Engeri y'okulondamu ekintu ekituufu eky'okuteeka mu kisambi .

Ekintu ekiyitibwa hip prosthesis kye kyuma eky’obujjanjabi ekiteekebwamu ebitundu bisatu: ekikolo ky’ekisambi, omutwe gw’ekisambi n’ekikopo ky’ekisambi. Ebitundu bino ebisatu bikyusa ekinywa ky’ekisambi ekyonoonese, okuzzaawo okutambula n’okumalawo obulumi eri omulwadde.

01.Ebitundu ki ebiri mu a . Ekiwanga .?

Ekitundu ky’omubiri ekiyitibwa hip prosthesis kirimu ebitundu bisatu ebikulu:

Ekikolo ky’ekisambi .

Oluvannyuma lw’okuggyawo omutwe gw’omulwadde ogw’ekisambi, omukutu gw’omulwadde ogw’ekisambi guyingirwamu era ekikolo ky’ekisambi ne kiteekebwamu. Ekikolo ky’ekisambi kiyinza okuba nga kissiddwamu seminti oba nga tekirina seminti (press fit technique) okusinziira ku myaka gy’omulwadde, enkula y’amagumba, amagumba ag’enjawulo n’emize gy’omusawo.

Omutwe gw’ekisambi .

Omutwe ogw’enkulungo ogukoleddwa mu kyuma, polimeeri oba keramiki guteekebwa ku nkomerero ey’okungulu ey’ekikolo ky’ekisambi okudda mu kifo ky’omutwe gw’ekisambi omukadde ogwonooneddwa oguggyiddwawo.

Acetabular prosthesis (oba ekikopo ky’ekikopo) .

Eggumba eryonooneddwa okuva waggulu ku acetabulum, omutwe gw’ekisambi ekikadde we gwaggibwa, guggyibwamu. Mu kifo kyayo mulimu ekitundu ekiyitibwa tapered acetabular prosthesis. Sikulufu oba seminti osobola okuzikozesa okugikwata mu kifo. Munda mu kikopo kino mulimu akaveera, ka ceramic oba ekyuma ekiteekebwamu ekijja okukwatagana n’omutwe gw’ekisambi eky’ekinnansi.

02. Biki ebikulu ebikozesebwa mu bitundu by’omubiri ebiyitibwa hip prostheses?

Ebitundu by’omubiri ebiyitibwa hip prostheses bisobola okwawulwa okusinziira ku bintu ebikozesebwa okubikola. Mu kiseera kino, ebikozesebwa bino bisobola okugabanyizibwamu ebika bisatu:

Ebyuma .

Ebyuma ebimu, gamba ng’ekyuma ekitali kizimbulukuse, cobalt-chroum alloy oba titanium bye bikozesebwa okukola ebikoola by’ekisambi.

Ebiwujjo .

Polyethylene, akaveera akakaluba ennyo era nga kye kintu ekisinga okukozesebwa mu nsi yonna. Ye kintu ekitaliiko kye kikola era ekikwatagana ennyo n’ebiramu ekyayingizibwa mu magumba mu myaka gya 1960 ng’ekitundu ky’ebitundu by’omubiri ebiyitibwa acetabular prostheses. Leero, ekintu kino kikyakozesebwa mu balwadde abamu, naye ekibi kiri nti ekiseera bwe kigenda kiyitawo, waliwo akabi nti ekiwanga kijja kwambala okuva mu buveera, n’olwekyo obulamu bw’ekiwanga bujja kukendeezebwa. Wabula akabi kano kakyayinza okukendeezebwa kuba abalwadde abamu basobola okukuuma ekiwanga kino okumala emyaka 30 ate abalala okumala emyaka mitono gyokka.

▲Ekifaananyi: Ekikopo kya Procotyl® L Acetabular (ekitono Ebiva mu kuzimba amagumba: bikwatagana ne delta ceramic liners ne A- kiraasi highly cross-linked polyethylene liners)

Ekitundu ky’okutambula wakati w’omutwe gw’ekisambi n’ekikopo ky’ekisambi kitondekawo kye tuyita ekiseera ky’okusikagana. Kitundu ekisinga obunafu mu kiwanga naddala mu by’okwambala n’okukutula. Waliwo pairing nnya ezisoboka:

-Ekitundu-polyethylene .

-Ceramic-Ceramic .

-ekyuma-polyethylene .

-Ekyuma-ekyuma .

Buli pair ya friction erina ebirungi n’ebibi, era omusawo alongoosa amagumba ajja kulondawo okugatta okusinga okutuukirawo nga kwesigamiziddwa ku misingi egiwerako, omuli emyaka gy’omulwadde, okukola emirimu gy’omubiri, n’amagumba.

Kikulu okumanya nti okutwalira awamu ebyuma ebikozesebwa mu kukola emirimu gy’emikono tebirungi. Kkampuni ezimu ezikola ebintu ng’ebyo zaasalawo okulekera awo okuzitunda mu 2010-2011, era olw’okuganyula abalwadde, zaasalawo okujjukira ebyo ebyateekebwamu ebitaakozesebwa. Ekizibu kiva ku kusikagana wakati w’ebintu eby’enjawulo eby’ekintu ekisimbibwa, era okusikagana kuno kuyinza okugoba obutundutundu obutonotono obw’ekyuma ne buyingira mu musaayi. Mu kiwanga ky’omu kiwato, obutundutundu buno obutono busobola okuleeta alergy, ekivaako obulumi n’ebiwundu mu kitundu.

03 . Enkola ki enkulu ez’okunyweza ebitundu by’omubiri ebiyitibwa hip prostheses?

Prostheses zisobola okuteekebwa ku femur oba acetabulum nga zirongoosebwa seminti oba secondary bone regeneration (obutakola oba okunyigiriza). Ebiseera ebisinga, ekikolo ky’ekisambi ekissiddwako seminti kikwatagana n’ekikopo ky’ekisambi ekitaliiko kawuka. Ebifaananyi by’enkola eno binnyonnyoddwa wansi:

Enkola ya Surgical Bone Cementing ekozesebwa .

Sementi y’amagumba ekozesebwa ye an . Acrylic polymer . Kikaluba mu ddakiika 15 ng’olongooseddwa era n’ateekawo amangu ddala ng’omaze okunyweza.

Obukodyo obutali bwa seminti oba obukwata ku press-fit bukozesebwa .

Ebintu ebitali bya seminti (ebikopo oba ebikopo eby’omubiri (prosthetic rods) bitereera oluvannyuma lwa wiiki mukaaga ku kkumi n’ebiri olw’ekintu eky’okuzza obuggya amagumba. Okutumbula okuddamu okukola amagumba, kungulu ku kiwanga kitera okusiigibwako oluwuzi olugonvu olwa hydroxyapatite, ekitundu ky’eggiriro eky’omu ttaka. Eggumba eririraanye litegeera hydroxyapatite nga ekimu ku bitundu byalyo ate oluvannyuma ne likula mangu okuva mu layeri y’amagumba g’ekiwanga. Hydroxyapatite esobola okukolebwa mu ngeri y’eddagala.

04. Ekintu ekiyitibwa hip prosthesis kimala bbanga ki?

Obulamu bw’obuweereza bw’ebitundu by’omubiri (prostheses) byeyongedde mu myaka egiyise: mu balwadde abali wansi w’emyaka 50, ekitundu ky’abalwadde abalina ebitundu by’omubiri ebikyakola oluvannyuma lw’emyaka kkumi nga bakozesa kibeera nga 99%.

Emiwendo egy’enjawulo giyinza okulabibwa mu balwadde abakadde n’olwekyo abatuula. N’olwekyo, okulongoosa mu kukyusa ekisambi kuyinza okukolebwa mu balwadde ab’emyaka gyonna.

Obulamu bw’obuweereza bw’ekiwanga businziira nnyo ku bintu bino wammanga:

-Emyaka gy'omulwadde, omuwendo gw'omubiri n'omutindo gw'emirimu .

-Obuwanvu bw’omutwe ogw’ekinnansi .

-Ekika ky'akaseera k'okusika .

Mu mbeera eyokubiri, kikulu okumanya nti obuwangaazi bw’ekiwanga businziira ku kigero ekinene ku butonde bw’ekiwanga. Omutwe gw’ekisambi n’ekikopo ky’ekiwanga byombi bwe biba nga bikolebwa mu kyuma oba mu keramiki, ebirungi ebikulu bye bipimo ebitono ennyo eby’okwambala n’okusobola okukozesa omutwe gw’ekisambi omugazi, ekikoma ku bulabe bw’okuseeseetula. Kikulu okumanya nti waliwo akabi k’okusaasaana kw’ebisasiro mu kitundu ekyetoolodde ekiwanga nga ekyuma okutuuka ku kyuma n’ekikomo eky’ekika kya ceramic-to-ceramic kigatta. Newankubadde nga prostheses za ceramic-ceramic zimenya wansi w’ebyuma-ebyuma prostheses era nga zigumira nnyo okukulugguka kw’okusika okusinga ebyuma-ebyuma ebibiri, bikyalina okukozesebwa n’obwegendereza.

05. Biki ebiyinza okuva mu bitundu by’omubiri ebiyitibwa hip prostheses?

Ng’oggyeeko obulabe obubeera mu kulongoosa kwonna (obulabe bw’okuva ku buziyiza, endwadde ezifunibwa mu ddwaaliro), ebizibu bisobola okubaawo:

Obulabe bw’okusengulwa .

Kino kye kizibu ekikulu mu balwadde era akabi kaawukana okumala ekiseera. Esinga kungi nnyo mu myezi egisooka oluvannyuma lw’okulongoosebwa n’okukendeera oluvannyuma lw’omwaka ogusooka. Olwo ne kiddamu okweyongera mpola ng’obudde bugenda buyitawo. Waliwo ensonga eziwerako eziyinza okuvaako okuseeseetula, ekiyinza okuba nga kyekuusa ku mulwadde, okulongoosa n’okuteekebwa mu mubiri, oba okugoberera oluvannyuma lw’okulongoosebwa. Obulabe bw’okuddamu okulwala bweyongera nnyo oluvannyuma lw’ekitundu ekisooka eky’okusengulwa.

Obulabe bw’okukwatibwa obulwadde .

Enkola yonna ey’okulongoosa etwala obulabe bw’okukwatibwa obulwadde, era ekiwanga bwe kiteekebwamu, akabi kano keeyongera ng’omubiri omugwira guyingira mu mubiri. Mu ngeri eno, abaserikale b’omubiri bakyusibwa era ekitundu ekisangibwa mu kitundu eky’obutafaali obuziyiza endwadde kitondebwawo. Obuwuuka obutera obutaba na mukisa gwa kuwona olwo busobola okukula ku mubiri guno ogw’ebweru. Obulabe buno obw’okukwatibwa obulwadde buyinza okuba nga businga kubeera mu bantu abakadde kubanga balina obusimu obuziyiza endwadde obutakola bulungi. Ensonga endala, gamba ng’omugejjo, ekikaluubiriza okuyingira mu nsonga oba ssukaali, ekikendeeza ku busimu obuziyiza endwadde, n’okunywa sigala, kiyinza okwongera ku bulabe bw’okukwatibwa obulwadde.

Obulabe bw’okukola alergy .

Ebimu ku bikozesebwa mu bitundu by’omubiri (prostheses) birina obusobozi okuleeta alergy.

Obulabe bw’okulongoosebwa okuddamu okukebera .

Okulemererwa, okwambala n’okukutuka oba okukutuka kw’ekiwanga kiyinza okwetaagisa okulongoosebwa okuddamu okutunula.