛ ji dɔɔni bɔ gɛnɛgɛnɛ kolotuguda la walasa ka laboratuwari sɛgɛsɛgɛ, o bɛ se ka kɛ.

12. Jolidimi sababu minnu ka teli ka sɔrɔ .

1. Joginw ni ɲɔgɔn cɛ .

Joginni joginw i n’a fɔ ɲɛgɛnɛsiralabanaw ɲɛfɛla ni kɔfɛla kolotugudaw ni u ɲɛjibɔlanw; Meniscus joginw; Patellar tendonitis and tears; kolo karilenw ani a ɲɔgɔnnaw.

2. Jolidɛsɛ min bɛ sɔrɔ .

Kolotugudaw bɛ sɔrɔ kolotugudaw kolotugudaw sɛgɛnni ni u tiɲɛni fɛ; Ɲɛgɛnɛsiraw bɛ sɔrɔ farikolo tangalanw fɛ minnu bɛ bin kolotugudaw kan; Gout bɛ sɔrɔ kristalɛw sɔrɔli fɛ ka bɔ asidi uriki caman na minnu bɛ nɔ bila kolotugudaw la.

3. A sababu wɛrɛw .

sinjibana bɛ kolotugudaw dimi ni funu bila mɔgɔ la; Patellar gɛlɛyaw i n’a fɔ dislocation ani cartilage wear; kuru minnu bɛ don joli la; Edema min bɛ sɔrɔ funu fɛ, a ɲɔgɔnnaw; a jɔli ka mɛn sen na; Fascia syndrome iliotibial min bɛ sɔrɔ sɔgɔsɔgɔninjɛ segin-segin fɛ min bɛ na ni dimi ye gɛnɛgɛnɛ kɔkan.

13. Furakɛli fɛɛrɛw minnu bɛ kɛ ka caya .

1.Furakɛli min bɛ kɛ ka banaw furakɛ .

-Lafiɲɛbɔ ni frein .

-Nɛnɛ ni funteni kompresi .

-Dɔrɔgu furakɛli .

-Fɛnɲɛnama furakɛli .

-Exercise furakɛli .

-Aw bɛ baara kɛ ni dɛmɛnanw ye .

2.Opereli .

-Arthroscopic Opereli .

-Arthroplastie .

3.Furakɛcogo wɛrɛw .

-Laadalata Sinuwa furakɛli (TCM) .

-Injection furakɛli .