Ukuntu Abaganga Basana Meniscus Yacitse Mumavi

Abaganga babaga ubu bibanda ku kubungabunga menisque aho kuyikuraho mugihe cyo kubaga ivi kuri menisque yacitse. Bakoresha tekinoroji ya arthroscopique yo gusana ingirangingo no kugarura ituze hamwe. Abarwayi bakira uburyo bwo gusana imbere-akenshi bagaragaza iterambere ryinshi mumikorere yivi no gukira, nkuko byatangajwe nubushakashatsi buherutse. Ubu buryo bushya bufasha kurinda ivi no gushyigikira kugenda igihe kirekire.

Ibyingenzi

• Abaganga babaga ubu bashyira imbere kubungabunga menisque mugihe cyo kubaga ivi, bifasha kubungabunga umutekano hamwe no kugenda igihe kirekire.

• Ubuhanga bugezweho bwa arthroscopique butuma gusana byoroheje, biganisha kububabare buke nigihe cyo gukira vuba kubarwayi.

• Kuvura kutabaga birashobora kuvura neza amarira mato mato, abarwayi benshi bagasubira mubikorwa bisanzwe mubyumweru.

• Gusobanukirwa ibimenyetso bya menisque yacitse, nk'ububabare no kubyimba, ni ngombwa mu gushaka inama z'ubuvuzi no kuvurwa ku gihe.

• Ubuvuzi bw'umubiri bugira uruhare runini mu gukira, bufasha gukomera ivi no kwirinda ibikomere biri imbere.

Ibyingenzi bya Meniscus

Anatomy

Menisk ni imiterere yingenzi imbere yivi. Buri ivi ririmo menisci ebyiri: menisque yo hagati imbere na menisque kuruhande. Utwo dusimba tumeze nk'ukwezi kwakozwe muri fibrocartilage kandi utwikiriye hafi 70% yubuso bwikivi. Imiterere yabo yihariye-yegeranye hejuru kandi iringaniye hepfo - ibemerera guhuza neza na gato kuri tibial plateau. Meniscus ifite umubyimba mwinshi ku mpande kandi yoroheje hagati, ifasha kwinjiza no gukwirakwiza imbaraga mugihe cyo kugenda.

Ibintu by'ingenzi bigize meniskus harimo:

• Igizwe ahanini n’amazi (72%) na kolagen (22%), hamwe na proteoglycans nkeya, glycoproteine, peptide, na selile zihariye bita fibrochondrocytes.

• Igabanyijemo ibice bitatu by'imitsi:

• Agace gatukura-umutuku : hanze ya gatatu, itanga amaraso menshi.

• Agace gatukura-cyera : hagati ya gatatu, gutanga amaraso igice.

• Agace cyera-cyera : imbere ya gatatu, ibura amaraso.

• Yagenewe kugabanya guterana no gukuramo uburemere hagati yigitereko na tibia.

Gusobanukirwa iyi miterere bifasha kubaga guhitamo uburyo bwiza mugihe cyo kubaga ivi meniscus yacitse, cyane cyane muguhitamo gusana cyangwa gukuraho ingirangingo zangiritse.

Imikorere

Menisk ikora imirimo myinshi yingenzi muri biomechanics. Imiterere yacyo irayemerera kurinda ingingo no gushyigikira ingendo nziza. Imbonerahamwe ikurikira irerekana ibikorwa by'ingenzi:

Meniskus nayo ikurura ihungabana mugihe cyo gukora nko kwiruka no gusimbuka. Imiterere ya wedge yimbitse ya tibial plateau, ifasha mugutezimbere imitwaro no kugabanya imihangayiko kuri karitsiye. Iyo menisque yangiritse, iyi mikorere irahungabana, niyo mpamvu kubaga ivi kubagabo bacitse meniscus akenshi iba igamije kubungabunga ingirabuzimafatizo nziza zishoboka.

Ibimenyetso bya Meniscus yatanyaguwe

Ibimenyetso

Meniscus yacitse akenshi itera kubura amahwemo kandi igabanya ivi. Abantu benshi babona ibimenyetso nyuma yimvune, ariko ibimenyetso bimwe bishobora gukura buhoro buhoro. Ibimenyetso bikunze kugaragara harimo kubabara, kubyimba, no kugora ivi. Bamwe mu barwayi bavuga ko batewe ubwoba igihe bakomeretse. Abandi bumva ko ivi ryabo rishobora gutanga cyangwa gufunga ahantu.

Ibindi bimenyetso bishobora kubamo:

• Ijwi ryumvikana mugihe cy'imvune

• Ingorane zo kugorora ivi byuzuye

• Ibyiyumvo bifunze mu gihimba

• Kwinangira cyangwa kubyimba bituma kugenda bigoye

Ibi bimenyetso birashobora kugira ingaruka kubikorwa bya buri munsi. Abantu bahuye nibi bimenyetso bagomba gushaka inama zubuvuzi. Gusuzuma hakiri kare no kuvura bifasha kwirinda kwangirika no kunoza ibisubizo nyuma yo kubagwa ivi kuri menisque yacitse.

Gusuzuma

Abaganga bakoresha intambwe nyinshi kugirango bamenye meniscus yacitse. Ubwa mbere, barabaza ibikomere nibimenyetso. Ibikurikira, bakora ikizamini cyumubiri kugirango barebe ubwuzu, kubyimba, hamwe nintera igenda. Ibizamini bidasanzwe, nkikizamini cya McMurray, bifasha kumenya amarira ya menisk mu kwimura ivi muburyo bumwe.

Kwerekana amashusho bigira uruhare runini mu kwemeza indwara. Magnetic resonance imaging (MRI) nigikoresho cyukuri cyo kumenya amarira ya menisk. MRI irashobora kwerekana ubwoko bwaho amarira. Amarira ya menisque yo hagati, MRI ifite sensibilité ya 91.8% kandi yihariye 79.9%. Ku marira ya meniscus kuruhande, sensitivite ni 80.8% naho umwihariko ni 85.4%. X-imirasire ntabwo yerekana tissue ya meniscus ahubwo ifasha kwirinda gukomeretsa amagufwa.

Impanuro: MRI itanga amashusho arambuye yinyama zoroshye, bigatuma ihitamo guhitamo gusuzuma ibikomere bya menisque mbere yo kubagwa ivi kuri menisque yacitse.

Isuzuma ryukuri riyobora gahunda nziza yo kuvura. Ifasha kubaga guhitamo niba kubaga kutabagwa cyangwa kubagwa ivi kubwa menisque yacitse bizatanga ibisubizo byiza.

Iyo hakenewe kubagwa

Ubuvuzi budasanzwe

Abaganga bakunze gusaba ubuvuzi budasanzwe bwo kubaga amarira menshi ya menisk. Ubu buryo bukora neza kumarira mato cyangwa ayo muri zone itukura yo hanze, aho gutanga amaraso bifasha gukira. Kuvura kutabaga bishobora kubamo kuruhuka, urubura, kwikuramo, kuzamuka, hamwe no kuvura umubiri. Izi ntambwe zifasha kugabanya ububabare no kubyimba mugihe utezimbere imbaraga zivi no guhinduka.

Abarwayi benshi bakira nta kubaga. Ubushakashatsi bwerekana ko ubuvuzi budasanzwe bwo kubaga bushobora kuba ingirakamaro cyane cyane amarira atambitse.

• Hafi ya 70% ya meniscus amarira atambitse yavuwe adakorewe kubagwa neza.

• Abarwayi bakurikiza gahunda yabo yo kubitaho akenshi basubira mubikorwa bisanzwe mubyumweru.

• Ubuvuzi bwumubiri bufasha kugarura ingendo no kwirinda ibikomere bizaza.

Abaganga bakurikirana iterambere hamwe no kwisuzumisha bisanzwe. Bashobora gukoresha MRI cyangwa ibindi bizamini kugirango bakurikirane gukira. Niba ibimenyetso bigenda neza, kubagwa ntibikenewe.

Icyitonderwa: Ubuvuzi budasanzwe bwo kubaga bukora neza mugihe abarwayi birinze ibikorwa bishimangira ivi, nko kwiruka cyangwa gusimbuka.

Ibipimo byo kubaga

Abaganga batekereza kubaga ivi kuri menisque yacitse mugihe ubuvuzi budasanzwe bwo kubaga budakuraho ibimenyetso. Kubaga birashobora gukenerwa mugihe amarira atera gufunga, kubabara bikomeje, cyangwa guhungabana. Amarira manini, imiterere igoye, cyangwa ibikomere ahantu hadafite amaraso make bisaba kubagwa.

Icyemezo giterwa nimpamvu nyinshi:

Abaganga bakoresha ibizamini bya MRI nibizamini kugirango bamenye niba kubaga aribwo buryo bwiza. Basobanura ingaruka nibyiza byo gufasha abarwayi guhitamo neza. Ubuhanga bugezweho bwibanda ku kubungabunga menisque igihe cyose bishoboka, irinda imikorere y'amavi kandi igabanya ibyago byo kurwara rubagimpande.

Kubaga amavi kuri Meniscus yacitse

Gusana Arthroscopique

Abaganga babaga ubu bakoresha tekinike ya arthroscopique kubagwa amavi hafi ya meniscus yacitse. Arthroscopy ikoresha kamera ntoya nibikoresho byabigenewe byinjijwe mubice bito. Ubu buryo butuma abaganga babona imbere mu ivi bagasana menisque ihungabanye cyane ku ngingo nziza. Inzira ikurikira intambwe nyinshi zingenzi:

1. Itsinda ryo kubaga ritegura agace kandi rigashyira umurwayi kugirango abone uburyo bwiza.

2. Umuganga ubaga yinjiza arthroscope abinyujije ku mbuga ntoya imbere y'amavi.

3. Umuganga abaga asuzuma amarira ya menici hamwe nuburyo bukikije.

4. Ahantu ho kurira harateguwe, hanyuma hashyirwaho suture kugirango uhuze impande zacitse.

5. Umuganga ubaga ahuza amapfundo agafunga ibice.

Ubu buryo butagaragara cyane bugabanya ububabare, bugabanya ibyago byo kwandura, kandi byihuta gukira. Gusana arthroscopique byabaye ihame kubarwayi benshi bakeneye kubagwa ivi kuri menisque yacitse.

Uburyo bwo gusana

Abaganga babaga bahisemo muburyo butandukanye bwo gusana ukurikije ubwoko bwamarira hamwe n’aho biherereye. Uburyo nyamukuru burimo:

• Byose-Imbere yo Gusana : Abaganga babaga bakora ubu buhanga muburyo bumwe hamwe nibikoresho byabugenewe. Uburyo bwose-bwimbere butuma menisk igenda yigenga mugihe cyo gukira. Igarura ivi aho ihurira neza muburyo bwagutse ugereranije no gusana imbere. Ubu buryo kandi bwirinda ingorane nko gukomeretsa imitsi kandi bigabanya igihe cyo gukora, biganisha ku gukira vuba.

• Gusana Imbere-Hanze : Abaganga babaga bashushanya suture imbere yimbere kugeza hanze. Ubu buryo butanga gukosorwa gukomeye, cyane cyane kurira mumubiri cyangwa ihembe ryinyuma rya menisk. Ariko, birashobora gusaba gutemwa gato inyuma yivi.

• Hanze-Mu gusana : Abaganga babaga bashiramo suture hanze yivi mu gihimba. Ubu buhanga bukora neza kurira imbere (ihembe ryimbere) rya menisk.

• Gusana Transtibial (Pullout) Gusana : Kubaga bakoresha ubu buryo kumarira. Barema umuyoboro unyuze muri tibia hanyuma bagakurura suture kugirango babone imizi ya menisk.

Imbonerahamwe ikurikira irerekana muri make ubushobozi bwo gukiza hamwe nubuhanga bwatoranijwe kubwoko butandukanye bwamarira hamwe nahantu:

Abaganga babaga bahitamo uburyo bwiza bwo gukira no kubungabunga menisque nyinshi zishoboka mugihe cyo kubaga ivi meniskus yacitse.

Intsinzi Igipimo cya Meniscus Uburyo bwo Gusana

Intsinzi iratandukanye bitewe na tekinike hamwe n'amarira. Imbonerahamwe ikurikira irerekana ibipimo byatsinzwe kuburyo butandukanye bwo gusana:

Ubuhanga	Igipimo cyo Kunanirwa	Inkomoko
Byose byo gusana	22.3%	Ihuza
Gusana imbere	5.6%	Ihuza
Muri rusange igipimo cyo gutsindwa	19.1%	Ihuza
Gusana bigezweho	19.5%	Ihuza
Gusana hagati	23.9%	Ihuza
Gusana kuruhande	12,6%	Ihuza
Gusana imbere	14.2%	Ihuza
Ibigezweho byose-imbere	15.8%	Ihuza

Udushya

Iterambere ryagezweho ryahinduye kubaga ivi kuri meniscus yacitse. Abaganga babaga ubu bibanda ku kubungabunga menisk kugirango barinde imikorere y'amavi no kwirinda arthrite. Ibikoresho bya arthroscopique bigezweho bituma ibikoresho byo gusana bifite umutekano kandi neza.

• Abaganga babaga bakoresha bioinspired na biomimetic ibikoresho bifasha kuvugurura karitsiye. Ibi bikoresho bitezimbere gukira kandi bitanga ubundi buryo bwo kubaga gakondo.

• Bio-ishobora kwinjizwamo hamwe nubuhanga bunoze bwo kudoda bifasha kongera intsinzi no kwihuta gukira.

• Ibikoresho bigezweho bya arthroscopique, nka XC Medico Meniscus Surgical Staple , tanga gukosorwa gukomeye hamwe nigitero gito. Iki gikoresho gishyigikira tekinike zose zo gusana hamwe na Hybrid, bigatuma inzira ikora neza kandi itekanye.

• Meniscus 2-0 # Inshinge ebyiri ziboneye kuva XC Medico zitanga imbaraga zidasanzwe za suture kandi zihinduka. Abaganga babaga babikoresha kugirango bashire ubudodo busobanutse ahantu hafatanye, ni ngombwa mugusana bigoye.

Imbonerahamwe ikurikira irerekana uburyo ibikoresho byateye imbere biteza imbere menisque:

Icyitonderwa: Kunonosora neza hamwe na tekinike yibasiwe biganisha ku guhuriza hamwe hamwe no gusubira mubikorwa byihuse nyuma yo kubagwa ivi kuri menisque yacitse.

Abaganga babaga bafite amahitamo menshi kuruta ikindi gihe cyose kugirango bagarure ubuzima bwivi. Guhitamo tekinike biterwa n'ubwoko bw'amarira n'aho biherereye, imyaka umurwayi afite, n'urwego rw'ibikorwa. Hamwe nudushya tugezweho, abarwayi barashobora kwitega uburyo butekanye nibisubizo byiza.

Gukira no Rehab

Kwitaho nyuma yo kubagwa

Abarwayi babazwe ivi kuri menisque yacitse bakurikiza gahunda yo gukira. Abaganga barasaba gutangira imyitozo yoroheje, nko kuzamura ukuguru kugororotse hamwe na pompe yamaguru, mugihe cyamasaha 24. Iyi myitozo ifasha kugumana imbaraga zimitsi no kwirinda gukomera. Abarwayi bagomba kurangiza imyitozo inshuro eshatu kugeza enye buri munsi kugeza basuye bwa mbere nyuma yibikorwa. Gucunga ububabare birimo anesthetike yaho, ishira mumasaha 8-12, hamwe nibiyobyabwenge nibikenewe. Aspirine ikunze gutegekwa ibyumweru bibiri kugirango igabanye ibyago byo gutembera kw'amaraso. Kuzamura ukuguru no gukoresha inkoni kugirango ukoreho uburemere mu byumweru bibiri byambere bigabanya kubyimba no kurinda gusana. Abarwayi bagomba kwambara igitambara cyagutse keretse mugihe imyitozo. Ubuvuzi bwa ice, burigihe cyangwa muminota 20 buri masaha abiri, bifasha kugabanya ububabare no kubyimba.

Icyitonderwa: Abarwayi bagomba kuvugana na muganga niba bafite ububabare bukabije bw'inyana cyangwa kubyimba.

Ubuvuzi bw'umubiri

Ubuvuzi bwumubiri bugira uruhare runini mugukiza. Abavuzi bayobora abarwayi binyuze mumyitozo igamije guteza imbere gukira no kugarura imikorere y'amavi. Iyi myitozo ikomeza imitsi ikikije ivi, itezimbere urwego, kandi ifasha gucunga ububabare. Abavuzi kandi bakemura ibibazo byihishe kugirango birinde ibikomere bizaza. Imyitozo isanzwe ikubiyemo kwadriceps gukora, gutambuka hamstring, kuzamura ukuguru kugororotse, kunyerera hejuru, agatsinsino gato, clamshells, nibihaha igice. Agatsinsino gahagaze kazamura hamwe na hamstring agatsinsino karushijeho gushyigikira ituze hamwe.

Intego zo kuvura umubiri:

1. Duteze imbere gukira kwa kamere binyuze mukigenda.

2. Komeza imitsi yo gushyigikira ivi.

3. Kunoza guhinduka no kugendagenda.

4. Koresha ububabare mugihe cyo gukira.

5. Irinde ibikomere bizaza kandi ushyigikire ubuzima bwigihe kirekire.

Igihe cyo gukiza

Gukira nyuma yo gusana meniscus biratandukanye kuri buri murwayi. Abantu benshi baragenda bagasubira ku kazi mu byumweru 4 kugeza 8. Ubusanzwe abarwayi bareka gukoresha inkoni n'imigozi hafi amezi 2 kugeza kuri 3. Gukira byuzuye birashobora gufata amezi 1.5 kugeza kuri 6, bitewe nibintu bitandukanye. Garuka kumurimo uremereye cyangwa siporo bikunze kubaho hagati y'amezi 3 na 6. Umuvuduko wo gukira uterwa nibintu nko kurira, ubwoko bwo gusana, no kumenya niba kwiyubaka kwa ACL byakorewe icyarimwe. Gusana kwa menici kuruhande bikunda gukira vuba kuruta gusana hagati, kandi amarira muri zone yera-yera ashobora gusaba igihe kinini.

• Kugenda no gukora: ibyumweru 4-8

• Kuva kumurongo no kugenda udafite inkoni: amezi 2-3

• Gukira byuzuye: amezi 1.5-6

• Garuka muri siporo cyangwa akazi karemereye: amezi 3-6

Inama: Gukurikiza gahunda yo gukira no kwitabira amasomo yo kuvura kumubiri bifasha abarwayi kugera kubisubizo byiza nyuma yo kubagwa ivi kuri menisque yacitse.

Kubungabunga Meniscus bihagaze nkintego yingenzi mu kubaga ivi kuri meniscus yacitse. Uburyo bugezweho bwo gusana bufasha kugarura imikorere ihuriweho no kugabanya ibyago byo kurwara osteoarthritis.

• Kudoda kwa Meniscus bitezimbere ubuzima bwigihe kirekire bwamavi kandi birinda arthrite kubarwayi benshi.

• Gusana kwa meniskus na meniscectomy byerekana igipimo gito, ariko gusana biganisha kumusubizo mwiza no gusubira muri siporo.

Akenshi abarwayi basubira mu bikorwa mu mezi. Kugisha inama abashinzwe ubuzima byemeza gahunda nziza yo gukira.

Ibibazo

Bifata igihe kingana iki kugirango ukire kubagwa ivi kuri menisque yacitse?

Abarwayi benshi bagenda nta nkoni mu mezi 2 kugeza kuri 3. Gukira kwuzuye akenshi bifata amezi 3 kugeza kuri 6. Igihe cyo gukira giterwa nubwoko bwamarira, uburyo bwo gusana, nurwego rwibikorwa byabarwayi.

Meniskus yacitse irashobora gukira nta kubaga?

Amosozi mato mato, cyane cyane muri zone itukura yo hanze, arashobora gukira hamwe no kuruhuka no kuvura umubiri. Abaganga barashobora gusaba ubuvuzi butari bwo kubagwa mbere yo gusuzuma kubaga ivi kuri menisque yacitse.

Ni ibihe bikorwa abarwayi bagomba kwirinda nyuma yo kubagwa ivi kuri menisk yacitse?

Abarwayi bagomba kwirinda kwiruka, gusimbuka, no kugoreka mugihe cyo gukira hakiri kare. Ibi bikorwa birashobora gushimangira gusanwa. Abaganga naba teriste bayobora ibikorwa byiterambere bitezimbere.

Ese gusana meniscus biruta gukuraho?

Gusana Meniscus birinda imikorere y'amavi kandi bigabanya ibyago bya artite. Gukuraho, cyangwa meniscectomy, birashobora kugabanya ububabare ariko byongera ibibazo byigihe kirekire. Abaganga babaga bahisemo gusanwa mugihe bishoboka mugihe cyo kubaga ivi meniskus yacitse.