Knee Ligament Fixation Devices Inoshandura Sei ACL Kugadzirisa?

Mushonga wemitambo · ACL reconstruction guide

ACL graft fixation midziyo inochengetedza kuvaka patsva kune femur uye tibia nepo biological kubatanidzwa kunokura. Kupindira screws, cortical mabhatani, staples, posts, anchors, uye mahybrid magadzirirwo anogadzira kugadzirisa munzvimbo dzakasiyana uye nenzira dzakasiyana. Hapana mudziyo mumwechete wakanakira murwere wese, graft, tunnel, kana kudzokorora mamiriro.

Kwekutanga kugadzikana Kugadziriswa kunodzivirira nzvimbo yegraft uye kushushikana panguva yekutanga kusati kwabatanidzwa-kune-bone kubatanidzwa.

Technique-chaiyo sarudzo Graft mhando, mhando yebhonzo, tunnel dhizaini, revision anatomy, uye chiremba wekuvhiya ruzivo kutungamira sarudzo.

Hapana anokunda wepasirese Nzira dzekugadzirisa dzakajairwa dzinogona kuburitsa zvibereko zvakanaka kana dzakanyatsoenderana uye dzakashandiswa nemazvo.

Knee joint anatomy uye ACL graft fixation pfungwa — Kuvaka patsva kweACL kunoda gireti yakanyatsomira uye yakachengeteka kugadzirisa pamativi ese echikadzi uye tibial.

ACL Repair uye ACL Reconstruction Haisi Iyo Yakafanana Maitiro

Izwi rekugadzirisa ACL uye ACL rekuvaka harifanirwe kushandiswa zvakasiyana.

Nzira	Chii chinorapwa	Kugadziriswa kunoshandiswa sei
Primary ACL kugadzirisa	Misodzi yakasarudzwa inofananidzwa zvakare mukuedza kuchengetedza ligament yemurwere.	Sutures, anchors, mabhatani, kana yekuwedzera kuvaka inogona kutsigira yakagadziriswa ligament, zvichienderana nehunyanzvi.
ACL kuvakazve	ACL yakabvaruka inotsiviwa ichishanda ne autograft kana allograft.	Iyo graft inochengeterwa mufemoral uye tibial tunnels kana zvigadziko uchishandisa aperture, suspensory, kana hybrid fixation.

Ichi chinyorwa chinonyanya kutarisisa pakugadzirisa kwegraft panguva yekuvakazve ACL . Kugadziriswa kwekutanga kunowanikwa chete kwemaitiro akasarudzwa ekukuvadza uye ane zviratidzo zvakasiyana, biology, instrumentation, uye kugadzirisa mafungiro.

Maturusi ekugadzirisa haaite kuti ACL maitiro aite zvishoma ega. Arthroscopic yekuwana, mugero kana socket kugadzirira, sarudzo yegraft, yakabatana meniscal kana cartilage kurapwa, uye iyo yese yekuvhiya nzira inosarudza kukanganisa kwetishu uye kupora.

Sei Graft Fixation Inobata mu ACL Reconstruction?

A reconstruction graft inofanira kubereka kudzikamisa basa rekuzvarwa ACL. Pamberi pekubatanidzwa kwebiological kwatangwa, iyo yekugadziridza inotakura inotakura mutoro uye inodzikamisa kusimuka kwegraft. Chinangwa ndechekuchengetedza nzvimbo yakarongwa yegraft uye kushushikana pasina kukuvadza girafu kana kukanganisa bhonzo.

Graft yakagadzirirwa Rudzi, saizi, kureba, uye magumo ekugadzirisa anosimbiswa.

Tunnels kana zvigadziko zvakagadzirwa Nzvimbo, dhayamita, kureba, uye cortex inoongororwa.

Graft yakapfuura uye tensioned Oriental uye zvigaro zvinotariswa.

Fixation yakasimbiswa Chinzvimbo cheChishandiso, kusawirirana kwegraft, kufamba, uye kugadzikana kunoongororwa.

Kugadzirisa chikamu chimwe chete chekuvaka patsva. Kuiswa kweTunnel, kusarudzwa kwegraft nekugadzirira, kunyepedzera, nzvimbo yemabvi panguva yekugadzirisa, kurapwa kwekukuvara kwakabatana, kugadzirisa, uye zvinhu zvevarwere zvinokanganisawo mhedzisiro.

Aperture, Suspensory, uye Supplemental Fixation

Aperture fixation

Aperture fixation inochengetedza girafu pedyo nejoin-line kuvhurwa kwebhonzo tunnel. An interference screw ndiyo muenzaniso unozivikanwa. Iyo screw inomanikidza yakapfava-tishu graft kana bhonzo block pamadziro etunnel. Izvi zvinogona kudzikamisa gireti-tunnel kufamba, asi kuiswa kunofanirwa kudzivirira graft laceration, kupatsanura, kupinda mukati, uye kurasikirwa kwekugadzirisa.

Suspensory fixation

Suspensory fixation inoendesa graft mutoro kune yekunze cortex. Bhatani rekortical rine yakagadziriswa kana kugadziriswa loop inowanzoshandiswa padivi remukadzi uye inogona kushandiswa nemaitiro ose emukati. Kureba chaiko kwemugero, bhatani ndima, cortical deployment, loop manejimendi, uye zvigaro zvegraft zvakakosha.

Supplemental kana hybrid kugadzirisa

Chigadzirwa chakasanganiswa chinosanganisa nzira dzekugadzirisa, kana kuwedzera staple, post-and-washer, anchor, kana chimwe chishandiso chekuchengetedza apo chiremba anovhiya ane zvinonetsa nezvekutanga kugadzirisa. Supplemental fixation inowedzera interfaces uye hardware, saka kubatsirwa kwayo uye zviratidzo zvinogona kutariswa kune imwe nyaya.

Mhando dzeKnee Ligament Fixation Devices

Kupindira screws

Aperture fixation Femoral kana tibial

Yakaiswa mukati memugero kudzvanya graft kana bone block. Sarudzo dzinosanganisira simbi, PEEK, uye bioabsorbable kana biocomposite zvinhu. Diameter, kureba, dhizaini yeshinda, nzira yekuisa, uye nyaya yekudzivirira yegraft.

Cortical mabhatani

Suspensory fixation Yakagadziriswa kana inogadziriswa loop

Bhatani rinogara pane yekunze cortex apo loop inotsigira graft. Iyo tekinoroji inogona kugarisa akapfava-matishu grafts uye socket-based kuvakazve, asi inoda yakasimbiswa kutumirwa uye zvigaro.

Staples uye posts

Supplemental fixation Backup sarudzo

Ligament staples kana screw-and-washer constructs inogona kuchengetedza sutures kana kusimbisa tibial fixation mumatambudziko akasarudzwa. Hardware mukurumbira uye kushatirwa kwenzvimbo ndiko kufunga kwakakodzera.

Suture anchors uye augmentation

Kugadzirisa kana kusimbisa Technique inotsamira

Anchors anogona kuchengetedza zvinyoro zvinyoro kana sutures mune yakasarudzwa kugadzirisa uye nzira dzekuwedzera. Suture-tepi augmentation haitsivi chiratidzo chakarurama, kuiswa kweanatomic, kushushikana kwakakodzera, kana kupora kwebiological.

Mienzaniso yeACL ligament fixation zvishandiso zvekuvaka patsva — ACL fixation systems inogona kusanganisira kupindira screws, mabhatani, staples, anchors, uye maitiro-chaiwo ekupinza zviridzwa.

Metallic, PEEK, uye Bioabsorbable Fixation Materials

Boka rezvinhu	Zvinogoneka zvakanakira	Pfungwa dzakakosha
Titanium kana zvimwe zvigadzirwa zvesimbi	Simba rakakwirira, kushandiswa kwakasimbiswa, kunoonekwa pamaradiographs, uye hapana mhinduro yekuderedza.	Imaging artifact, zvinogoneka zviratidzo zvehardware, uye zvinogona kukanganisa basa rekudzokorora mugero.
PEEK	Radiolucent polymer, hapana bioabsorption, uye nyore kuona kwenzira yakatenderedza pane imwe fungidziro.	Mudziyo unoramba uri mumuviri; chinzvimbo chinogona kuda radiopaque mamaki kana kumwe kuoneswa.
Bioabsorbable kana biocomposite polymers	Yakagadzirirwa kudzikisira nekufamba kwenguva uye inogona kuderedza zvachose implant zvinhu.	Kudzikira kune zvinhu-zvakananga; cyst, mhinduro yekuzvimba, kuputsika, kutama, kana shanduko yemugero yakataurwa.

Meta-analysis ye14 randomized miedzo yakawana pasina mutsauko wakakura mukuzviisa pasi pemabvi basa kana kusununguka pakati pe bioabsorbable uye metallic interference screws, nepo boka rebioabsorbable raiva nepamusoro-soro pangozi yezvinetso. Izvi hazvireve kuti simbi yese sikuruu inodiwa; zvinhu, dhizaini, kubatanidza, tekiniki, uye mamiriro evarwere zvichiri kukosha.

Maitiro ekuvhiya anosarudza ACL Fixation Construct

Kusarudzwa kunoitirwa mativi maviri egraft. Iyo femoral uye tibial zvishandiso hazvifanirwe kushandisa iyo imwechete nzira. Zvinhu zvakakosha zvinosanganisira:

Graft: bone-patellar tendon-bone, hamstring, quadriceps tendon, autograft kana allograft, soft-tissue-chete kana bone-block end.
Tunnel dhizaini: izere mugero kana soketi, dhayamita, kureba, cortical kutendeseka, tunnel kutungamira, uye iripo pfupa stock.
Zvirwere zvevarwere: hutano hwemapfupa, zera, zvinangwa zvekuita, skeletal maturity, kuvhiyiwa kwekare, uye kukuvara kwakabatana.
Kuvhiyiwa kwepuraimari kana kudzokororwa: kukwidziridzwa kwemugero, kuchengetedzwa kwehardware, kuremara kwemapfupa, uye kudiwa kwekuvakwa patsva.
Kuvaka zvinodiwa: kurongeka kwakarongwa kutevedzana, nzvimbo yekugadzirisa, gadziriro yekuchengetedza, zvido zvekufungidzira, uye kudzokororwa kunotarisirwa.
Kuenderana kweSistimu: saizi yegraft, dhiraivha uye dhairekitori zviyero, zvinopinza zvekuisa, loop kureba, screw dimensions, uye yakasimbiswa chiridzwa-chishandiso chinopindirana.
Chiitiko cheChiremba: kujairana nekutumirwa, nzira dzekutadza, sarudzo dzekununura, uye intraoperative verification.

XC Medico's ACL/PCL ligament fixation system inoratidza mienzaniso yekudyara uye magadzirirwo emidziyo. Ruzivo rwechigadzirwa runofanira kugara ruchiongororwa maererano nemvumo yekushandiswa kwechigadzirwa uye maitiro akarongwa nachiremba.

Ko Mabhatani kana Kupindira Screws Inoburitsa Zvirinani Mibairo?

Humbowo hwazvino hautsigire kurongeka kwepasi rose. Network meta-analysis inoenzanisa kupindira sikuruu, cortical bhatani, uye cross-pini femoral fixation ye hamstring autografts yakawana pasina misiyano yakakosha pane yekutanga kliniki mhedzisiro yakadzidzwa. Imwe ongororo yakarongeka yakawana basa rakafanana, kushaya simba, uye kudzoreredza mhedzisiro pakati pese-mukati mekumiswa kwekugadzirisa uye yakazara-mugero kuvakazve, nepo mamwe radiographic tunnel zvakawanikwa zvakasiyana.

Mubvunzo wekuenzanisa	Kuturikira zvine mwero
Ko aperture fixation yakawanda anatomic here?	Iyo inochengetedza gireti padhuze nekuvhurwa kwemutsara-mutsara wekuvhura, asi budiriro yeanatomic zvakare inoenderana neyakaringana tunnel chinzvimbo, saizi yegraft, kushushikana, uye kuiswa.
Ko suspensory fixation yakasimba here?	Cortical kuturika kunogona kupa simba rekutanga rakakwana, asi kuita kwekuvaka kunoenderana nekugara kwebhatani, loop maitiro, cortex, tunnel, uye graft.
Ko bioabsorbable screw inovandudza mhedzisiro?	Iyo inoderedza zvimiro zvesimbi zvechigarire, asi hukuru hwekiriniki hahusati hwasimbiswa uye matambudziko akanangana nezvinhu anoda kutariswa.
Ko backup fixation inogara ichibatsira here?	Inogona kubatsira kana kugadzirisa kwekutanga kuri kunetseka, asi inowedzera Hardware uye inogona kusanatsiridza zvine musoro mhedzisiro mukuvakazve kwega kwega.

Mhedziso inoshanda ndeyekuti yakachengeteka, yakanyatso shandiswa gadziriso inofananidzwa negraft uye mugero wakakosha pane kusarudza mudziyo nekutengesa chikamu chete.

Sei Chiridzwa Sets Tsigiro Reproducible ACL Reconstruction

Implant inoshanda sechikamu chehurongwa hwakakwana. Tunnel dhairekitori, masaizi ezvivharo, anopfuura sutures, reamers, kudzika geji, mabhatani anopinza, screwdriver, matepi, maturusi ekugadzirira maturusi, uye tireyi sangano zvese zvinokanganisa mafambiro ebasa. Nhungamiro isingaenderane, mutyairi akakuvadzwa, saizi yekubooresa isiriyo, kana chiridzwa chisipo chekupfuura chinogona kukanganisa imwe nzira yakakodzera yekugadzirisa.

All-in cruciate ligament reconstruction instrument yakagadzirirwa ACL uye PCL kuvhiyiwa — Nzira-inofananidzwa chiridzwa seti inogona kuronga mugero wekugadzirira, girafu ndima, uye matanho ekugadzirisa eACL kana PCL kuvaka patsva.

Explore an all-in cruciate ligament reconstruction instrument set kana yakafara arthroscopy instrument-set range . Usati washandisa, simbisa zviri mukati metireyi, kuenderana, kuchenesa uye sterilization mirairo, maitiro ekuongorora, uye kutsiva kuwanikwa.

Zvinogona Kugadziriswa-Zvinoenderana Nematambudziko

Matambudziko anogona kubuda kubva muchishandiso, kubatanidza, mugero, tekinoroji, biology, kutapukirwa, kudzoreredza, kana kukuvara zvakare. Matambudziko ane chekuita nekugadzirisa anogona kusanganisira:

kurasikirwa kwekugadzirisa, kutsvedza kwegraft, kurebesa, kana kuvaka kusunungura;
kutama kwebhatani, cortical deployment isina kukwana, soft-tissue interposition, kana matambudziko ane chekuita ne loop;
screw divergence, kuputsika, kutama, kupinda mukati, kana kukuvara kwegraft panguva yekuisa;
akatanhamara staple, post, washer, kana bhatani rinokonzera kushatirwa kwenzvimbo;
kuwedzera kwemugero, kuumbwa kwecyst, kana mhinduro ine chekuita nekuzvimba;
kuomerwa nekududzira kwekufungidzira kana kugadzirira remangwana rekudzokorora mugero;
hutachiona, kuoma, arthrofibrosis, kusagadzikana kunoramba kuripo, kukundikana kwegraft, kana kukuvara zvakare.

Zviratidzo uye kupora hazvigone kufanotaurwa kubva pachigadziro chekugadzirisa chete. Kusagadzikana kutsva, fivha, maronda emvura, kuwedzera kuzvimba, kurwadziwa kwemhuru, kurasikirwa kwekufamba, kana kurwadziwa kusingatarisirwi kuri kuwedzera kunoda kuongororwa neboka rekiriniki rinorapa.

Kugadzirisa Kwakasimba Kunoreva Kukurumidza Kudzoreredzwa Here?

Kuchengetedza kwekutanga kugadzirisa kunobatsira kutsigira chirongwa chekudzorera chakarongwa, asi hachingopfupiki kupora. Kutakura uremu, kubvongodza, kufamba-famba, kusimbisa, kumhanya, kutenderera, uye kudzoka-ku-mutambo kufambira mberi kunoenderana negraft, inobatanidza meniscal kana cartilage maitiro, kugadzirisa, kuzvimba, simba, neuromuscular control, kuongororwa kwekliniki, uye chiremba anovhiya uye chiremba wepanyama protocol.

Nhungamiro yeAAOS inosimbisa ongororo yekushanda isati yadzokera kumitambo uye inokurudzira kuvandudzwa kwemunhu mumwe nemumwe. Chigadziriso chekugadzirisa hachifanirwe kushandiswa sechikonzero chega chekumhanyisa kurodha kana kubvisa bhurashi. Mazhinji ACL reconstruction anoitwa senzira dzekunze, asi nguva yekubuda inotarwa nemamiriro ekiriniki akazara kwete chikamu chekuisa.

Chii Chinofanira Kutariswa Zvipatara uye Vanogovera?

Kuongorora kwekutenga kunofanirwa kubatanidza kuisirwa kwega kwega kune zviridzwa zvayo, kunyora, zvinyorwa zvemitemo, uye kuteedzera. Katalogi yakakwenenzverwa kana kuti yakafara yekuteedzera nyika haina kukwana.

Simbisa chinangwa chekushandiswa uye mvumo yemusika Matanidza mudziyo chaiwo, modhi, zvinhu, mugadziri wepamutemo, kupatsanura, uye musika wekuenda.
Ongorora kuenderana kwekudyara-chiridzwa Chengetedza nzvimbo dzemutyairi, chibooreso uye saizi yemugero, zvinopinza, mageji akadzika, mabhatani, zvishwe, screws, staples, uye backup sarudzo.
Simbisa zvekushandisa uye humbowo hwemuchina Kumbira zvakatemwa, zvitupa-zvakabatana zvakawanda, bvunzo dzakakodzera, nzira dzekuongorora, uye maitiro ekugamuchira.
kurongedza uye sterilization mamiriroOngorora
Ongorora tireyi yakazara Shandisa inodzorwa kuverenga pepa, simbisa mamaki uye mamiriro, uye bvunzo chiridzwa basa usati watenderwa.
Ongorora shanduko yekutonga nerutsigiro rwekunyunyuta Tsanangura chiziviso chekuchinja kune zvinhu, dhizaini, mutengesi, maitiro, kunyora, kurongedza, kana sterilization.

Vatengi vanogona kuongorora XC Medico's kutonga kwemhando uye maitiro ekuongorora uye kukumbira humbowo-chaicho chemudziyo panguva yekufanirwa.

Inoenderana XC Medico Sports Medicine Zviwanikwa

Ligament Fixation System ACL/PCL yekuvakazve maimplants, kugadzirisa sarudzo, uye zviridzwa zvinoenderana. Ligament Fixation Staple Staple zvirevo zvezvakasarudzwa zvinyoro-tishu uye zvekuwedzera kugadzirisa zvikumbiro. Cruciate Ligament Instrument Set Guides uye zviridzwa zve ACL/PCL tunnel uye socket kugadzirira. Arthroscopy Instrument Sets Bhurawuza maitiro-yakananga arthroscopy uye ligament kuvakazve zviridzwa. Suture Anchors Anchor zvigadziriso zvezvakasarudzwa zvinyoro-tishu kugadzirisa maitiro. Sports Medicine System Ongorora ligament, meniscal, arthroscopy, suture, uye zvine chekuita nemitambo-mishonga zvigadzirwa. Hunhu Kudzora Ongororo yekugadzira yekuongorora, marabhoritari, uye ruzivo rwekuteedzera. Technical Product Inquiry Chikumbiro chakanangana, ruzivo rwekuenderana, zvitupa, kana zvinyorwa zvechigadzirwa.

Mibvunzo Inowanzo bvunzwa

Chii chinobata ACL graft panzvimbo?

Iyo graft inowanzo chengetedzwa pamativi echikadzi uye tibial nekukanganisa screws, cortical mabhatani, cross-pini, mbiru, staples, kana musanganiswa. Kuvaka kunoenderana nemhando yegraft, tunnel dhizaini, mhando yebhonzo, uye hunyanzvi.

Ndeupi mutsauko uripo pakati pekukanganisa screw nebhatani recortical?

Iyo yekukanganisa screw inopa aperture gadziriso nekumanikidza graft kana bhonzo block mukati memugero. Bhatani recortical rinopa suspensory fixation nekugara pane yekunze cortex uye nekutsigira kugraft kuburikidza ne loop.

Ko masiruuru anobatika ACL ari nani pane masiruu esimbi?

Kwete pasi rose. Randomized-yeyedzo humbowo hwakawana yakafanana subjective basa uye laxity, nepo mamwe akaunganidzwa ongororo inoshuma mamwe matambudziko ane bioabsorbable screws. Material, dhizaini, tekinoroji, kufungidzira, uye kudzokorora kufunga zvese zvine basa.

Ko iyo imwechete yekugadziridza mudziyo inogona kushandiswa kune yega yega graft?

Kwete Bone-block uye soft-tissue grafts ane nzvimbo dzakasiyana-siyana, uye graft dhayamita, kureba, tunnel design, uye cortical bone zvinokanganisa kuenderana. Tevedzera zvakatenderwa mudziyo mirayiridzo uye akaronga kuvhiya unyanzvi.

Ko simbi yemukati inotsiva iyo ACL graft?

Kwete zvoga. Suture-tape augmentation inogona kusimbisa yakasarudzwa kugadzirisa kana kuvakazve kuvaka, asi basa rayo rinoenderana nemaitiro uye chiratidzo. Iyo haigadzirise hurombo husina kunaka hwematishu, nonanatomic kuiswa, kana kusakwana kwekutanga kugadzirisa.

Ko ACL fixation zvishandiso zvinoda kubviswa here?

Kubvisa nguva dzose hakudiwi nguva dzose. Kubvisa kunogona kutariswa sechiratidzo kana chakakurumbira Hardware, hutachiona, kutama, kuvhiyiwa kwekudzokorora, kana chimwe chikonzero chekiriniki.

Mhedziso

Midziyo yekugadziridza yeACL inoita kuti kuvakwazve kwemazuva ano kugoneke nekudzikamisa gireti uku kubatanidzwa kwebiological kunoitika. Kukosha kwavo kunouya kubva mukusanganiswa kwechiratidzo chaicho, anatomic tunnel yekuisa, inoenderana chiridzwa, yakakodzera graft tension, yakasimbiswa mudziyo wekuisa, uye yakarongeka kugadzirisa. Kupindira screws, cortical mabhatani, uye mahybrid anovaka chimwe nechimwe chine mabasa anobatsira; Sarudzo inofanira kuitwa yega kwete kubva pane 'zvakanakisa mudziyo' zvinoda.

References uye Basi reKunyora

Medical uye regulatory disclaimer: Ichi chinyorwa ndechedzidzo yakajairika uye nehunyanzvi chigadzirwa-referenzi zvinangwa. Izvo hazvitarise kukuvara kwe ACL, kurudzira kuvhiyiwa, sarudza kuisirwa, kana kutsiva mirairo yemudziyo, mirau yenzvimbo, kana kuongororwa neanokwanisa hutano uye nyanzvi dzekutonga. Kuwanikwa kwechigadzirwa uye zviratidzo zvine mvumo zvinosiyana nenyika.