Iwe unoshandisa kupindira screws kuti ubate magraft akasimba mumatanho emapfupa panguva yekuvhiyiwa kwemapfupa. Aya ma screws akakosha mu ligament uye nyoro kugadzirisa matishu, kunyanya mukugadzirisa acl, nekuti anochengeta zvinhu zvakagadzikana. Zvidzidzo zvinoratidza kuti ese ari maviri bioabsorbable uye titanium kupindira screws anoshanda zvakafanana, saka iwo ese isarudzo yakanaka yebasa rako. Masisitimu matsva, senge Ligament Fixation System na XC Medico , hunza mazano matsva kuvhiyiwa kwako uye kukubatsira kuti uwane mhinduro dziri nani kune varwere.
Key Takeaways
Kupindira screws kunobatsira kuchengetedza magirafu akatsiga mumatanho emapfupa panguva yekuvhiya. Izvo zvakakosha zvikuru pakugadzirisa ligaments.
Bioabsorbable screws uye titanium screws zvese zvinoshanda zvakanaka pakuvhiya kwe ACL. Vanobatsira varwere kupora nenzira dzakafanana.
Kutora yakanakisa screw size uye zvinhu zvakakosha zvakanyanya. Inobatsira vanhu kupora zviri nani uye inoderedza mukana wematambudziko.
Mazano matsva seaya Ligament Fixation System neXC Medico inoita kuti kuvhiyiwa kuve nani. Vanoshandisa zvinhu zvakasimba uye magadzirirwo akangwara.
Vanachiremba vanoda kutarisa varwere mushure mekuvhiyiwa. Izvi zvinobatsira kuwana matambudziko nekukurumidza uye zvinoita kuti kurapa kufambe zvakanaka.
Kupindira Screws Overview
Chii chinonzi Kupindira Screws
Kupindira screws anobatsira kubata magraft zvakasimba mumabhonzo tunnel panguva yekuvhiyiwa. Izvo zvakakosha pakugadzirisa ligaments uye zvinyoro zvinyoro. Vanachiremba vanowanzovashandisa mukugadzirisa ACL. Aya masiruuru anoita kuti girafu rigadzikane nekuridzvanya pabhonzo. Izvi zvinobatsira girafu kupora uye kubatana nematishu akaitenderedza.
Vanachiremba vanoti kupindira screws inzira yakajairika yekugadzirisa kukuvara kwe ACL. Ivo vanoshandira zvese bhonzo-kune-pfupa uye zvinyoro zvinyoro-kune-bhonzo kugadzirisa. Iyo screws inobata girafu panzvimbo uye rega vanachiremba vadzore nzvimbo yayo uye kusimba. Kudzora uku kunobatsira varwere kupora zvakanaka uye kupora nekukurumidza.
Ongorora: Kupindira screws anovimbwa uye anodzidzwa kugadzirisa ligament. Zvidzidzo zvakawanda zvinoratidza kuti vanoshanda zvakanaka mumapfupa-patellar tendon-bone ACL surgeries.
Mashandiro Anoita Kupindira Screws
Kutanga, vanachiremba vanoita tunnel mupfupa apo ligament inoda kugadziriswa. Zvadaro, vanoisa girafu nemukoto uyu. Iyo screw inosundira graft kumadziro emugero. Izvi zvinoita kuti girafu isafambe.
Hezvino izvo zvinoitika panguva yekuvhiyiwa:
Vanachiremba vanoboora mugero mubhonzo, kazhinji kacho hupamhi hwemamita masere.
Vanoisa girafu nemukoto.
Vanoisa screw yekupindira pedyo negraft uye vanoidzvanya zvakasimba.
Inenge 20 mm yegraft inogara mukati memugero kuitira simba.
Vanachiremba vanogona kushandisa zvinobatika kana simbi screws, zvichienderana nenyaya.
Mabasa makuru ekupindira screws ndeaya:
Kuchengeta graft iri panzvimbo chaiyo uye pakusimba chaiko.
Kupa kubata kwakasimba uko screw inobata bhonzo.
Kubata bata zvakasimba kusvika bhonzo rapora.
Kune mhando nyowani dzekupindira screws futi. Mamwe anogadzirwa nemagnesium inoputsika mumuviri. Vamwe vanosanganisa magnesium nedzimwe simbi kuti vawedzere simba. Vamwe vakadaro maumbirwo matsva eshinda kuti abate zvirinani . Shanduko idzi dzinobatsira kuti screws dzishande zvirinani uye kubatsira mapfupa kupora.
Innovation Type |
Tsanangudzo |
Biodegradable Magnesium-based Screws |
Kuderedza kushushikana kwepfupa uye kubatsira pfupa kukura. |
Hybrid Fixators |
Sanganisa magnesium nesimbi kuti uwedzere simba uye kuporesa. |
Structural Optimization |
Chinja shinda chimiro kubatsira sikuruu kubata uye kushanda zvirinani. |
Zvidzidzo zvinoratidza kuti masiruuru ane tapered akaomarara uye anochengeta gireti rakaomarara kupfuura masiruuru enguva dzose. Izvi zvinoreva kuti varwere vanowana mabvi ari nani uye akasimba nekufamba kwenguva.
Vanachiremba vanoverengera kupindira screws kuchengetedza magraft akachengeteka paunenge uchipora. Izvo zvakagadzirirwa uye zvinhu zvinobatsira vanachiremba kuwana zvibereko zvakanaka pakugadzirisa marashi.
Mhando uye Zvishandiso zveKupindira Screws
Metal uye Bioabsorbable Options
Kune marudzi akasiyana-siyana ekupindira screws ekugadzirisa ligaments. Zvinhu zvinonyanya kushandiswa ndezvi:
Titanium
Simbi isina ngura
Polymer
Bioactive girazi
Metal screws, setitanium, yakasimba kwazvo uye inogara kwenguva refu. Titanium haina ngura, saka inogara yakanaka mukati memuviri. Vanachiremba vanoshandisa titanium screws kune dzakaoma kesi nekuti dzakasimba zvakanyanya kupfuura bioabsorbable screws. Titanium screws inogona kuve negoho resimba rinosvika 1130 MPa. Izvi zvakapetwa kagumi kupfuura mamwe ma bioabsorbable screws, sePLA. Saka, titanium screws inopa tsigiro yakasimba paunenge uchiida zvakanyanya.
Bioabsorbable screws inogadzirwa kubva kuzvinhu zvakaita sePLA kana magnesium. Mascrews aya anotsemuka zvishoma nezvishoma mumuviri. Magnesium isimbi yakareruka yakasimba uye inogona kutorwa nemuviri. Aya screws anogona kubata zvinhu munzvimbo yekuvhiya kwakawanda. Nyowani bioabsorbable screws dzinenge dzakaoma setitanium screws, kusvika 90%. Asi, haasati akasimba semasikiru esimbi. Zvakadaro, zvidzidzo zvinoratidza mhando mbiri dzinoshanda zvakanaka pakugadzikana kwemabvi mushure mekuvhiyiwa kwe ACL. Hapana matambudziko akawanda kune imwe mhando kupfuura imwe.
Dhizaini Zvimiro uye Zvitsva
Kupindira screws anoramba achiita zvirinani nemagadzirirwo matsva. Zvikuru zvino zvine zvimiro zvakasiyana, shinda, uye zvinhu zvinovabatsira kubata uye kupora zvirinani. Semuenzaniso, conical kana tapered core shape inoita kuti screw ibate zvakasimba. Izvi zvinobatsira sikuruu kuchengetedza graft iri panzvimbo. Tafura iri pazasi inoratidza kuti screw shape inochinja sei simba rekudhonza-kunze:
Screw Type |
Dhonza-Kunze Simba |
Kubatana neFOA |
Kudyidzana neContact Area |
Tapered Core |
Strong |
Ehe |
Ehe |
All Types |
Weak |
Aihwa |
Aihwa |
Maumbirwo matsva eshinda uye matipi ari nani eku screw anoita kuti zvive nyore kuisa mukati sikuruu. Vanoitawo kuti itore simba shoma. Hybrid screws anoshandisa zvikamu kubva kune zvakasiyana zvinhu kuti zvive zvakasimba uye zvakachengeteka kumuviri. Titanium nePEEK sarudzo dzakanaka nekuti dzakachengeteka uye dzinobatsira bhonzo kukura. Aya mazano matsva anobatsira vanachiremba kuchengetedza girafu yakagadzikana uye kubatsira varwere kupora zvirinani.
ACL Interference Screws muKuvhiya
![ACL Interference Screws muKuvhiya]()
ACL Reconstruction Applications
ACL interference screws inobata magraft panzvimbo panguva yekuvhiyiwa kweAACL. Aya masiruuru anodzvanya girafu pamusoro pebhonzo tunnel. Izvi zvinoita kuti girafu rirambe rakagadzikana kuitira kuti ripore zvakanaka. Iyo yegraft inosungirirana nematishu akaitenderedza. Iwe unogona kutora simbi kana bioabsorbable screws yekuvhiya ACL. Mhando mbiri idzi dzinoshanda zvakanaka uye dzinopa mhedzisiro yakafanana.
Paunosarudza ACL kupindira screws, unoda kuti graft igare yakanyarara. Haifanire kufamba ichipora. Zvidzidzo zvinoratidza bioabsorbable screws ine hydroxyapatite inoshanda zvakanyanya. Havakonzeri migumisiro yakaipa. Aya screws isarudzo yakanaka pane titanium screws. Metal uye bioabsorbable screws inotadza pachiyero chimwe chete. Varwere vanoitawo saizvozvo nemhando ipi zvayo.
Dzimwe nguva, vanachiremba vanoshandisa zvinogadziriswa suspensory fixation zvishandiso. Zvishandiso izvi zvinopawo zvibereko zvakanaka uye kuchengetedza ibvi rakagadzikana. Mwero wekutadza wakadzikira, senge nemimwe michina. ACL interference screws inopa yakasimba bone-kune-bhonzo uye yakapfava tishu-kune-bhonzo kugadzirisa. Izvi zvinobatsira varwere kupora nekukurumidza uye kudzokera kumabasa avo.
Zano: Ita shuwa kuti girafu rinenge 20 mm mukati mebhonzo tunnel. Izvi zvinobatsira kuti graft igare yakasimba uye kuporesa zviri nani.
Mamwe Ligament Fixation Anoshandisa
Kupindira screws haisi yekuvhiya ACL chete. Vanachiremba vanovashandisa kune mamwe ligament kugadzirisa, sePCL neMPFL. Aya screws anobatsira kugadzirisa ligaments uye zvinyoro zvinyoro munzvimbo dzakawanda. Ivo vanoshandira zvese bhonzo-kune-pfupa uye zvinyoro zvinyoro-kune-bhonzo kugadzirisa.
Iyo Ligament Fixation System neXC Medico ine zvinhu zvitsva zvekuvhiya uku. Inoshandisa PEEK, iyo yakachengeteka kumuviri uye isingakonzeri maitiro akaipa. Iyo screws inouya muhukuru hwakawanda kuti ikwane zvakasiyana zvinodiwa. PEEK screws regai vanachiremba vaone mifananidzo yakajeka mushure mekuvhiyiwa. Izvo zviri nyore kuisa mukati, izvo zvinoponesa nguva muimba yekushanda. Iyo sisitimu yakachengeteka yeMRI scans, saka vanachiremba vanogona kutarisa kupora pasina matambudziko.
Heino tafura ine akakosha maficha eLigament Fixation System neXC Medico:
Feature |
Tsanangudzo |
Biocompatibility |
Yakagadzirwa kubva kuPEEK, yakachengeteka kune tishu uye haikonzeri maitiro akaipa. |
Radiolucency |
Rega vanachiremba vaone mifananidzo yakajeka mushure mekuvhiyiwa. |
Multiple Size |
Inokodzera mhando dzakawanda dzemuviri uye zvinodiwa. |
Durability |
Yakasimba asi yakareruka, saka inoshanda nemazvo. |
Kusununguka Kwekushandisa |
Kurumidza kuisa mukati, izvo zvinoita kuti kuvhiyiwa kukurumidze. |
MRI Kuenderana |
Yakachengeteka kuMRI scans, saka vanachiremba vanogona kutarisa kupora nyore nyore. |
Vanachiremba vanoshandisa masiruuru ekupindira mune dzakawanda ACL maoparesheni. Bioabsorbable screws ndiyo inonyanya kushandiswa kubata girafu mu tibia. Vamwe varwere, kunyanya vatambi vechidiki, vanogona kunzwa kurwadziwa pane screw. Cysts inogona kuumba kusvika ku5% yezviitiko mushure mekuvhiyiwa kwe ACL ne bioabsorbable screws. Izvi zvinoitika nekuti muviri unobata screw, saka vanachiremba vanotarisisa varwere.
Vanachiremba vanotora zvimedu zvekupindira nekuti zvinoshanda zvakanaka kune akawanda ligament uye mavhiya akapfava. Vanovimba nema screws aya kuti abate graft yakasimba uye kubatsira varwere kupora zvakanaka.
Kusarudza Interference Screws
Kusarudzwa kwezvinhu uye Saizi
Paunenge uchitora kupindira screws, iwe unofanirwa kufunga nezvezvinhu uye saizi. Iyo screw chaiyo inobatsira varwere kupora zvirinani. Kuenderana kwezvinhu kwakakosha kune matishu emuviri. Unoda kumisa kuita kwakaipa kuti kurege kuitika. Biocompatible zvinhu, senge zvinobatika mapolymer kana titanium, zvinowanzo shandiswa. Zvinhu izvi zvinobatsira kuchengetedza muviri.
Iwe unofanirwawo kutarisa screws dzakagadzirwa nechaizvo machining. Izvi zvinoreva kuti sikururu inokwana zvakanaka uye inobata graft yakasimba. Kukwana kwakanaka kunogona kuita kuti kuvhiyiwa kushande zviri nani.
Screw size yakakosha, zvakare. Kukura sikururu madhayamita anopa simba rekugadzirisa rakawanda. Izvi zvinobatsira kuti graft igare panzvimbo. Tafura iri pazasi inoratidza kuti screw size inochinja sei mhedzisiro:
Finding |
Tsanangudzo |
Kugadzirisa Simba |
Kukura sikururu madhayamita anopa simba rekugadzirisa rakawanda. |
Rehabilitation Impact |
Lower fixation simba zvinoreva rehab ingangoda kuenda zvishoma. |
Saizi Kutsamira |
Simba rekugadzirisa rinokwira netendon dhayamita mune iyi nzira. |
Kufunga Kwemurwere uye Kuvhiya
Iwe unofanirwa kugara uchifunga nezvemurwere wega wega paunenge uchitora screws. Bone quality yakakosha zvikuru. Kana murwere ane mapfupa akasimba, unogona kushandisa sikuruu yakasiyana pane yemapfupa asina simba. Chiyero chechiitiko chakakosha, zvakare. Vatambi vangada masiuruu akasimba.
Heino tafura yekukubatsira kuziva chekutarisa:
Murwere-Chaicho Factor |
Tsanangudzo |
Bone Quality |
Inobatsira iwe kutora screw diameter uye zvinhu. |
Chikamu Chekuita |
Inobatsira iwe kusarudza simba rakakodzera uye kusimba. |
Pre-existing Conditions |
Inogona kuchinja sarudzo yako kudzivirira matambudziko. |
Allergies |
Yakakosha pakutora zvakachengeteka, biocompatible zvinhu. |
Kufananidza screw nekuvhiya kwakakosha. Zvidzidzo zvinoratidza screw chaiyo inobatsira varwere kupora nekukurumidza uye zvirinani. Iwe unogona kubatsira varwere nekutarisa pane zvese zvechiitiko chimwe nechimwe. Iyi nzira yekungwarira inokubatsira iwe kupa yakanyanya kutarisirwa mune acl uye kumwe kuvhiya ligament.
Njodzi uye Dziviriro
Zvinogona Kunetsa
Kana vanachiremba vakashandisa zvisungo zvekupindira, vanofanirwa kutarisa matambudziko. Matambudziko aya anogona kushandura mavhiya akanaka senge acl reconstruction basa. Mamwe matambudziko akajairika ndeaya:
Siruuru inogona kutsemuka.
Muviri unogona kuita uye kuzvimba.
Iyo graft inogona kuchekwa.
Iyo screw inogona kunge isiri munzvimbo chaiyo kana kuti yakasimba zvakakwana.
Anenge 1 muvarwere gumi anogona kunge aine zviratidzo mushure mekuvhiyiwa. Vanosvika 5% yevarwere vanoda kumwe kuvhiyiwa kugadzirisa matambudziko aya. Vanhu vazhinji vanogona kutamba mitambo zvakare mushure mekunge screw yabviswa. Screws inogona kusunungurwa kana kuputsika kana paine kufamba kwakanyanya kana kushushikana. Izvi zvinogona kuita kuti screw itsemuka. Mune zvimwe zvidzidzo, screws dzakasimuka kubva panzvimbo kusvika 16.9% yezviitiko. Masiruu anoiswa pakona akabuda kunze kupfuura masiruuru akatwasuka.
Type yeScrew |
Risk Ratio (RR) |
Matambudziko Akabatanidzwa |
Bioabsorbable Screws |
1.70 |
Graft kuputika, kuputika kwemajoini, hutachiona |
Metallic Screws |
<1.70 |
Zvinetso zvishoma zvakazara |
Ongorora: Mukana wematambudziko unogona kuchinja neiyo screw type uye kuti kuvhiyiwa kunoitwa sei.
Kuchengetedza uye Maitiro Akanakisisa
Vanachiremba vanogona kuderedza njodzi nekutevera mitemo yekuchengetedza uye tsika dzakanaka. Heano mamwe matipi ekubatsira kuwana zvirinani mibairo nekukanganisa screws:
Sarudza saizi yakakodzera sikuru uye zvinhu zvemurwere wega wega.
Isa screw mukati zvakanyatsonaka kuitira kuti graft irege kukuvara.
Ita shuwa kuti girafu rinenge 20 mm mukati mebhonzo tunnel.
Tarisa varwere kune zviratidzo zvekuti screw yakasununguka kana kuti yafamba mushure mekuvhiyiwa.
Best Practice |
Benefit |
Shandisa bioabsorbable screws yekurapa kwakagadzikana |
Kuderera kwekutanga kwegraft |
Deredza synovial fluid mumugero wemapfupa |
Zvishoma zvakashata zvinokonzerwa nemacytokines |
Gadzirisa pedyo nemusuwo wemukoto |
Inodzivisa bungee effect |
Tarisa uone kutsvedza kwegraft |
Inodzivirira kukundikana kwekliniki |
Vanachiremba vanofanirwawo kuchengetedza chero zviitiko zvakaipa uye kutarisa varwere kazhinji. Zvese zviri zviviri bioabsorbable uye simbi screws zvinoshanda zvakafanana pakurwadziwa, kufamba, uye nemafambiro anoita mubatanidzwa. Kana screw ikatsemuka uchiiisa, haigare ichikonzera dambudziko, asi vanachiremba vanofanirwa kuramba vachitarisa murwere.
Zano: Kunyatsoronga uye kunyatsoteerera kune ruzivo kunobatsira kudzikisira njodzi uye kuita kuti mhedzisiro yemurwere ive nani kana uchishandisa kuvhiringa screws.
Iwe unoshandisa kupindira screws kuchengetedza magraft akatsiga mukuvhiya kweacl uye ligament. Zvidzidzo zvinoratidza bioabsorbable screws uye masisitimu matsva anobatsira varwere kupora zvirinani mushure mekugadzirisa acl. Iyo Ligament Fixation System neXC Medico inopa tsigiro yakasimba, inobatsira kuporesa, uye inoderedza matambudziko. Vanachiremba vazhinji vanoona zviri nani kusimba kwemajoini uye yakanaka yenguva refu mhedzisiro nehurongwa uhu.
XC Medico inotevera mitemo yemhando yepamusoro.
Iwe unowana kukurumidza kutumirwa uye rubatsiro nemibvunzo.
Iyo sisitimu inokubatsira iwe kuwana mibairo mikuru yevarwere vako.
Sarudza XC Medico sekambani yako yaunovimba nayo yekukanganisa screws uye zvimwe zvigadzirwa.
FAQ
Chii chinangwa chikuru chekukanganisa screw?
Iwe unoshandisa screw yekukanganisa kubata gireti zvakasimba mumugero webhonzo. Izvi zvinoita kuti girafu rirambe rakagadzikana panguva yekuporesa. Iyo screw inobatsira iyo ligament nyowani kunamatira pabhonzo.
Unosarudza sei saizi yekukanganisa siruuru?
Iwe unofananidza saizi yekukurisa kune graft uye bhonzo tunnel. Siruuru yakakura inopa kubata kwakawanda. Nguva dzose tarisa hutano hwemapfupa emurwere uye rudzi rwekuvhiya kwaunoronga.
Ko bioabsorbable screws yakachengeteka kune vese varwere?
Bioabsorbable screws yakachengeteka kune vazhinji varwere. Iwe unofanirwa kutarisa kune allergies kana mamiriro ehutano akakosha. Aya ma screws anoputsika mumuviri nekufamba kwenguva.
Iwe unogona here kushandisa kupindira screws pakuvhiya kunze kweACL kuvakazve?
Ehe, unogona kushandisa kupindira screws kune mamwe ligament kugadzirisa, senge PCL kana MPFL kuvhiyiwa. Ivo zvakare vanobatsira neakapfava matishu kugadzirisa mune akawanda orthopedic maitiro.
