Li-Screws tsa Tšitiso ke Life le Karolo ea Tsona ho Opereishene ea Orthopedic?

U sebelisa li-screws tsa tšitiso ho tšoara li-graft ka thata lithapong tsa masapo nakong ea opereishene ea masapo. Li-screws tsena li bohlokoa ho lokisoeng ha li-ligament le lisele tse bonolo, haholo-holo litokisong tsa acl, hobane li boloka lintho li tsitsitse. Boithuto bo bonts'a hore li-screw tsa bioabsorbable le tsa titanium li sebetsa ka mokhoa o ts'oanang, ka hona ke khetho e ntle bakeng sa mosebetsi oa hau. Litsamaiso tse ncha, joalo ka Ligament Fixation System ka XC Medico , tlisa mehopolo e mecha ho liopereishene tsa hau le ho u thusa ho fumana liphetho tse ntle bakeng sa bakuli.

Lintlha tsa bohlokoa

• Li-screws tsa ho kena-kenana li thusa ho boloka li-graft li tsitsitse likotopong tsa masapo nakong ea opereishene. Li bohlokoa haholo bakeng sa ho lokisa li-ligaments.

• Li-screw tse nang le bioabsorbable le li-screw tsa titanium ka bobeli li sebetsa hantle bakeng sa liopereishene tsa ACL. Ba thusa bakuli ka tsela e tšoanang.

• Ho khetha boholo bo botle ba screw le thepa ke habohlokoa haholo. E thusa batho ho fola hantle le ho fokotsa menyetla ea mathata.

• Likhopolo tse ncha joalo ka Ligament Fixation System ka XC Medico e etsa hore ho buuoa ho be betere. Ba sebelisa thepa e matla le meralo e bohlale ho feta.

• Lingaka li hloka ho shebella bakuli ka mor'a ho buuoa. Sena se thusa ho fumana mathata kapele mme se etsa bonnete ba hore pholiso e tsamaea hantle.

Tlhaloso ea Li-Screws tsa Tšitiso

Li-Screws tsa Tšitiso ke Eng

Li-screws tsa ho kena-kenana li thusa ho tšoara li-graft ka thata lithapong tsa masapo nakong ea opereishene. Li bohlokoa bakeng sa ho lokisa li-ligamente le lisele tse bonolo. Hangata lingaka li li sebelisa ho lokisa ACL. Li-screw tsena li boloka graft e tsitsitse ka ho e hatella khahlanong le lesapo. Sena se thusa hore graft e fole le ho ikopanya le lisele tse e potolohileng.

Lingaka li re li-screws tsa ho kena-kenana ke mokhoa o tloaelehileng oa ho lokisa likotsi tsa ACL. Li sebetsa bakeng sa tokiso ea lesapo ho isa lesapong le ho lokisa lisele tse bonolo ho isa lesapong. Li-screw li tšoara graft sebakeng 'me li lumella lingaka ho laola boemo ba eona le ho tiea. Taolo ena e thusa bakuli ho fola hantle le ho fola kapele.

Tlhokomeliso: Li-screw tsa tšitiso lia tšeptjoa ebile li ithutoa bakeng sa tokiso ea ligament. Liphuputso tse ngata li bontša hore li sebetsa hantle ho opereishene ea bone-patellar tendon-bone ACL.

Kamoo Li-Screws tsa Tšitiso li Sebetsang Kateng

Ntlha ea pele, lingaka li etsa kotopo lesapong moo ligament e hlokang ho lokisoa. Ka mor'a moo, ba kenya kotopo ka kotopong ena. Sekurufu se sututsa sehlomathiso khahlanong le lebota la kotopo. Sena se etsa hore sethopo se se ke sa sisinyeha.

Mona ke se etsahalang nakong ea opereishene:

• Lingaka li phunya kotopo lesapong, hangata bophara ba limilimithara tse 8.

• Ba kenya sehlomathiso ka kotopo.

• Ba beha screw ea tšitiso haufi le graft ebe ba e hatella ka thata.

• Bonyane 20 mm ea graft e lula ka har'a kotopo bakeng sa matla.

• Lingaka li ka sebelisa li-screw tse monyehang kapa tsa tšepe, ho latela boemo.

Mesebetsi ea mantlha ea li-screws tsa interference ke:

• Ho boloka graft sebakeng se nepahetseng le ho tiea ho nepahetseng.

• Ho tshoara ka matla moo sekukuru se thetsang lesapo.

• Ho tšoara graft ka thata ho fihlela lesapo le fola.

Ho na le mefuta e mecha ea li-screws tsa ho kena-kenana le tsona. Tse ling li entsoe ka magnesium e senyehang 'meleng. Ba bang ba kopanya magnesium le litšepe tse ling bakeng sa matla a eketsehileng. Ba bang ba entse joalo libopeho tse ncha tsa khoele ho tšoara hantle . Liphetoho tsena li thusa li-screw ho sebetsa hantle le ho thusa masapo ho fola.

Liphuputso li bontša hore li-screws tse tapered li thata ebile li boloka graft e le thata ho feta li-screw tse tloaelehileng. Sena se bolela hore bakuli ba fumana mangole a molemo le a matla ha nako e ntse e ea.

Lingaka li itšetleha ka li-screws tsa ho kena-kenana ho boloka li-graft li bolokehile ha li ntse li fola. Moqapi le lisebelisoa li thusa lingaka ho fumana liphello tse ntle ha li lokisa li-ligamente.

Mefuta le Lisebelisoa tsa Li-Screw tsa Tšitiso

Metal le Bioabsorbable Options

Ho na le mefuta e fapaneng ea li-screws tsa tšitiso bakeng sa ho lokisa li-ligamente. Lisebelisoa tse sebelisoang haholo ke:

• Titanium

• Ts'epe e sa beng le mabali

• Polymer

• Khalase ea bioactive

Li-screws tsa tšepe, joalo ka titanium, li matla haholo 'me li nka nako e telele. Titanium ha e ruse, kahoo e lula e le ntle ka hare ho 'mele. Lingaka li sebelisa li-screws tsa titanium bakeng sa linyeoe tse thata hobane li matla haholo ho feta li-screws tse nang le bioabsorbable. Li-screw tsa Titanium li ka ba le matla a tlhahiso a ka bang 1130 MPa. Sena se batla se feta makhetlo a leshome ho feta li-screw tse ling tse absorbable, joalo ka PLA. Kahoo, li-screws tsa titanium li fana ka tšehetso e matla ha u e hloka haholo.

Li-screws tse nang le bioabsorbable li entsoe ka lintho tse kang PLA kapa magnesium. Likurufu tsena li senyeha butle-butle 'meleng. Magnesium ke tšepe e bobebe e matla 'me e ka monngoa ke' mele. Li-screw tsena li ka boloka lintho sebakeng sa liopereishene tse ngata. Li-screws tse ncha tse khonang ho monya li batla li le thata joaloka li-screw tsa titanium, ho fihla ho 90%. Empa, li ntse li se matla joalo ka likurufu tsa tšepe. Leha ho le joalo, liphuputso li bontša hore mefuta ka bobeli e sebetsa hantle bakeng sa botsitso ba lengole ka mor'a ho buuoa ka ACL. Ha ho na mathata a mangata ka mofuta o mong ho feta o mong.

Likarolo tsa Moqapi le Litlhahiso

Li-screw tsa ho kena-kenana li lula li ntlafala ka meralo e mecha. Li-crews joale li na le libopeho tse fapaneng, likhoele, le lisebelisoa ho li thusa ho tšoara le ho fola hamolemo. Mohlala, sebopeho sa conical kapa tapered core se etsa hore screw e tšoarelle ka thata. Sena se thusa screw ho boloka graft e le teng. Tafole e ka tlase e bontša kamoo sebopeho sa screw se fetolang matla a ho hula:

Libopeho tse ncha tsa khoele le malebela a matle a li-screw li etsa hore ho be bonolo ho kenya screw. Li boetse li etsa hore ho nke matla a fokolang. Li-screws tsa Hybrid li sebelisa likarolo tsa thepa e fapaneng ho ba matla le ho bolokeha bakeng sa 'mele. Titanium le PEEK ke likhetho tse ntle hobane li bolokehile ebile li thusa lesapo ho hola. Mehopolo ena e mecha e thusa lingaka ho boloka graft e tsitsitse le ho thusa bakuli ho fola hamolemo.

Li-Screws tsa ho kena-kenana tsa ACL ha ho buuoa

Likopo tsa ho tsosolosa ACL

Li-screws tsa ho kena-kenana tsa ACL li tšoara li-graft nakong ea opereishene ea ACL. Likurufu tsena li hatella sehlomathiso khahlanong le kotopo ea masapo. Sena se boloka graft e tsitsitse e le hore e ka fola hantle. The graft tlama le lesela le pota-potileng. U ka khetha li-screws tsa tšepe kapa tsa bioabsorbable bakeng sa opereishene ea ACL. Mefuta ena ka bobeli e sebetsa hantle 'me e fana ka liphello tse tšoanang.

Ha u khetha li-screw tsa ACL, u batla hore graft e lule e khutsitse. Ha ea lokela ho sisinyeha ha e ntse e fola. Lithuto li bonts'a li-screws tse nang le bioabsorbable tse nang le hydroxyapatite li sebetsa hantle haholo. Ha li bake litla-morao tse mpe. Li-screws tsena ke khetho e ntle ho e-na le li-screws tsa titanium. Li-screws tsa tšepe le li-bioabsorbable li hlōleha ka tekanyo e lekanang. Bakuli ba etsa hantle ka mofuta ofe kapa ofe.

Ka linako tse ling, lingaka li sebelisa lisebelisoa tse feto-fetohang tsa suspensory fixation. Lisebelisoa tsena li boetse li fana ka liphello tse ntle le ho boloka lengole le tsitsitse. Sekhahla sa ho hloleha se tlase, joalo ka lisebelisoa tse ling. Li-screws tsa ho kena-kenana tsa ACL li fana ka matla a ho tiisa lesapo ho isa lesapong le ho tiisa mesifa e bonolo. Sena se thusa bakuli ho fola kapele le ho khutlela mesebetsing ea bona.

Keletso: Etsa bonnete ba hore graft e bonyane 20 mm ka har'a kotopo ea masapo. Sena se thusa hore sefate sa graft se lule se le matla 'me se fole hantle.

Lisebelisoa tse ling tsa ho lokisa Ligament

Li-screws tsa ho kena-kenana ha se tsa ho buuoa ka ACL feela. Lingaka li li sebelisa bakeng sa tokiso ea ligament tse ling, joalo ka PCL le MPFL. Li-screw tsena li thusa ho lokisa li-ligamente le lisele tse bonolo libakeng tse ngata. Li sebetsa bakeng sa tokiso ea lesapo ho isa lesapong le ho lokisa lisele tse bonolo ho isa lesapong.

The Ligament Fixation System ka XC Medico e na le likarolo tse ncha bakeng sa liopereishene tsena. E sebelisa PEEK, e bolokehileng bakeng sa 'mele ebile e sa bake maikutlo a mabe. Li-screw li tla ka boholo bo bongata ho lekana litlhoko tse fapaneng. Li-screw tsa PEEK li lumella lingaka ho bona litšoantšo tse hlakileng ka mor'a ho buuoa. Li bonolo ho li kenya, tse bolokang nako ka kamoreng ea ho sebetsa. Sistimi e bolokehile bakeng sa litlhahlobo tsa MRI, kahoo lingaka li ka hlahloba pholiso ntle le mathata.

Mona ke tafole e nang le likarolo tsa bohlokoa tsa Ligament Fixation System ka XC Medico:

Lingaka li sebelisa li-screws tsa ho kena-kenana le li-screws nakong ea liopereishene tse ngata tsa ACL. Li-screws tse nang le bioabsorbable ke tsona tse tloaelehileng ka ho fetisisa bakeng sa ho tšoara graft ka tibia. Bakuli ba bang, haholo-holo baatlelete ba bacha, ba ka utloa bohloko moo screw e leng teng. Li-cysts li ka hlaha ho fihlela ho 5% ea linyeoe ka mor'a ho buuoa ka ACL ka li-screws tse nang le bioabsorbable. Sena se etsahala hobane 'mele o itšoara ho screw, kahoo lingaka li shebella bakuli haufi-ufi.

Lingaka li khetha li-screws tsa tšitiso hobane li sebetsa hantle bakeng sa liopereishene tse ngata tsa ligament le lisele tse bonolo. Ba tšepa li-screw tsena ho tšoara graft ka thata le ho thusa bakuli ho fola hantle.

Ho Khetha Li-Screws tsa Tšitiso

Khetho ea Lintho le Boholo

Ha u khetha li-screws tsa tšitiso, u tlameha ho nahana ka thepa le boholo. Sekurufu se nepahetseng se thusa bakuli ho fola hantle. Ho lumellana ha lintho ho bohlokoa bakeng sa lisele tsa 'mele. U batla ho thibela liketso tse mpe hore li se ke tsa etsahala. Lisebelisoa tsa biocompatible, joalo ka li-polymers tse monyehang kapa titanium, hangata li sebelisoa. Lisebelisoa tsena li thusa ho boloka 'mele o sireletsehile.

U lokela hape ho sheba li-screws tse entsoeng ka machining a nepahetseng. Sena se bolela hore screw e lumellana hantle 'me e tšoara graft ka thata. Ho lekana hantle ho ka etsa hore opereishene e sebetse hantle.

Boholo ba screw bo bohlokoa, hape. Li-diameter tse kholoanyane tsa screw li fana ka matla a ho lokisa haholoanyane. Sena se thusa hore graft e lule e le teng. Tafole e ka tlase e bonts'a hore na boholo ba screw bo fetola liphetho joang:

Mehopolo ea Mokuli le ea Opereishene

U lokela ho lula u nahana ka mokuli e mong le e mong ha u khetha li-screw. Boleng ba masapo bo bohlokoa haholo. Haeba mokuli a e-na le masapo a matla, u ka sebelisa screw e fapaneng le ea masapo a fokolang. Boemo ba ts'ebetso le bona bo bohlokoa. Baatlelete ba ka 'na ba hloka li-screw tse matla.

Tafole ke ena ho u thusa ho tseba seo u lokelang ho se hlahloba:

Ho amahanya screw le opereishene ho bohlokoa haholo. Boithuto bo bonts'a screw e nepahetseng e thusa bakuli ho fola kapele le betere. U ka thusa bakuli ka ho tsepamisa maikutlo ho lintlha tsa nyeoe ka 'ngoe. Mokhoa ona o hlokolosi o u thusa ho fana ka tlhokomelo e ntle ka ho fetisisa ho acl le liopereishene tse ling tsa ligament.

Likotsi le Litlhokomelo

Mathata a ka 'nang A etsahala

Ha lingaka li sebelisa li-screws tsa ho kena-kenana, li tlameha ho shebella mathata. Mathata ana a ka fetola tsela eo liopereishene tse kang mosebetsi oa ho aha bocha acl. Mathata a mang a tloaelehileng ke:

• Sekurufu se ka robeha.

• 'Mele o ka itšoara le ho ruruha.

• The graft e ka khaoloa.

• Sekoti se kanna sa se be sebakeng se nepahetseng kapa sa tiea ka ho lekana.

Hoo e ka bang mokuli a le 1 ho ba 10 a ka ba le matšoao ka mor'a ho buuoa. Hoo e ka bang 5% ea bakuli ba hloka opereishene e 'ngoe ho lokisa mathata ana. Batho ba bangata ba ka bapala lipapali hape ka mor'a hore screw e ntšoe. Li-screw li ka hlepha kapa tsa robeha haeba ho e-na le motsamao o mongata kapa khatello ea maikutlo. Sena se ka etsa hore screw e phanye. Lithutong tse ling, li-screw li ile tsa tloha sebakeng ho fihlela 16.9% ea linyeoe. Li-crews tse kentsoeng ka lehlakoreng le tsoileng ho feta li-screw tse otlolohileng.

Tlhokomeliso: Monyetla oa mathata o ka fetoha ka mofuta oa screw le hore na opereishene e etsoa joang.

Tšireletseho le Mekhoa e Molemo ka ho Fetisisa

Lingaka li ka fokotsa likotsi ka ho latela melao ea tšireletso le mekhoa e metle. Malebela ke ana a ho thusa ho fumana liphetho tse betere ka li-screws tsa ho kena-kenana:

• Khetha boholo bo nepahetseng ba screw le thepa bakeng sa mokuli e mong le e mong.

• Kenya screw ka hloko e le hore graft e se ke ea tsoa kotsi.

• Etsa bonnete ba hore graft e bonyane 20 mm ka har'a kotopo ea masapo.

• Shebella bakuli ho bona matšoao a hore screw e hlephile kapa e tsamaile kamora ho buuoa.

Lingaka li boetse li lokela ho boloka tlaleho ea liketsahalo leha e le life tse mpe le ho hlahloba bakuli hangata. Ka bobeli li-screw tsa bioabsorbable le tsa tšepe li sebetsa ka mokhoa o ts'oanang bakeng sa bohloko, motsamao, le hore na lenonyeletso le sebetsa hantle hakae. Haeba sekoti se robeha ha se se kenya, ha se kamehla se bakang mathata, empa lingaka li ntse li lokela ho hlahloba mokuli.

Keletso: Ho rera ka hloko le ho ela hloko lintlha ho thusa ho fokotsa likotsi le ho etsa hore liphetho tsa mokuli li be betere ha u sebelisa lisekere tse sitisang.

U sebelisa li-screws tsa tšitiso ho boloka li-grafts li tsitsitse ho acl le ligament opereishene. Liphuputso li bonts'a li-screw tsa bioabsorbable le litsamaiso tse ncha li thusa bakuli ho fola hantle kamora ho lokisoa ha acl. The Ligament Fixation System ka XC Medico e fana ka tšehetso e matla, e thusa ho folisa, le ho theola mathata. Lingaka tse ngata li bona matla a manonyeletso a ntlafetseng le liphello tse ntle tsa nako e telele ka tsamaiso ena.

• XC Medico e latela melao ea boleng bo holimo.

• U fumana thomello e potlakileng le thuso ka lipotso.

• Sistimi e u thusa ho fumana liphetho tse ntle ho bakuli ba hau.

Khetha XC Medico joalo ka k'hamphani ea hau e tšepahalang bakeng sa li-screw tsa tšitiso le lihlahisoa tse ling.

LBH

Sepheo se seholo sa sekoti sa ho kena-kenana ke sefe?

U sebelisa sekoti sa tšitiso ho tšoara graft ka thata kotopong ea masapo. Sena se boloka graft e tsitsitse nakong ea pholiso. The screw thusa ligament e ncha ho khomarela lesapo.

U ka khetha sekoti sa tšitiso sa boholo bo nepahetseng joang?

U bapisa boholo ba screw ho graft le kotopo ea masapo. Sekurufu se seholo se tiisa ho feta. Kamehla hlahloba boleng ba masapo a mokuli le mofuta oa ho buuoa oo u rerang ho o etsa.

Na li-screws tse nang le bioabsorbable li bolokehile ho bakuli bohle?

Li-screws tse nang le bioabsorbable li bolokehile ho bakuli ba bangata. U lokela ho hlahloba ho kula kapa maemo a khethehileng a bophelo bo botle. Likurufu tsena lia senyeha 'meleng ha nako e ntse e ea.

A na u ka sebelisa li-screws tsa tšitiso bakeng sa liopereishene ntle le ho aha bocha ACL?

Ee, o ka sebelisa li-screws tsa tšitiso bakeng sa tokiso ea ligament tse ling, joalo ka opereishene ea PCL kapa MPFL. Li boetse li thusa ka ho lokisa lisele tse bonolo lits'ebetsong tse ngata tsa masapo.