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Be woakpɔ egbɔ be wole dedie eye wowɔ ɖe seawo dzi la, ele be woatsɔ dukɔwo dome dzidzenuwo abe FDA (USA), CE Mark (Europe), kple ISO 13485 (nyonyodzikpɔkpɔ ƒe ɖoɖowo) aɖo kpe kamedefefe ƒe atike siwo wotsɔ dea ame me dzi. Ðaseɖigbalẽ siawo ɖea sewo ƒe mɔɖeɖe kple kakaɖedzi le adzɔnuwo ŋu fiana.
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Amekolawo bua nusiwo le abe abi ƒomevi, dɔnɔa ƒe dɔwɔwɔ ƒe agbɔsɔsɔ, ƒu ƒe nyonyome, nusi wotsɔ dea ƒu me, kple amekoko ƒe mɔnu ene ŋu. Zi geɖe la, woɖoa ŋu ɖe dɔdamɔnu ŋuti nuteƒekpɔkpɔ kple numekuku siwo wowɔ fifia ŋu be woatia mɔ̃ nyuitɔ kekeake siwo woatsɔ aɖɔ ACL, meniscus, alo abɔta ɖo.
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Ƒunukpeƒetetedɔ si me womezãa nu boo aɖeke le o ɖea amekoko ƒe nuveviwɔame dzi kpɔtɔna, eɖea ɣeyiɣi si woatsɔ ahayae dzi kpɔtɔna, eɖea dɔlékuiwo xɔxɔ ƒe afɔkua dzi kpɔtɔna, eye wònaa wokpɔa ƒunukpeƒewo nyuie ŋutɔ. Eva zu mɔnu si wozãna ɖaa tsɔ dia abi siwo woxɔna le ƒunukpeƒewo le kamedefefewo ta ahada wo.
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3D tata wɔnɛ be woate ŋu awɔ nusiwo wotsɔ dea ame me kple amekoko ƒe mɔfiamewo ƒe kpɔɖeŋu kabakaba eye woatrɔ asi le wo ŋu pɛpɛpɛ. Enaa ƒumeŋutinunyadɔwɔƒewo te ŋu wɔa dɔwɔnu siwo sɔ na dɔnɔwo koŋ, tsɔa ŋutilã ƒe wɔwɔme ƒe tɔtrɔwo sɔna kple wo nɔewo, eye wodoa biomechanical dɔwɔwɔ kpɔ hafi wɔa wo.
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Nu yeye siwo wowɔ dometɔ aɖewoe nye seke siwo wotsɔa lãfu wɔe katã, seke siwo woate ŋu aƒo wo ɖokui, seke siwo wotsɔa ʋuƒo ƒoa ƒui, ƒunukpeƒetetedɔ si wotsɔa mɔzɔzɔ kpena ɖe ame ŋu, kple dɔwɔnu siwo wowɔ ɖe ɖoɖo nu siwo wota le 3D me. Dɔwɔnu siawo nana dɔwɔwɔ nyona ɖe edzi, woɖea lãmenugbagbeviwo ƒe gbegblẽ dzi kpɔtɔna, eye wonaa nusiwo wotsɔ ɖoa lãmenugbagbeviwo ŋu nyuie wu.
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Dɔwɔnu siwo wowɔ ɖe ɖoɖo nu nana amekokoa wɔa dɔ pɛpɛpɛ wu, ɖea ɣeyiɣi si wozãna le dɔwɔwɔ nɛ me dzi kpɔtɔna, eye wònaa dɔnɔwo ƒe dɔwɔwɔ nyona ɖe edzi. Le ŋutilã ƒe wɔwɔme sesẽwo alo amekola ƒe didi tɔxɛwo gome la, mɔfiame alo dɔwɔnu siwo wowɔ na ame ŋutɔ kpɔa egbɔ be woda nusiwo wotsɔ dea ame me la ɖe teƒe nyuitɔ eye wosɔ nyuie wu.
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Amekolawo zãa seke siwo wotsɔ blaa nu siwo wotsɔ nusiwo le abe titanium, PEEK, alo bioabsorbables ene wɔ. Wotsɔa seke siawo dea ƒua me eye wozãa wo tsɔ gbugbɔ blaa lãkusi si vuvu la to aŋe sesẽwo zazã me. Seke siwo wotsɔa fli eve alo esiwo wotsɔa aŋe blaa wo katã bɔe le alesi woadzrae ɖo nu.
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PEEK implants nye radiolucent eye mɔ̃ɖaŋununya ƒe nɔnɔmewo le wo ŋu abe ƒu ene, si wɔe be wosɔ nyuie na dɔwɔwɔ abe interference screws, suture anchors, kple fixation buttons ene. Wozãa wo zi geɖe le ACL/PCL gbugbɔgatu kple abɔta dzadzraɖo me.
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Nusiwo wotsɔ dea lãme na ame siwo te ŋu xɔa nugbagbeviwo gblẽna le ɣeyiɣi aɖe megbe eye mlɔeba la, dzɔdzɔmeŋusẽwo va ɖɔlia wo, si wɔnɛ be megahiã be woawɔ dɔ na wo be woaɖe wo ɖa o. Gake titanium-nu siwo wotsɔ dea lãme na ame ya nɔa anyi ɖaa, wosẽna, eye wowɔa dɔ ɖe nugbagbewo dzi, gake ate ŋu ahiã be woaɖe wo ɖa ne wodo dziku alo kuxiwo do mo ɖa.
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Wozãa ACL ƒe nutete ƒe gaviwo le lãkusi gbugbɔgatu me tsɔ léa lãkusia (autograft alo allograft) ɖe afɔkpodzi alo afɔkpodzi ƒe mɔ̃a me. Wokpɔa egbɔ be woblae enumake eye wokpena ɖe ame ŋu be dɔlékuiwo ƒe dɔyɔyɔ nɔa bɔbɔe le ƒu si wodo kple ƒu dome.
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Nusiwo wozãna zi geɖe dometɔ aɖewoe nye titanium-kpewo, PEEK (polyether ether ketone), gakpo si mexɔ dzo o, kple polymer siwo te ŋu xɔa nugbagbeviwo abe PLLA alo PGA ene. Tiatia la nɔ te ɖe nusiwo le abe ŋusẽ, nugbagbewo ƒe dɔwɔwɔ ɖekae, kple nenye be wowɔ nusi wotsɔ de ame me be wòanɔ ŋutilãa me alo wòalɔ le ɣeyiɣi aɖe megbe dzi.
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Ɣeyiɣi si woatsɔ ahaya la toa vovo le dɔnɔa kple abi ƒe sesẽme nu, gake dɔnɔ akpa gãtɔ trɔna yia kekeli ƒe dɔwɔwɔ me le ɣleti 3–6 me. Hoʋiʋli ƒe kamedefefewo ƒe hayahaya blibo ate ŋu axɔ ɣleti 6–9 alo esi wu nenema, le ŋgɔyiyi si wowɔ le gbugbɔgaɖɔɖo me nu.
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Abi siwo bɔ wue nye anterior cruciate ligament (ACL) ƒe aɖatsi, meniscal ƒe aɖatsi, rotator cuff ƒe abi, labral ƒe aɖatsi, kple ƒunukpeƒe ƒe abi. Ƒunukpeƒetetedɔ na amekolawo te ŋu dzraa lãkusi siwo gblẽ ɖo alo gbugbɔa wo ɖo evɔ womeɖea fu boo aɖeke o eye woƒe hayahaya ƒe ɣeyiɣiwo hã nɔa wo ŋu kabakaba wu.
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Amekoko to ƒunukpeƒetetedɔ nye dɔ si me womewɔa nu boo aɖeke le o si me wotsɔa fotoɖemɔ̃ sue aɖe (ƒunukpeƒekpɔmɔ̃) kple dɔwɔnuwo dea to ʋuʋudedi suewo me tsɔ dea dzesi ƒunukpeƒewo ƒe nyawo hedaa wo. Wokafunɛ zi geɖe na lãkusi ƒe aɖatsi, meniscus ƒe abixɔxɔ, ƒunukpeƒetetedɔ ƒe gbegblẽ, kple ƒunukpeƒewo ƒe malikenyenye, vevietɔ le klo, abɔta, kple afɔkpodzi.
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Kamedefefewo ƒe atikewɔwɔ nye ƒumeŋutinunya ƒe alɔdze tɔxɛ aɖe si ƒe susu nɔa mɔxexe ɖe lãmekawo ƒe abi siwo woxɔna le kamedede ta nu, wo didi, kple wo dada ŋu. Ewɔa akpa vevi aɖe le kpekpeɖeŋu nana kamedefefewɔlawo kple amesiwo le dɔ dzi vevie me be woahaya to amekoko kple esiwo menye amekoko o ƒe atikewɔwɔwo me, siwo dometɔ aɖewoe nye kamedede, ƒunukpeƒetetedɔ, kple ƒunukpeƒetetedɔ siwo wotu ɖe ƒunukpeƒetetedɔ dzi abe ACL alo rotator cuff repair ene.
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Míeɖoa nyabiasewo katã ŋu le gaƒoƒo 12 me.
Míenaa subɔsubɔdɔ si wowɔna kabakaba eye wòwɔa dɔ nyuie ɣesiaɣi.
Abe nudzrala si tsɔa agbanɔamedzi ene la, míetsɔ mía ɖokui na bliboe ɖe nudɔdɔ ɖesiaɖe si míaƒe asisiwo abia ŋu.
Ne nya aɖewo do mo ɖa le mía ŋutɔwo ƒe vodada ta (abe nyonyome ƒe kuxiwo alo nudɔdɔ ƒe megbetsitsi ene) la, míakpɔ wo gbɔ heheɖemegbe manɔmee!
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Míewɔa tɔtrɔ ɖe nɔnɔmewo ŋu ƒe dɔwɔna siwo gbɔna:
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Wò dzesidenu ƒe dzesidede ɖe míaƒe adzɔnu siwo li fifia dzi
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Adzɔnuwo wɔwɔ le wò nɔnɔmetatawo nu
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Aɖaŋuwɔwɔ si wotu ɖe wò kpɔɖeŋu dzi kple mɔ̃ɖaŋununya ƒe nɔnɔmetatawo wɔwɔ
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Nudzraɖoƒe gbogbo aɖewo le mía si eye zi geɖe la, míate ŋu aɖo wo ɖe mí le kwasiɖa ɖeka me.
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Ẽ, míate ŋu ana kpɔɖeŋuwo femaxee hena nyonyome dodokpɔ. Taflatse na míanya wò nudidi tɔxɛwo.
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Míenye ƒumeŋuɖui kple amekoko dɔwɔnuwo wɔlawo. Míaƒe nu vevitɔwo dometɔ aɖewoe nye:
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Nusiwo wotsɔ dea aklã me
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Nail siwo le lãkusi me
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Trauma plates (siwo wotu kple esiwo womexe o) .
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Craniomaxillofacial ƒe agbalẽviwo
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Dɔwɔnu siwo ŋu ŋusẽ le siwo wozãna tsɔ wɔa amekoko
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Nusiwo wotsɔna léa nu ɖe te le gota
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Akɔta kple klo ƒe ƒunukpeƒetetedɔ
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Kamedefefewo ƒe atikewo
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Dɔwɔnu siwo wozãna tsɔ léa ŋku ɖe dɔgboa ŋu
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Ƒumeŋutinunya ƒe dɔwɔnu siwo wozãna le mɔ gbadza nu
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Lãwo ƒe ƒumeŋuɖui ƒe atikewo
