Nigute Ibikoresho byo Kuvunika Amavi Byahindura Gusana ACL?

Ubuvuzi bwa siporo · Igitabo cyo kwiyubaka kwa ACL

Ibikoresho bya ACL byo gutunganya bikingira ubwubatsi bwa femur na tibia mugihe guhuza ibinyabuzima bitera imbere. Imigozi yo kwivanga, buto ya cortical, staples, post, inanga, hamwe nubwubatsi bwa Hybrid bitera gukosorwa ahantu hatandukanye hamwe nuburyo butandukanye. Nta gikoresho kimwe cyiza kuri buri murwayi, igishushanyo, umuyoboro, cyangwa gusubiramo ibintu.

Ihinduka ryambere ryibanze Gukosora birinda ibihingwa hamwe nimpagarara mugihe cyambere mbere yo guhuza amagufwa.

Guhitamo tekinike yihariye Ubwoko bwubwoko, ubwiza bwamagufwa, igishushanyo mbonera, gusubiramo anatomy, hamwe nuburambe bwo kubaga buyobora ibikoresho.

Nta watsinze isi yose Uburyo busanzwe bwo gukosora bushobora gutanga umusaruro mwiza mugihe bihuye neza kandi bigashyirwa mubikorwa neza.

Gupfukama hamwe anatomiya hamwe na ACL graft fixation igitekerezo — Kwiyubaka kwa ACL bisaba ibihingwa bihagaze neza kandi bikosorwa neza kumpande zombi zumugore na tibial.

Gusana ACL no Kwiyubaka kwa ACL Ntabwo aribwo buryo bumwe

Amagambo yo gusana ACL no kwiyubaka kwa ACL ntagomba gukoreshwa muburyo bumwe.

Inzira	Ikivurwa	Uburyo gukosora bikoreshwa
Gusana ACL ibanza	Amarira yatoranijwe yongeye kwemezwa mugushaka kurinda umurwayi kavukire.	Suture, inanga, buto, cyangwa inyubako yubaka irashobora gushyigikira ligamenti yasanwe, bitewe nubuhanga.
Kwiyubaka kwa ACL	ACL yatanyaguwe isimburwa mubikorwa na autograft cyangwa allograft.	Igishushanyo cyizewe muri tunnel cyangwa tibial tunel cyangwa socket ukoresheje aperture, suspensory, cyangwa hybrid fixation.

Iyi ngingo yibanze cyane cyane kubikosora mugihe cyo kwiyubaka kwa ACL . Isanwa ryibanze riraboneka gusa kuburyo bwatoranijwe kandi bufite ibimenyetso bitandukanye, ibinyabuzima, ibikoresho, hamwe nibitekerezo byo gusubiza mu buzima busanzwe.

Ibikoresho byo gukosora ntibikora gahunda ya ACL byibasiye ubwabo. Kwinjira kwa arthroscopique, tunnel cyangwa sock gutegura, guhitamo ibihingwa, kuvura meniscal cyangwa karitsiye, hamwe nubuhanga rusange bwo kubaga bugena ihungabana ryimitsi no gukira.

Ni ukubera iki Gukosora Igishushanyo bifite akamaro mu kwiyubaka kwa ACL?

Igishushanyo cyo kwiyubaka kigomba kubyara imikorere ihamye ya ACL kavukire. Mbere yuko ibinyabuzima byinjizwamo, ibyubaka byubaka bitwara umutwaro kandi bigabanya kwimura ibihingwa. Ikigamijwe ni ugukomeza imyanya igenewe hamwe nimpagarara zitiriwe zangiza igihombo cyangwa ngo kibangamire umuyoboro wamagufwa.

Igishushanyo cyateguwe Ubwoko, ingano, uburebure, hamwe no gukosora birangiye.

Imirongo cyangwa socket yaremye Umwanya, diameter, uburebure, na cortex birasuzumwa.

Igishushanyo cyatsinzwe kandi cyerekanwe Icyerekezo no kwicara birasuzumwa.

Ikosorwa ryagenzuwe Igikoresho cyumwanya, impagarara zingana, icyerekezo, hamwe niterambere birasuzumwa.

Gukosora nigice kimwe gusa cyo kwiyubaka. Gushyira umuyoboro, guhitamo ibihingwa no kubitegura, kwiyitirira, umwanya w ivi mugihe cyo gukosora, kuvura ibikomere bifitanye isano, gusubiza mu buzima busanzwe, hamwe n’ibintu by’abarwayi nabyo bigira ingaruka kumusubizo.

Aperture, Suspensory, hamwe ninyongera

Gukosora neza

Gukosora neza bituma igiti cyegereye umurongo ufungura umurongo wamagufwa. Intera yo kwivanga ni urugero ruzwi cyane. Imashini isunika igikoresho cyoroshye cyangwa igufwa ryamagufwa kurukuta rwa tunnel. Ibi birashobora kugabanya imigozi ya tunnel, ariko kubishyira bigomba kwirinda kwangirika, gutandukana, kwinjirira hamwe, no gutakaza gukosorwa.

Gukosora

Suspensory fixation yimura graft umutwaro kuri cortex yo hanze. Akabuto ka cortical hamwe na loop ihamye cyangwa ihindagurika ikoreshwa muburyo busanzwe bwigitsina gore kandi irashobora no gukoreshwa hamwe nubuhanga bwimbere. Uburebure bwa tunnel, inzira ya buto, kohereza cortical, gucunga loop, hamwe no kwicara byingirakamaro.

Kwiyongera cyangwa kuvanga

Imvange ya Hybrid ikomatanya uburyo bwo gukosora, cyangwa ikongeramo ikintu cyingenzi, nyuma-yoza, icyuma, cyangwa ikindi gikoresho cyo kugarura ibintu mugihe umuganga abaga afite impungenge zijyanye no gukosora ibanze. Inyongera yinyongera yongeramo interineti nibikoresho, bityo inyungu zayo nibimenyetso bishobora kugaragara bigomba gusuzumwa kubibazo byihariye.

Ubwoko bwibikoresho byo gupfukama Amavi

Imiyoboro yo kwivanga

Aperture fixation Femoral cyangwa tibial

Bishyizwe mumurongo kugirango ugabanye ibihingwa cyangwa amagufwa. Amahitamo arimo ibyuma, PEEK, hamwe na bioabsorbable cyangwa biocomposite ibikoresho. Diameter, uburebure, igishushanyo mbonera, inzira yo gushiramo, hamwe ningingo yo gukingira.

Utubuto twa Cortical Utubuto twahagaritswe

Gukosora neza cyangwa guhinduka

Akabuto kicaye kuri cortex yo hanze mugihe loop ishyigikira igihangano. Tekinike irashobora kwakira ibihangano byoroheje hamwe na sock ishingiye ku kwiyubaka, ariko bisaba koherezwa hamwe no kwicara.

Ibyingenzi na post

Byongeweho gukosora Amahitamo yo gusubira inyuma

Ligament staples cyangwa screw-na-washer yubaka irashobora gushiraho suture cyangwa gushimangira gukosora tibial mugihe cyatoranijwe. Ibyamamare byamamare hamwe no kurakara byaho nibitekerezo bifatika.

Gushushanya inanga no kongera

Gusana cyangwa gushimangira Tekinike ishingiye

Inanga zirashobora kurinda uduce tworoshye cyangwa kudoda muburyo bwatoranijwe bwo gusana hamwe nubuhanga bwiyongera. Kwiyongera kwa Suture-kaseti ntabwo bisimbuza kwerekana neza, gushyira anatomic, guhagarika umutima, cyangwa gukiza ibinyabuzima.

Ingero za ACL ligament ibikoresho byo gutunganya ibyubaka — Sisitemu yo gukosora ACL irashobora gushiramo imiyoboro yo kubangamira, buto, staples, inanga, hamwe nibikoresho byihariye byo kwinjiza.

Ibyuma, PEEK, na Bioabsorbable Ibikoresho byo Gukosora

Itsinda ryibikoresho	Ibyiza byingenzi	Ibitekerezo byingenzi
Titanium cyangwa ibindi bikoresho byuma	Imbaraga nyinshi, zashyizweho zikoreshwa, zigaragara kuri radiyo, kandi nta gisubizo cyo gutesha agaciro.	Kwerekana ibihangano, ibimenyetso byibyuma bishoboka, hamwe nibishobora kwivanga mubikorwa bya tunnel.
PEEK	Imirasire ya radiolucent, nta bioabsorption, kandi byoroshye kubona amashusho yumurongo uzengurutse kumashusho amwe.	Igikoresho kiguma mu mubiri; umwanya urashobora gusaba ibimenyetso bya radiopaque cyangwa ubundi bugenzuzi.
Bioabsorbable cyangwa biocomposite polymers	Yagenewe gutesha agaciro igihe kandi irashobora kugabanya ibikoresho bihoraho.	Gutesha agaciro ibintu byihariye; cyst, igisubizo kibabaza, kumeneka, kwimuka, cyangwa impinduka za tunnel byavuzwe.

Isesengura ryakozwe na 14 ryageragejwe ryasanze nta tandukaniro rinini riri mumikorere yivi ifatika cyangwa ubunebwe hagati ya bioabsorbable na metallic intervention interrew, mugihe itsinda rya bioabsorbable ryagize ibyago byinshi byo guhura nibibazo. Ibi ntibisobanura ko ibyuma byose byuma ari byiza; ibikoresho, igishushanyo, igishushanyo, tekinike, n'imiterere y'abarwayi biracyafite akamaro.

Uburyo Abaganga Bahitamo Guhindura ACL

Guhitamo bikozwe kumpande zombi. Ibikoresho byigitsina gore na tibial ntabwo bigomba gukoresha uburyo bumwe. Ibintu by'ingenzi birimo:

Igishushanyo: amagufa-patellar tendon-amagufwa, hamstring, quadriceps tendon, autograft cyangwa allograft, yoroshye-tissue-gusa cyangwa amagufwa-guhagarika impera.
Igishushanyo mbonera: umuyoboro wuzuye cyangwa sock, diameter, uburebure, uburinganire bwa cortical, icyerekezo cya tunnel, hamwe namagufwa yaboneka.
Impamvu z'abarwayi: ubwiza bw'amagufwa, imyaka, intego z'ibikorwa, gukura kwa skeletale, kubagwa mbere, no gukomeretsa bifitanye isano.
Kubaga ibanze cyangwa gusubiramo: kwagura umuyoboro uriho, ibyuma bigumana, inenge zamagufwa, hamwe no gukenera kwiyubaka.
Kubaka ibisabwa: gahunda iteganijwe gukurikiranwa, aho ikosora, gukosora ibikenewe, gukenera amashusho, no gusubiramo biteganijwe.
Guhuza sisitemu: ingano yubunini, gucukura no kuyobora ibipimo, gushiramo, uburebure bwa loop, ibipimo bya screw, hamwe nibikoresho byemewe-ibikoresho.
Ubunararibonye bwo kubaga: kumenyera kubohereza, uburyo bwo kunanirwa, uburyo bwo gutabara, hamwe no kugenzura ibikorwa.

XC Medico's Sisitemu yo gukosora ACL / PCL yerekana ingero zo gushiramo ibikoresho. Amakuru y'ibicuruzwa agomba guhora asubirwamo hifashishijwe igikoresho cyemewe cyo gukoresha hamwe nubuhanga bwateganijwe bwo kubaga.

Ese Utubuto cyangwa Imiyoboro yo Gutanga Bitanga Ibisubizo Byiza?

Ibimenyetso biriho ntabwo bishyigikira urutonde rworoshye. Urusobe meta-isesengura rugereranya interineti, interineti ya cortical, na cross-pin femoral fixation ya hamstring autografts yasanze nta tandukanyirizo rishingiye ku mibare rishingiye ku mavuriro y'ibanze yize. Ubundi isubiramo ritunganijwe ryasanze imikorere igereranywa, ubunebwe, hamwe nubusubizo bwibisubizo hagati yimbere-imbere yo guhagarika gukosora no kongera kubaka-tuneli yuzuye, mugihe ibyagaragaye kumurongo wa radiyo bitandukanye.

Ikigereranyo cyo kugereranya	Ibisobanuro biringaniye
Gukosora aperture birarenze anatomic?	Irinda igihangano hafi yumurongo uhuza umurongo, ariko intsinzi ya anatomic nayo iterwa numwanya wukuri wa tunnel, ingano yubunini, impagarara, hamwe nugushira.
Gukosora guhagarikwa birakomeye?	Guhagarika Cortical birashobora gutanga imbaraga zambere zihagije, ariko kubaka imikorere biterwa no kwicara kuri buto, imyitwarire ya loop, cortex, tunnel, na graft.
Ese umugozi wa bioabsorbable utezimbere ibisubizo?	Igabanya ibyuma bihoraho, ariko ivuriro ntirishyirwaho kandi ibibazo byihariye bisaba kwitabwaho.
Gukosora ibikubiyemo buri gihe bifasha?	Irashobora kuba ingirakamaro mugihe gukosora ibanze ari impungenge, ariko ikongeramo ibyuma kandi ntishobora kunoza ibisubizo bifatika muri buri gihe cyo kwiyubaka.

Umwanzuro ufatika ni uko umutekano, ushyizwe mubikorwa neza gukosora bihujwe na graft na tunnel ni ngombwa kuruta guhitamo igikoresho ukurikije icyiciro cyamamaza wenyine.

Uburyo Igikoresho Gishyiraho Inkunga Yororoka ACL Kwiyubaka

Guterwa bikora nkigice cya sisitemu yuzuye. Imiyoboro ya tunnel, ibipimo binini, kunyuramo suture, reamers, ibipimo byimbitse, gushyiramo buto, screwdrivers, kanda, ibikoresho byo gutegura ibihingwa, hamwe na tray organisation byose bigira ingaruka kumurimo. Ubuyobozi budahuye, umushoferi wangiritse, ingano yimyitozo itari yo, cyangwa ibikoresho byabuze bishobora guhungabanya gahunda ikwiye yo gukosora.

Ibikoresho byose byubaka ligamenti yo kubaka byashyizweho kubaga ACL na PCL — Igikoresho gihuye nigikoresho gishobora gutegurwa gutegura tunnel, kunyuramo, hamwe nintambwe yo gukosora ACL cyangwa PCL yo kwiyubaka.

Shakisha an byose-muburyo bukomeye ligamenti yo kwiyubaka byashizweho cyangwa mugari arthroscopy igikoresho-cyashyizweho . Mbere yo gukoresha, genzura ibiri muri tray, guhuza, gusukura no guhagarika amabwiriza, ibipimo byo kugenzura, no gusimburwa kuboneka.

Ibishobora gukosorwa bifitanye isano nibibazo

Ingorane zirashobora guturuka kubikoresho, graft, tunnel, tekinike, ibinyabuzima, kwandura, gusubiza mu buzima busanzwe, cyangwa reinjury. Ibibazo bijyanye no gukemura birashobora kubamo:

gutakaza gukosorwa, kunyerera, kurambura, cyangwa kubaka kurekura;
buto yo kwimuka, gahunda ya cortical ituzuye, guhuza byoroshye-tissue, cyangwa ibibazo bijyanye na loop;
gutandukanya ibice, kumeneka, kwimuka, kwinjirira hamwe, cyangwa kwangirika kwangiritse mugihe cyo kwinjiza;
ikintu cyingenzi, iposita, koza, cyangwa buto itera uburakari bwaho;
kwaguka kwa tunnel, gushiraho cyst, cyangwa igisubizo kijyanye nibikoresho byo gutwika;
ingorane zo gusobanura amashusho cyangwa gutegura ejo hazaza gusubiramo tunnel;
kwandura, gukomera, arthrofibrosis, guhora udahungabana, kunanirwa kwangiritse, cyangwa reinjury.

Ibimenyetso no gukira ntibishobora guhanurwa uhereye kubikoresho byakosowe wenyine. Guhungabana gushya, umuriro, gukuramo ibikomere, kongera kubyimba, kubabara inyana, kubura umuvuduko, cyangwa ububabare bukabije butunguranye bisaba gusuzumwa nitsinda ryivura.

Gukosora gukomeye bisobanura gusubiza mu buzima bwihuse?

Umutekano wambere wibanze ufasha gushyigikira gahunda iteganijwe yo gusubiza mu buzima busanzwe, ariko ntabwo ihita igabanya gukira. Kwikorera ibiro, gutondekanya, urwego rwimikorere, gushimangira, kwiruka, pivoti, no gusubira muri siporo biterwa nubukorikori, uburyo bujyanye na meniscal cyangwa karitsiye, gukosora, kubyimba, imbaraga, kugenzura imitsi, kwisuzumisha kwa muganga, hamwe na protocole yo kubaga no kuvura umubiri.

Ubuyobozi bwa AAOS bushimangira isuzuma ryimikorere mbere yo gusubira muri siporo kandi irasaba abantu kugiti cyabo. Igikoresho cyo gukosora ntigomba gukoreshwa nkimpamvu yonyine yo kwihutisha gupakira cyangwa gukuraho igitereko. Kwiyubaka kwinshi kwa ACL bikorwa nkuburyo bwo kuvura indwara, ariko igihe cyo gusohora kigenwa nubuzima bwuzuye aho kuba icyiciro cyatewe.

Ni ibihe bitaro n'ababitanga bagomba kugenzura?

Isubiramo ryamasoko rigomba guhuza buri cyashizwe mubikoresho byacyo, kuranga, inyandiko zerekana amabwiriza, hamwe nibishobora gukurikiranwa. Cataloge isennye cyangwa ikirego kinini cyo kubahiriza mpuzamahanga ntabwo gihagije.

Emeza ikoreshwa ryemewe nuburenganzira bwisoko Huza igikoresho nyacyo, icyitegererezo, ibikoresho, uwakoze amategeko, ibyiciro, nisoko ryerekeza.
Ongera usuzume ibikoresho-byuzuzanya Kugenzura ibice bya shoferi, drill na tunnel ingano, inserters, igipimo cyimbitse, buto, imirongo, imigozi, staples, hamwe nuburyo bwo gusubira inyuma.
Kugenzura ibikoresho nibimenyetso bya tekinike Gusaba ibisobanuro, ibyemezo bifitanye isano byinshi, ibizamini bijyanye, uburyo bwo kugenzura, hamwe nibisabwa.
Suzuma ibipfunyika hamwe na sterisizasiya Sobanura neza itangwa rya sterile cyangwa idafite sterile, ubuzima bwubuzima aho bibaye ngombwa, kuranga, gukurikiranwa, hamwe namabwiriza yemewe yo gusubiramo.
Kugenzura inzira yuzuye Koresha urupapuro rwabigenewe rugenzurwa, wemeze ibimenyetso nibisabwa, hamwe nigikoresho cyibizamini mbere yo kubyemeza.
Ongera usuzume kugenzura no gushyigikira ibirego Sobanura imenyesha ryimpinduka kubintu, igishushanyo, utanga, inzira, ikirango, gupakira, cyangwa sterisizione.

Abaguzi barashobora gusuzuma XC Medico kugenzura ubuziranenge no kugenzura no gusaba ibimenyetso byihariye mugihe cyujuje ibyangombwa.

Bifitanye isano XC Medico Imikino Yubuvuzi

Ligament Fixation Sisitemu ACL / PCL yongeye gushyirwaho, amahitamo yo gukosora, nibikoresho bihuye. Ligament Fixation Staple Staple Ibisobanuro byihariye byatoranijwe byoroshye-tissue hamwe ninyongera yo gukosora. Igikoresho cya Cruciate Ligament Gushiraho Ubuyobozi nibikoresho bya tuneli ya ACL / PCL no gutegura sock. Igikoresho cya Arthroscopy Gushiraho uburyo bwihariye bwa arthroscopi nibikoresho byo kubaka ligament. Ibikoresho bya Suture Ibishushanyo mbonera byatoranijwe byoroshye-tissue ikosora. Sisitemu y'Ubuvuzi bwa Siporo Shakisha ligament, meniscal, arthroscopy, suture, nibicuruzwa bijyanye na siporo. Kugenzura ubuziranenge Isubiramo ryakozwe, laboratoire, namakuru yamakuru. Kubaza ibicuruzwa bya tekiniki Gusaba ibisobanuro, ibisobanuro birambuye, ibyemezo, cyangwa ibicuruzwa.

Ibibazo Bikunze Kubazwa

Niki gifata igihangano cya ACL?

Ubusanzwe ibihingwa bifite umutekano kuruhande rwigitsina gore na tibial hamwe nintera yo kwivanga, buto ya corticale, cross-pin, post, staples, cyangwa guhuza. Kubaka biterwa nubwoko bwubugeni, igishushanyo mbonera, ubwiza bwamagufwa, na tekinike.

Ni irihe tandukaniro riri hagati ya screw ya interineti na buto ya cortical?

Imiyoboro yo kwivanga itanga aperture ikosora mugukata ibihingwa cyangwa amagufwa muri tunnel. Akabuto ka cortical gatanga gukosorwa mukwicara kuri cortex yo hanze no gushyigikira ibihingwa binyuze mumuzinga.

Ese imigozi ya bioabsorbable ACL iruta ibyuma byicyuma?

Ntabwo ari rusange. Ibimenyetso byemewe-byageragejwe byabonye imikorere isa nubunebwe, mugihe isesengura ryakozwe ryerekana raporo zingorabahizi hamwe na bioabsorbable screw. Ibikoresho, igishushanyo, tekinike, amashusho, hamwe no gusubiramo ibitekerezo byose.

Igikoresho kimwe cyo gukosora gishobora gukoreshwa kuri buri gihangano?

No. Kurikiza amabwiriza yemewe yububiko hamwe nubuhanga buteganijwe bwo kubaga.

Ikirangantego cyimbere gisimbuza ACL?

Ntabwo byikora. Kwiyongera kwa Suture-kaseti birashobora gushimangira ibyatoranijwe gusanwa cyangwa kwiyubaka, ariko uruhare rwarwo rushingiye kubikorwa no kwerekana. Ntabwo ikosora ubuziranenge bwimyenda, gushyira nonanatomic, cyangwa gukosora ibanze bidahagije.

Ibikoresho byo gukosora ACL bigomba kuvaho?

Gukuraho inzira ntabwo buri gihe bisabwa. Gukuraho birashobora gufatwa nkibikoresho byerekana ibimenyetso cyangwa bikomeye, kwandura, kwimuka, kubaga ubugororangingo, cyangwa indi mpamvu yihariye yubuvuzi.

Umwanzuro

Ibikoresho byo gutunganya ACL bituma kwiyubaka bigezweho bishoboka muguhuza ibihingwa mugihe guhuza ibinyabuzima bibaho. Agaciro kabo kava mubihuza byerekana neza, gushyiramo anatomic tunnel, ibikoresho bihuye, impagarara zikwiye, ibikoresho byagenzuwe, hamwe no gusubiza mu buzima busanzwe. Imigozi yo kwivanga, buto ya cortical, na Hybrid yubaka buriwese afite inshingano zingirakamaro; guhitamo bigomba kuba byihariye aho gushingira kubisabwa 'igikoresho cyiza '.

Ibyerekeye Ibyingenzi

Ubuvuzi n'amabwiriza: Iyi ngingo ni iy'uburere rusange n'intego z'umwuga. Ntabwo isuzuma imvune ya ACL, irasaba kubagwa, guhitamo icyatewe, cyangwa gusimbuza amabwiriza y'ibikoresho, amabwiriza yaho, cyangwa isuzumabumenyi ryujuje ibyangombwa byubuzima n’inzobere mu kugenzura. Ibicuruzwa biboneka nibimenyetso byemewe biratandukanye bitewe nigihugu.