Kodi Knee Ligament Fixation Devices Imasintha Bwanji Kukonza kwa ACL?

Mankhwala amasewera · Kalozera womanganso wa ACL

Zipangizo za ACL graft fixation zimateteza kulumikizanso ku femur ndi tibia pomwe kuphatikiza kwachilengedwe kukukula. Zomangira zosokoneza, mabatani a cortical, ma staples, nsanamira, anangula, ndi zomangira zosakanizidwa zimapanga kukhazikika m'malo osiyanasiyana ndi makina osiyanasiyana. Palibe chipangizo chimodzi chomwe chili choyenera kwa wodwala aliyense, kumezanitsa, ngalande, kapena kukonzanso.

Kukhazikika koyambirira Kukhazikika kumateteza malo omezanitsa ndi kukangana pakanthawi koyambirira kusanaphatikizidwe kwa mafupa.

Chisankho chokhazikika mwachindunji Mtundu wa Graft, mtundu wa mafupa, kapangidwe ka ngalande, kukonzanso kapangidwe kake, ndi kusankha zida zowongolera zomwe adokotala adakumana nazo.

Palibe wopambana wapadziko lonse Njira zokhazikika zofananira zitha kutulutsa zotulukapo zabwino zikalumikizidwa bwino ndikugwiritsiridwa ntchito molondola.

Knee joint anatomy ndi ACL graft fixation concept — Kumanganso kwa ACL kumafuna kumezanitsa kokhazikika komanso kukhazikika kotetezedwa kumbali zonse zachikazi ndi tibial.

Kukonzanso kwa ACL ndi Kumanganso kwa ACL sikufanana

Mawu akuti kukonza kwa ACL ndi kukonzanso kwa ACL sayenera kugwiritsidwa ntchito mosiyana.

Ndondomeko	Zomwe zimachitidwa	Momwe fixation imagwiritsidwira ntchito
Kukonzekera koyambirira kwa ACL	Misozi yosankhidwa imayesedwanso poyesa kusunga mitsempha yachibadwa ya wodwalayo.	Sutures, anangula, mabatani, kapena zowonjezera zowonjezera zimatha kuthandizira ligament yokonzedwa, kutengera luso.
Kusintha kwa mtengo wa ACL	ACL yong'ambika imasinthidwa ndi autograft kapena allograft.	Kumezanitsa kumatetezedwa munjira zachikazi ndi tibial kapena zitsulo pogwiritsa ntchito kabowo, suspensory, kapena hybrid fixation.

Nkhaniyi imangoyang'ana kwambiri pakukonzekera kumezanitsa panthawi yomanganso ACL . Kukonzekera koyambirira kumapezeka kokha pamapangidwe ovulala osankhidwa ndipo ali ndi zizindikiro zosiyana, biology, zida, ndi malingaliro okonzanso.

Zipangizo zokhazikika sizimapangitsa kuti njira ya ACL ikhale yochepa yokha. Kufikira kwa arthroscopy, tunnel kapena socket kukonzekera, kusankha kwa graft, chithandizo chogwirizana ndi meniscal kapena cartilage, ndi njira yonse ya opaleshoni imatsimikizira kusokonezeka kwa minofu ndi kuchira.

Chifukwa Chiyani Graft Fixation Imafunika Pakumanganso kwa ACL?

Kumanganso kumezanitsa kuyenera kubweretsanso ntchito yokhazikika ya ACL mbadwa. Kuphatikizika kwachilengedwe kusanakhazikitsidwe, chokhazikikacho chimanyamula katundu ndikuchepetsa kusamuka kwa ma graft. Cholinga chake ndi kusunga malo omwe akufunidwa kuti agwirizane ndi kukanikiza popanda kuwononga kumezanitsa kapena kusokoneza njira ya fupa.

Kukonzekera kwa Graft Mtundu, kukula, kutalika, ndi malekezero okhazikika amatsimikiziridwa.

Tunnel kapena zitsulo zopangidwa Malo, m'mimba mwake, kutalika, ndi kotekisi zimawunikidwa.

Kuphatikizika kwa Graft ndikukhazikika kokhazikika komanso kukhala pansi kumafufuzidwa.

Kukhazikika Kutsimikiziridwa Malo a Chipangizo, kukanidwa kwa graft, kusuntha, ndi kukhazikika kumawunikidwa.

Kukonzekera ndi gawo limodzi lokha la kumanganso. Kuyika kwa ngalande, kusankha ndi kukonzekera kwa graft, kudziyerekezera, malo a mawondo panthawi yokonza, chithandizo cha kuvulala kogwirizana, kukonzanso, ndi zinthu za odwala zimakhudzanso zotsatira.

Aperture, Suspensory, ndi Supplemental Fixation

Kukonza kabowo

Kukhazikika kwa kabowo kumateteza kumezanitsa kufupi ndi kutseguka kwa mzere wa fupa. Kusokoneza screw ndiye chitsanzo chodziwika kwambiri. Chomangiracho chimakanikiza cholumikizira chofewa kapena fupa pakhoma la ngalandeyo. Izi zitha kuchepetsa kufalikira kwa tunnel, koma kuyika kuyenera kupewa kupatukana kwa graft, kupatukana, kulowa limodzi, ndi kutayika kokhazikika.

Suspensory fixation

Suspensory fixation imasamutsa katundu wa graft kupita ku kotekisi yakunja. Bokosi la cortical lomwe limakhala lokhazikika kapena losinthika limagwiritsidwa ntchito kwambiri kumbali yachikazi ndipo lingagwiritsidwe ntchito ndi njira zonse zamkati. Kutalika kolondola kwa tunnel, mabatani, kuyika kwa cortical, kasamalidwe ka malupu, ndi mipando yomezanitsa ndizofunikira.

Zowonjezera kapena hybrid fixation

Chopanga chosakanizidwa chimaphatikiza njira zokometsera, kapena kuwonjezera chokhazikika, positi-ndi-washer, nangula, kapena zida zina zosunga zobwezeretsera dokotalayo akakhala ndi nkhawa zokhudzana ndi kukonza koyambirira. Kukonzekera kowonjezera kumawonjezera ma interfaces ndi ma hardware, kotero phindu lake ndi zizindikiro zomwe zingatheke ziyenera kuganiziridwa pazochitikazo.

Mitundu ya Knee Ligament Fixation Devices

Kusokoneza zomangira

kabowo fixation Femoral kapena tibial

Kuyikidwa mkati mwa ngalandeyo kuti kufinya kumezanitsa kapena fupa chipika. Zosankha zikuphatikizapo zitsulo, PEEK, ndi bioabsorbable kapena biocomposite zipangizo. Diameter, kutalika, kapangidwe ka ulusi, njira yoyikapo, ndi chitetezo chamtengo wapatali.

Makatani a Cortical

Suspensory fixation Yokhazikika kapena yosinthika loop

Batani limakhala pa kotekisi yakunja pomwe lupu imathandizira kumezanitsa. Njirayi imatha kutengera zomangira zofewa komanso kumangidwanso kwazitsulo, koma zimafunikira kutumizidwa kotsimikizika ndikukhala.

Zosakhazikika ndi zolemba

yowonjezera yosungira zosunga zobwezeretsera Njira

Zomangamanga za ligament kapena screw-and-washer zomanga zimatha kuteteza sutures kapena kulimbikitsa kukhazikika kwa tibial muzochitika zosankhidwa. Kutchuka kwa Hardware ndi kukwiya kwanuko ndizofunikira.

Suture nangula ndi augmentation

Kukonza kapena kulimbikitsa Technique amadalira

Nangula amatha kuteteza minofu yofewa kapena sutures muzosankha zokonzekera ndi njira zowonjezera. Suture-tepi augmentation sikulowa m'malo mwa chizindikiritso cholondola, kuyika kwa anatomiki, kukakamira koyenera, kapena kuchiritsa kwachilengedwe.

Zitsanzo za zida za ACL ligament fixation pakumanganso kumezanitsa — ACL fixation system ingaphatikizepo zomangira zosokoneza, mabatani, ma staples, anangula, ndi zida zoyikira ndondomeko.

Metallic, PEEK, ndi Bioabsorbable Fixation Materials

Gulu lazinthu	Ubwino womwe ungakhalepo	Mfundo zofunikira
Titaniyamu kapena zida zina zachitsulo	Mphamvu yayikulu, yokhazikika yogwiritsidwa ntchito, yowonekera pa radiographs, ndipo palibe kuyankha konyozeka.	Kujambula zojambula, zizindikiro za hardware zomwe zingatheke, ndi kusokoneza komwe kungasokoneze ntchito yokonzanso.
PEEK	Polima wa radiolucent, wopanda bioabsorption, komanso kuwona kosavuta kwa ngalande yozungulira pazithunzi zina.	Chipangizo chimakhala m'thupi; malo angafunike zolembera za radiopaque kapena zitsimikizo zina.
Ma polima a bioabsorbable kapena biocomposite	Zapangidwa kuti ziwonongeke pakapita nthawi ndipo zimatha kuchepetsa implantation yokhazikika.	Kuwonongeka kumatengera zinthu; cyst, kuyankha kotupa, kusweka, kusamuka, kapena kusintha kwa ngalande zanenedwa.

Meta-analysis of 14 randomized trials sanapeze kusiyana kwakukulu mu subsubjective mawondo ntchito kapena kufooka pakati pa bioabsorbable ndi zitsulo interference screws, pamene gulu bioabsorbable anali ndi chiwopsezo chachikulu cha mavuto. Izi sizikutanthauza kuti wononga zitsulo zonse ndi zabwino; zinthu, kapangidwe, kumezanitsa, njira, ndi nkhani za odwala akadali zofunika.

Momwe Maopaleshoni Amasankhira ACL Fixation Construct

Kusankhidwa kumapangidwira mbali zonse za kumezanitsa. Zida zachikazi ndi tibial siziyenera kugwiritsa ntchito njira yomweyo. Zinthu zofunika ndi izi:

Kumezanitsa: fupa-patellar tendon-fupa, hamstring, quadriceps tendon, autograft kapena allograft, minofu yofewa yokha kapena fupa-block end.
Mapangidwe a tunnel: tunnel wathunthu kapena socket, m'mimba mwake, kutalika, kukhulupirika kwa cortical, njira yolowera, ndi mafupa omwe alipo.
Odwala: khalidwe la fupa, zaka, zolinga za ntchito, kukula kwa chigoba, opaleshoni yam'mbuyo, ndi kuvulala kogwirizana.
Opaleshoni yoyambirira kapena yokonzanso: kukulitsa ngalande yomwe ilipo, zida zosungidwa, kuwonongeka kwa mafupa, komanso kufunikira kokonzanso.
Zofunikira pakumanga: kukhazikika kokhazikika, malo okhazikika, kukonza zosunga zobwezeretsera, zosowa zamaganizidwe, ndi kukonzanso komwe kukuyembekezeka.
Kugwirizana kwamakina: kukula kwa graft, kubowola ndi kalozera, zoyikapo, kutalika kwa loop, makulidwe a screw, ndi mawonekedwe ovomerezeka a zida.
Zochitika za Opaleshoni: kuzolowera kutumizidwa, njira zolephera, njira zopulumutsira, komanso kutsimikizira kwa intraoperative.

Zithunzi za XC Medico ACL/PCL ligament fixation system ikuwonetsa zitsanzo za implant ndi masinthidwe a zida. Zambiri zamalonda ziyenera kuwunikiridwa nthawi zonse motsutsana ndi zomwe zidavomerezedwa ndi chipangizocho komanso njira yomwe dokotala wakonza.

Kodi Mabatani Kapena Zosokoneza Zosokoneza Zimapanga Zotsatira Zabwino?

Umboni wamakono sugwirizana ndi kusanja kosavuta konsekonse. Kuwunika kwa meta kwa netiweki kuyerekeza screw yosokoneza, batani la cortical, ndi kukhazikika kwa chikazi chapakatikati kwa ma hamstring autografts sanapeze kusiyana kwakukulu pazotsatira zoyambira zamankhwala zomwe zaphunziridwa. Kuwunika kwina mwadongosolo kunapeza magwiridwe antchito ofanana, kufooka, ndi kuyambiranso kwapakati pakati pa kukhazikika koyimitsidwa kwamkati ndikumanganso ngalande zonse, pomwe zopeza zina zama radiographic zidasiyana.

Funso lofanizira	Kutanthauzira koyenera
Kodi kukonza kabowo kochulukirachulukira?	Imatchinjiriza kumezanitsa pafupi ndi kutsegulidwa kwa mizere yolumikizana, koma kupambana kwa anatomiki kumadaliranso malo olondola a ngalandeyo, kukula kwa mizere, kukangana, ndi kuyika kwake.
Kodi suspensory fixation ndi yamphamvu?	Kuyimitsidwa kwa Cortical kumatha kupereka mphamvu zokwanira zoyambira, koma magwiridwe antchito amatengera mabatani, machitidwe a loop, cortex, tunnel, ndi kumezanitsa.
Kodi wononga bioabsorbable bwino zotsatira?	Zimachepetsa zitsulo zokhazikika, koma kupambana kwachipatala sikunakhazikitsidwe ndipo zovuta zenizeni zakuthupi zimafunikira kuganiziridwa.
Kodi kukonza zosunga zobwezeretsera kumathandiza nthawi zonse?	Zitha kukhala zothandiza ngati kukonza koyambirira kumakhala kodetsa nkhawa, koma kumawonjezera ma hardware ndipo sikungasinthe zotsatira zabwino pakumanganso kwachizolowezi.

Zotsatira zake ndikuti kukhazikika kotetezedwa, kogwiritsidwa ntchito molondola kofananira ndi kumezanitsa ndi ngalande ndikofunikira kwambiri kuposa kusankha chida ndi gulu lotsatsa lokha.

Momwe Instrument Imakhazikitsira Kuthandizira Kukonzanso kwa ACL Reproducible

Implant imagwira ntchito ngati gawo la dongosolo lonse. Maupangiri amachulukidwe, ma siling blocks, ma sutures odutsa, zowerengera, zoyezera kuya, zoyika mabatani, screwdrivers, matepi, zida zokonzekera kumezanitsa, ndi kulinganiza thireyi zonse zimakhudza kayendedwe ka ntchito. Kalozera wosagwirizana, dalaivala wowonongeka, kukula kobowola kolakwika, kapena chida chosowa chodutsa chingasokoneze dongosolo loyenera lokonzekera.

Chida chonse chomangiranso ligament chokhazikitsidwa pa opaleshoni ya ACL ndi PCL — Chida chofananira ndi njira chingathe kukonza zokonzekera ngalande, ndime yomezanitsa, ndi masitepe okonzeranso ma ACL kapena PCL.

Onani ndi zonse mu cruciate ligament reconstruction zida seti kapena yotakata arthroscopy chida-set range . Musanagwiritse ntchito, tsimikizirani zomwe zili mu thireyi, kugwirizana, kuyeretsa ndi kutsekereza malangizo, njira zoyendera, ndi kupezeka m'malo.

Zomwe Zingatheke Zogwirizana ndi Kukonzekera

Zovuta zimatha kubwera kuchokera ku chipangizocho, kumezanitsa, ngalande, njira, biology, matenda, kukonzanso, kapena kuvulalanso. Mavuto okhudzana ndi kukonza angaphatikizepo:

kutayika kwa kukhazikika, kutsetsereka kwa graft, elongation, kapena kumanga kumasuka;
kusamuka kwa mabatani, kusakwanira kwa cortical, kuphatikizika kwa minofu yofewa, kapena zovuta zokhudzana ndi loop;
kupatukana kwa screw, kusweka, kusamuka, kulowa limodzi, kapena kuwonongeka kwa mamezanidwe pakuyika;
chodziwika kwambiri, positi, chochapira, kapena batani lomwe limayambitsa kukhumudwa kwanuko;
kukulitsa kwa ngalande, kupanga chotupa, kapena kuyankha kotupa kokhudzana ndi zinthu;
zovuta ndi kutanthauzira zithunzi kapena kukonzekera mtsogolo mwanjirayo;
matenda, kuuma, arthrofibrosis, kusakhazikika kosalekeza, kulephera kwa graft, kapena kuvulalanso.

Zizindikiro ndi kuchira sikungathe kunenedweratu kuchokera ku chipangizo chokonzekera chokha. Kusakhazikika kwatsopano, kutentha thupi, kukhetsa kwa mabala, kuchuluka kwa kutupa, kupweteka kwa ng'ombe, kusayenda bwino, kapena kupweteka kosayembekezereka kumafunika kuunika ndi gulu lachipatala.

Kodi Kukhazikika Kwamphamvu Kumatanthauza Kukonzanso Mwachangu?

Kukonzekera koyambirira kotetezedwa kumathandizira kuthandizira pulogalamu yokonzanso, koma sikungofupikitsa kuchira. Kulemera, kulimbitsa, kuyenda kosiyanasiyana, kulimbikitsa, kuthamanga, kuyendayenda, ndi kubwereranso ku masewera olimbitsa thupi kumadalira kumezanitsa, kugwirizanitsa meniscal kapena cartilage njira, kukonza, kutupa, mphamvu, neuromuscular control, kuwunika kwachipatala, ndi ndondomeko ya dokotala wa opaleshoni ndi opaleshoni.

Upangiri wa AAOS umatsindika kuunika kwa magwiridwe antchito musanabwererenso kumasewera ndipo imalimbikitsa kukonzanso kwamunthu payekha. Chipangizo chokhazikika sichiyenera kugwiritsidwa ntchito ngati chifukwa chokha chofulumizitsira kutsitsa kapena kuchotsa chingwe. Kumanganso kwa ACL kumachitika ngati njira zachipatala, koma kutulutsa nthawi kumatsimikiziridwa ndi momwe chipatala chilili m'malo mwa gulu la implant.

Kodi Zipatala ndi Ogawa Ayenera Kuwona Chiyani?

Kuwunika kogulira kuyenera kulumikiza choyika chilichonse ku zida zake, zolemba, zolemba zamalamulo, komanso kutsata. Katundu wopukutidwa kapena kudzinenera kokulirapo kwa kutsatiridwa kwa mayiko sikokwanira.

Tsimikizirani kugwiritsiridwa ntchito komwe mukufuna ndi chilolezo chamsika Fananizani ndi chipangizo chenichenicho, chitsanzo, zinthu, opanga malamulo, magulu, ndi msika komwe mukupita.
Unikaninso kuyanjana kwa zida zoyimilira Yang'anani molumikizana ndi madalaivala, makulidwe a kubowola ndi ngalande, zoyikapo, zoyezera kuya, mabatani, malupu, zomangira, zomangira, ndi zosunga zobwezeretsera.
Tsimikizirani zida ndi umboni wamakina Funsani zatsatanetsatane, ziphaso zolumikizidwa ndi zambiri, mayeso oyenera, njira zowunikira, ndi njira zovomerezera.
Yang'anani momwe zinthu zilili popaka ndi kutsekereza Fotokozani za kupezeka kapena kusabereka, alumali ngati kuli kotheka, kulemba zilembo, kufufuza, ndi malangizo ovomerezeka okonzanso.
Yang'anani thireyi yathunthu Gwiritsani ntchito pepala lowerengera loyendetsedwa, tsimikizirani zolembera ndi momwe zilili, ndi ntchito yoyeserera musanavomereze.
Unikaninso zowongolera zosintha ndi chithandizo chodandaula Tanthauzirani zidziwitso zakusintha kwa zinthu, kapangidwe, ogulitsa, kachitidwe, kulemba zilembo, kuyika, kapena kutsekereza.

Ogula atha kuwonanso za XC Medico's kuwongolera ndi kuyang'anira ndi kupempha umboni wokhudzana ndi chipangizo panthawi yoyenerera.

Zogwirizana ndi XC Medico Sports Medicine Resources

Ligament Fixation System ACL / PCL yomanganso implants, zosankha zokonzekera, ndi zida zogwirizana. Ligament Fixation Staple Staple mafotokozedwe osankhidwa a minofu yofewa ndi zowonjezera zowonjezera. Cruciate Ligament Instrument Set Guides ndi zida za ACL/PCL ngalande ndi kukonzekera socket. Arthroscopy Instrument Sets Sakatulani njira yeniyeni ya arthroscopy ndi zida zomangira ligament. Kukonzekera kwa Suture Anchor Anchor kwa njira zosankhidwa zokometsera zofewa. Sports Medicine System Onani ligament, meniscal, arthroscopy, suture, ndi mankhwala okhudzana ndi masewera. Kuwongolera Kwabwino Kuwunikanso kuwunika kopanga, labotale, ndi chidziwitso chotsatira. Funso la Technical Product Inquiry Funsani zatsatanetsatane, zofananira, ziphaso, kapena zolemba zamalonda.

Mafunso Ofunsidwa Kawirikawiri

Kodi ndi chiyani chomwe chimagwirizanitsa ACL m'malo?

Kumezanitsa nthawi zambiri kumakhala kotetezedwa kumbali zachikazi ndi tibial ndi zomangira zosokoneza, mabatani a cortical, mapini opingasa, nsanamira, zakudya, kapena kuphatikiza. Kupanga kumatengera mtundu wa graft, kapangidwe ka ngalande, mtundu wa mafupa, ndi luso.

Kodi pali kusiyana kotani pakati pa screw screw ndi batani la cortical?

Chidutswa chosokoneza chimathandizira kukonza kabowo mwa kukanikiza cholumikizira kapena fupa mkati mwa ngalandeyo. Batani la cortical limapereka kukhazikika koyimitsidwa mwa kukhala pa kotekisi yakunja ndikuthandizira kumezanitsa kudzera pa lupu.

Kodi zomangira za ACL za bioabsorbable zili bwino kuposa zomangira zitsulo?

Osati konsekonse. Umboni woyeserera mwachisawawa wapeza ntchito yofananira ndi kufooka, pomwe kusanthula kwina kophatikizana kumapereka zovuta zambiri zomangira zomangira. Zipangizo, kapangidwe, luso, kujambula, ndi kuwunikiranso zonse ndizofunikira.

Kodi chipangizo chokhazikika chomwechi chingagwiritsidwe ntchito pa kumezanitsa kulikonse?

Ayi. Mitsempha ya mafupa ndi yofewa imakhala ndi mawonekedwe osiyanasiyana, ndipo m'mimba mwake, kutalika, mapangidwe a ngalande, ndi fupa la cortical zimakhudza kugwirizanitsa. Tsatirani malangizo ovomerezeka a chipangizo ndi njira yopangira opaleshoni.

Kodi cholumikizira chamkati chimalowa m'malo mwa ACL graft?

Osati zokha. Suture-tepi augmentation ikhoza kulimbikitsa kukonzanso kosankhidwa kapena kumanganso, koma udindo wake umadalira ndondomeko ndi zizindikiro. Sichikonza minofu yabwino, kuyika kwa nonanatomic, kapena kusakhazikika koyambirira.

Kodi zida za ACL fixation ziyenera kuchotsedwa?

Kuchotsa mwachizolowezi sikofunikira nthawi zonse. Kuchotsa kumatha kuganiziridwa ngati zizindikiro kapena zodziwika bwino, matenda, kusamuka, opaleshoni yokonzanso, kapena chifukwa china chachipatala.

Mapeto

Zipangizo zopangira ACL zimapangitsa kumangidwanso kwamakono kukhala kotheka mwa kukhazikika kwa kumezanitsa pomwe kuphatikiza kwachilengedwe kumachitika. Mtengo wawo umachokera ku kuphatikiza kolondola, kuyika kwa ngalande ya anatomiki, zida zofananira, kukanikizana koyenera, kutsimikizika kwa zida, komanso kukonzanso mwadongosolo. Zomangira zosokoneza, mabatani a cortical, ndi zomangira zosakanizidwa chilichonse chimakhala ndi ntchito zothandiza; kusankha kuyenera kukhala kwapayekha m'malo motengera 'chipangizo chabwino kwambiri'.

Maupangiri ndi Maziko Olemba

Chodzikanira pazachipatala ndi malamulo: Nkhaniyi ndi ya maphunziro wamba komanso zolinga zamaluso zamaluso. Simazindikira kuvulala kwa ACL, kupangira opaleshoni, kusankha choyikapo, kapena kusintha malangizo a chipangizo, malamulo am'deralo, kapena kuunika ndi akatswiri odziwa zaumoyo ndi owongolera. Kupezeka kwazinthu ndi zovomerezeka zimasiyana malinga ndi mayiko.