Orthopedic Sports Medicine Guide
Suture anchors zvidimbu zvidiki zvinoshandiswa kubatanidza zvinyoro zvinyoro-zvakadai setendon, ligament, kana labrum-kupfupa. Ivo vanowanzoshandiswa mukuvhurika uye arthroscopic kuvhiyiwa kwemapfupa , kunosanganisira rotator cuff kugadzirisa, kugadzikana kwepfudzi, uye yakasarudzwa ibvi, tsoka, gumbo, ruoko, uye maitiro egokora.
Mhinduro inokurumidza: Chiremba anovhiya anoisa anchor mupfupa uye anoshandisa suture yakasungirirwa kubata yakakuvara yakapfava pfupa apo kuporesa kuchiitika. Kuti suture anchor inonyungudika zvinoenderana nechinhu chayo. Titanium, Stainless-steel, uye PEEK anchors hazvibatike, nepo bioabsorbable uye mamwe biocomposite anchors zvakagadzirirwa kudzikisa zvishoma nezvishoma. Kudzikisira kunogona kutora mwedzi kana makore uye kungasave kwakakwana mune zvese.
Key Takeaways
Chii chinonzi Suture Anchor?
Mukuvhiyiwa kwemapfupa, 'anchor' mudziyo wekugadzirisa unopinzwa mubhonzo kupa chinonamatirwa chesuture imwe kana kupfuura. Idzo sutures dzinopfuura kana kutenderedza ganda rakapfava rakakuvara uye ribatanidze pfupa. Chinangwa ndechekuchengetedza nzvimbo yekugadzirisa apo biological healing inokura; iyo inoiswa pachayo haipodze tishu.
Iyo yakajairika suture anchor system inosanganisira:
The anchor body: chikamu chakaiswa mubhonzo. Zvichienderana nekugadzirwa kwayo, inogona kuve yakarukwa, kudzvanya-yakakodzera, kuwedzera, kana kugadzirwa zvakanyanya kubva kune suture material.
Iyo eyelet kana suture-retention mechanism: chikamu chinobatanidza anchor uye suture. Mune mamwe mafundo madhizaini, iyo michina zvakare inonetsa uye inokiya kugadzirisa.
Musutu kana tepi: chinhu chinopfuura nemunyama. Wider tepi-mhando sutures inogona kusarudzwa kune mamwe magadzirirwo ekugadzirisa, kunyange zvazvo biomechanical kusiyana hakuiti pakarepo kuvimbisa zviri nani migumisiro yekliniki.
Suture Anchors Inoshanda Sei?
Iyo chaiyo tekinoroji inosiyana nekushanda uye anchor dhizaini, asi yekutanga kugadzirisa inotevedzera iwo masimidhi akafanana:
Chiremba anovhiya anogadzirira poindi yekupinza mubhonzo padyo nenzvimbo yainosungirwa yetishu.
Iyo anchor inoiswa panzvimbo yakarongwa uye kona uchishandisa iyo yakakodzera yekuburitsa chiridzwa.
Iyo suture inopfuudzwa kuburikidza netendon, ligament, capsule, kana labrum.
Iyo suture inosungirirwa kana kuvharirwa neknotless locking mechanism kuti matishu abatane nebhonzo.
Iko kugadzirisa kunodzivirira iyo tishu-kune-bhonzo interface panguva yekutanga kupora, nepo postoperative rehabilitation inodzora mutoro uye kufamba.
Kugadzirisa simba kunokonzerwa nekupfuura anchor chete. Bone quality, kupinza angle, anchor dhayamita uye dhizaini, suture kumisikidzwa, tishu mamiriro, nzira yekuvhiya, uye kudzoreredza zvese zvinokanganisa kugadzirisa. An anchor iyo yakakodzera kune imwe anatomical saiti kana murwere angave asina kukodzera kune imwe.
Zvakakosha: Suture anchors inogona kutsigira nzira dzinopinda zvishoma, asi ivo pachavo havavimbisi kurwadziwa kushoma, kupora nekukurumidza, kana mhedzisiro yekiriniki. Kudzorera kunoenderana nekukuvara kwepakutanga, maitiro, hutano hwemurwere, kugadzirisa hutano, uye chirongwa chekugadzirisa.
Ko Suture Anchors Inonyungudika?
Dzimwe suture anchors dzakagadzirirwa kuderedza, asi dzimwe dzinoramba dziri mumuviri. 'Dissolvable' itsananguro yemazuva ese inobatsira, asi bioabsorbable kana biodegradable inonyatso kunyatsoita. Zvibatiso izvi zvinoputsika kuburikidza nemaitiro ehupenyu nemakemikari pane kungonyangarika pakarepo.
| Anchor zvinhu kana dhizaini | Inonyungudika here? | Kufunga kunoshanda |
|---|---|---|
| Metal, yakadai setitanium kana simbi isina tsvina | Aihwa | Inopa zvachose radiopaque gadziriso asi inogona kugadzira yekufungidzira artifact uye inogona kuomesa kudzokorora mune mamwe mamiriro. |
| PEEK | Aihwa | Iyo isingabatike polymer iyo ine radiolucent pane yakajairwa X-rays uye kazhinji inogadzira kushoma kwekufungidzira artfact pane simbi. |
| Bioabsorbable polymer | Yakagadzirirwa kuderedza | Mwero unosiyana zvakanyanya nekuumbwa kwepolymer, saizi yeancho, nzvimbo, uye biological mhinduro. |
| Biocomposite | Kazhinji yakagadzirirwa kuderedza zvishoma nezvishoma | Inobatanidza polymer yakaora ine mineral component; kutsiva nebhonzo kunosiyana uye hakufanirwe kufungidzirwa. |
| All-suture anchor | Zvinotsamira pazvinhu | 'All-suture' inotsanangura kuvaka, kwete hazvo kunyura. Ruzivo rwechigadzirwa chakanangana nechinhu chinofanira kutariswa. |
Bioabsorbable anchors haadzikise ese pane imwechete hurongwa. Zvichienderana nechinhu, zvisaririra zvinogona kuoneka kwemakore, uye kunyura kwakazara hakuna kuvimbiswa. Saka kusarudzwa kweanchor kunofanira kunge kwakavakirwa pamamiriro ekiriniki uye zvinyorwa zvechigadzirwa-kwete chete pane zvaunofarira zvekudyara izvo 'zvinonyungudika'.
Mhando dzeSuture Anchor Devices
Suture anchor madhizaini anosiyana mune zvinhu, geometry, nzira yekuisa, uye suture-yekuchengeta michina.
Non-Absorbable Anchors
Maancho asingabatike anoitirwa kuti arambe ari mumuviri kunze kwekunge kubviswa kwave kuri madikanwa. Chikamu chacho chinosanganisira magadzirirwo esimbi pamwe neasingabatike mapolymer magadzirirwo akadai sePEEK. Non-absorbable anchors inogona kupa kugadzirisa kwenguva refu, asi mhedzisiro yekufungidzira uye inogoneka kudzokorora zvinoenderana nezvinhu uye kuiswa.
| Mhando yeSuture Anchor | Inogoneka zvakanakira | Mapoinzi ekufunga |
|---|---|---|
| Zvisingabatike | Permanent material; inowanikwa mumhando dzakawanda dzakagadzirwa uye zvigadzirwa. | Zvinhu zvinoramba zviri mumuviri; yekufungidzira artifact uye yekudzokorora kufunga kunosiyana. |
| Bioabsorbable kana biocomposite | Yakagadzirirwa kuderedza zvishoma nezvishoma; mamwe magadzirirwo anogona kuderedza zvachose implant material. | Kudzikira kunoshanduka; mhinduro yekuzvimba, kuumbwa kwecyst, kana shanduko yemapfupa inogona kuitika. |
| Zvese-suture | Inoshandisa tunnel diki yebhonzo uye inogona kuchengetedza bhonzo rakawanda kupfuura mamwe maanchor akasimba. | Kuita kunoenderana nekutumirwa, kunaka kwepfupa, uye dhizaini; kutorwa hakugone kutorwa kubva pazita. |
PEEK Corded Anchors
PEEK corded suture anchor zvishandiso zvinoshandisa polyether ether ketone, isingabatike engineering polymer. PEEK ine radiolucent payakajairwa radiographs uye kazhinji inogadzira mashoma ekufungidzira artifact pane simbi, kunyangwe nzvimbo yekuisirwa inogona kuratidzwa neakabatana mamaki kana yakatenderedza bhonzo tunnel. PEEK anchors hainyungudika.
Anchor size inongova imwe chete yekusarudza chinhu; anatomy, mhando yebhonzo, matishu, uye yakarongwa kugadzirisa kuvaka kunofanirwawo kutariswa.
Knotless Anchors
Knotless anchors anoshandisa inokiya nzira kuchengetedza uye tension iyo suture pasina yakajairwa arthroscopic knot. Knot-free anchors anogona kurerutsa mamwe matanho ekugadzirisa uye kudzivirira mukurumbira ane chekuita nemafundo, asi kukodzera kwawo kunoenderana nemaitirwo uye zano rekugadzirisa rechiremba. 'Knotless' inotsanangura kuti suture inochengetedzwa sei; haizive kana anchor isimbi, PEEK, inobatika, kana biocomposite.
All-Suture Anchors
All-suture anchors anoumbwa zvakanyanya kubva kune yakakwira-simba suture zvinhu pane kuomesa anchor muviri. Ivo vanowanzoda diki bhonzo mugero uye kuwedzera kana kuendesa pasi peiyo cortical pamusoro. Maitiro avo anoenderana nemaitiro ekutumira uye emunharaunda bhonzo mhando. Haafanire kungoerekana atsanangurwa seanonyungudika.
Suture anchors anowanikwa muhukuru hwakasiyana, zvinhu, uye kurodha zvigadziriso. XC Medico inopa orthopedic sports-medicine zvigadzirwa, zvinosanganisira yakasarudzwa PEEK uye titanium-alloy suture anchor sarudzo. Sarudzo yechigadzirwa inofanirwa kuenderana nezvakada kushandiswa, mamiriro ezvemitemo munharaunda, zviridzwa zvinoenderana, uye mutongo wemurapi ane hunyanzvi.
Suture Anchors Inoshandiswa Kupi?
Suture anchors inogona kuverengerwa mumaitiro anosanganisira:
Shoulder: rotator cuff kugadzirisa, Bankart kana labral kugadzirisa, uye akasarudzwa biceps maitiro.
Hip: yakasarudzwa labral kugadziriswa.
Knee: yakasarudzwa ligament, tendon, meniscal-root, kana capsular kugadzirisa maitiro.
Tsoka nechidzitiro: yakasarudzwa Achilles tendon, ligament, uye tendon kugadzirisa.
Elbow, wrist, uye ruoko: yakasarudzwa tendon kana ligament rettachment maitiro.
Chiremba anovhiya anosarudza kana anchor-based repair, transosseous technique, kana imwe nzira inonyanya kukodzera. Mhedzisiro yekiriniki inokonzerwa nemaitiro ekukuvadza uye kugadzirisa zvachose-kwete chete nekuvapo kweimwe anchor material.
Kuchengeteka, Hurefu Hweupenyu, uye Zvinogoneka Zvinetso
Suture anchors anoshandiswa zvakanyanya, asi hapana kuisirwa kana kuvhiya nzira isina njodzi. A anchor yakasarudzwa uye yakarongedzwa inotarisirwa kuramba yakagadzikana panguva yekuporesa. Zvibatiso zvisingabatike zvinogona kugara zvachose, nepo zvinobatika zvinochinja nekufamba kwenguva pamitengo yakanangana nezvinhu.
Zvinetso zvinogona kusanganisira:
Anchor pullout, kusunungura, kutama, kuputsika, kana kurasikirwa kwekugadzirisa
Suture abrasion, kuputsika, kana kushatirwa kwakabatana nemafundo
Cartilage kukuvara kana anchor yakakurumbira kana kupinda mujoini
Bone reaction, tunnel kuwedzera, cyst kuumbwa, kana osteolysis
Kuzvimba kana kupinduka kwemuviri kune zvimwe zvinhu
Utachiona, kuoma, kurwadziwa kunoramba kuripo, kana kutadza kugadzirisa
Njodzi inosiyana nemaitirwo, kuisirwa zvinhu, nzira yekuvhiya, mhando yetishu, kunaka kwebhonzo, kugadzirisa, uye zvinhu zvemurwere. Kurwadza kutsva kana kuwedzera kuipa, kutsvuka, mvura, fivha, kuzvimba, kubata michina, kana kurasikirwa nekufamba kusingatarisirwi mushure mekuvhiyiwa kunopa mvumo yekukurumidza kuongororwa neboka rekiriniki.
Mhedzisiro yezvidzidzo zvekiriniki inofanirwa kududzirwa mumamiriro ekuita, huwandu hwevarwere, nguva yekutevera, uye dhizaini yekudzidza.
Maonero Anoita Vanachiremba Anchor
Pakusarudza gadziriro yekugadzirisa, timu yekuvhiya inogona kufunga nezve:
Iyo anatomical saiti uye inowanikwa bhonzo vhoriyamu
Cortical uye cancellous bone quality
Huwandu uye mamiriro enyama ari kugadziriswa
Anchor dhayamita, kureba, geometry, uye nzira yekuisa
Metal, PEEK, bioabsorbable, biocomposite, kana zvese-suture kuvaka
Knotted kana knotless kugadzirisa nzira
Suture kana tepi saizi, kumisikidzwa, uye kuenderana
Revision strategy uye postoperative imaging zvinodiwa
Regulatory clearance, traceability, sterile packaging, uye chiridzwa kuenderana
Kuvandudzwa kwechigadzirwa kunoenderera mberi nekunatsa zvinhu, masisitimu ekuisa, mafundo mafundo, uye magadzirirwo ekuchengetedza mapfupa. Zvisineyi, 'zvitsva' hazvingorevi kuti kiriniki yepamusoro. Mhosva pamusoro pekuvhiya nekukurumidza, kuderera kwematambudziko, kuporeswa kwakasimba, kana kuvandudzwa kwemhedzisiro kunofanirwa kutsigirwa nechigadzirwa-chaiyo biomechanical kana kiriniki humbowo.
Vagadziri vanofanirwa kupa akajeka ehunyanzvi zvinyorwa uye anowirirana emhando yekutonga. XC Medico inotsigira orthopedic chigadzirwa kukura uye tekinoroji nyowani mune suture anchors , asi vashandi vezvehutano nevashambadziri vanofanirwa kuramba vachiona zvakatemwa, humbowo, chinangwa chekushandiswa, uye chimiro chekunyoresa chechigadzirwa chimwe nechimwe pamusika wavo.
Suture Anchor FAQ
Ko 'ancho' inorevei pakuvhiyiwa kwemapfupa?
Anchor isimbi diki inoiswa mubhonzo kuti ibate masuture. Iyo sutures inochengetedza tendon, ligament, capsule, kana labrum kurwisa pfupa uku iyo yakagadziriswa tishu inopora.
Ko suture anchors inonyungudika?
Vamwe vanoita uye vamwe havadaro. Titanium, Stainless-simbi, uye PEEK anchors hazvibatike. Bioabsorbable uye mamwe biocomposite anchors akagadzirirwa kuderedza zvishoma nezvishoma, asi izvi zvinogona kutora mwedzi kana makore uye zvinogona kunge zvisina kukwana mumurwere wese.
Musono weanchori wakafanana neanchor yesuture here?
Kwete. 'Anchor stitch' kazhinji inoreva musono patani kana nzira yekuisa. Suture anchor chinhu chinopinzwa mubhonzo kuti chipe poindi yekumisikidza yesuture.
Inguva yakareba sei ma anchors anogara mumuviri?
Zvibatiso zvisingabatike zvinogona kugara zvachose kunze kwekunge kubviswa kwave kuri madikanwa. Zvibatiso zvinobatika zvinodzikisira pamitengo yakasiyana zvichienderana nezvadzinoita, nzvimbo, uye mhinduro yemurwere.
Unogona here kunzwa suture anchor?
Zvibatiso zvakawanda zvinogara mukati memapfupa uye hazvinzwike zvakananga. Kusagadzikana kwePostoperative kunogona kusimuka kubva pakuporesa tishu, kuomarara, kuzvimba, mukurumbira, kuisirwa matambudziko, kana zvimwe zvikonzero. Chirwere chinoramba chiripo kana kuti chinoramba chichiwedzera chinofanirwa kuongororwa nemurapi anorapa.
Anchors anogona kuonekwa paX-rays kana MRI?
Metal anchors anowanzo kuoneka paX-rays uye anogona kugadzira imaging artifact. PEEK ine radiolucent uye haiwanzo kuoneka payakajairwa X-rays. Kuonekwa uye MRI artifact inosiyana nekugadzirwa kwezvinhu uye chigadzirwa, saka varwere vanofanirwa kuudza vashandi vekufungidzira nezve chero mudziyo wakasimwa.
Chii chaunofanira kutarisira mushure mekuvhiyiwa kwesuture anchor?
Kudzoreredza kunosiyana neyakagadziriswa tishu uye maitiro. Varwere vangada kuchengetedzwa kwechinguvana, kufamba kwakaganhurirwa, uye kuvandudzwa kunofambira mberi. Kudzokera kubasa, kuita maekisesaizi, kana mutambo unofanirwa kutevera mirairo yachiremba wezvekuvhiya uye yeboka rekuvandudza pane kuita nguva yakatarwa.
Ndeipi nguva yaunofanira kuonana nachiremba wako mushure mekuvhiyiwa?
Bata boka rinorapa kuti uwedzere kurwadziwa, kutsvuka, mvura, fivha, kuzvimba zvisina kujairika, kubatwa nemagetsi, kupera simba kamwe kamwe, kana kurasikirwa kusingatarisirwe kwekufamba. Zviratidzo zvekukurumidzira zvinofanirwa kuongororwa nekukurumidza.
Kurukurai Zvako Suture Anchor Zvinodiwa
Zvekutsanangurwa kwechigadzirwa, sarudzo dzezvinhu, inoenderana instrumentation, kana OEM kugadzira hurukuro, XC Medico inopa zvakachengeteka uye zvakavimbika zvigadzirwa kwauri.
Medical disclaimer: Ichi chinyorwa ndechezvakawanda zvekudzidzisa uye chigadzirwa-ruzivo zvinangwa. Iyo haipe kuongororwa, zano rekurapa, kana kurudziro kune chaiyo implant. Varwere vanofanirwa kubvunza nyanzvi yezvehutano ine hunyanzvi. Kuwanikwa kwechigadzirwa, chinangwa chekushandiswa, uye chimiro chekutonga chinosiyana nemusika.
