Tataiso ea meriana ea lipapali | Cortical suspensory fixation
Cortical button fixation ke mokhoa oa ho lokisa o emisitsoeng o sebelisoang mekhoeng e khethiloeng ea ligament le tendon reconstruction. Konopo e lutse khahlano le lesapo la cortical mme e sebetsa ka loop e tsitsitseng kapa e feto-fetohang ea suture ho boloka moralo o hlophisitsoeng kapa oa mesifa e bonolo. Sesebelisoa se fana ka tokiso ea mochini ha pholiso ea tlhaho e ntse e tsoela pele, empa ha e fane ka tiisetso ea ho fola kapele, mathata a fokolang kapa ho khutlela papaling pele ho nako.
Cortical Button Fixation ke Eng?
Tokiso ea konopo ea cortical, eo hape e bitsoang cortical suspensory fixation, e sebelisa konopo e nyane e eme khahlano le cortex e thata ea kantle ea lesapo. Loop kapa suture construct e hokahanya konopo ho graft ea tendon, ligament graft kapa lisele tse bonolo tse lokisoang. Ha e se e kentsoe sebakeng se reriloeng, konopo e fana ka ntlha ea tšehetso ea cortical bakeng sa moaho o emisitsoeng.
Ka ACL reconstruction, ka mohlala, femoral cortical konopo ka 'na tšehetsa graft ka hare lokiselitsoeng femoral soketeng kapa kotopo. Sistimi tse ling tsa likonopo li etselitsoe libaka le lits'ebetso tse fapaneng tsa anatomical. Lihlahisoa tsena ha li fetohe hobane feela li arolelana sebopeho se tšoanang.
Likarolo Tse Ka sehloohong tsa Mohaho oa Konopo ea Cortical
Konopo ea Cortical vs Cortical Screw
Konopo ea cortical ha e tšoane le sekoti se tloaelehileng sa cortical bone. Sekurufu se tloaelehileng sa cortical se sebelisa likhoele ho kopanya lesapo 'me hangata se amahanngoa le ho lokisa lesapo kapa lipolanete. Konopo ea cortical ka kakaretso e fana ka tokiso ea suspensory ka konopo-le-loop kapa konopo-le-suture construct.
U se ke ua ferekanya lihlahisoa: 2.7, 3.5 kapa 4.5 mm cortical bone screw ha ea lokela ho hlalosoa e le karolo e hlokahalang ea tloaelo ea ho lokisa konopo ea ACL cortical ntle le haeba tsamaiso e nepahetseng e lumelletsoeng le mokhoa oa ho buoa li kenyeletsa ka ho khetheha.
Fixed-Loop vs Adjustable-Loop Cortical Buttons
Lisebelisoa tsa femoral cortical suspension tse sebelisoang ho tsosolosoa ha ligament hangata li tšohloa e le li-fixed-loop kapa adjustable-loop systems. Phapang e ama ho hlophisoa ha graft, kotopo kapa moralo oa socket, deployment le tensioning workflow.
Loop e na le bolelele bo reriloeng esale pele. Botebo ba kotopo, bolelele ba ho hlomathiseletsoa le konopo li tlameha ho reroa ho pota-pota tekanyo eo e tsitsitseng.
Bolelele ba loop bo ka fetoloa nakong ea ts'ebetso ka har'a meeli le mokhoa oa sistimi e ikhethileng, e lumellang hore graft e tsoele pele kapa e hatellehe kamora ho tsamaisoa ha konopo.
Seo liteko tsa laboratori li se etsang
Tlhahlobo ea biomechanical e ka tlaleha ho falla ha cyclic, bolelele ba loop, ho satalla, mojaro oa lihlahisoa le mojaro ho hloleha. Liteko tsena li thusa ho tsebahatsa boitšoaro ba sesebelisoa tlas'a protocol e hlalositsoeng ea laboratori, empa liphetho li ipapisitse le tlhahlobo ea tlhahlobo, mohlala, tataiso ea ho laela, ho kenya pele, protocol ea libaesekele le ntlha ea ho qetela.
Boleng bo phahameng ba ho hloleha ha mojaro thutong e le 'ngoe ea laboratori ha bo bontše pholiso e potlakileng ea tendon-to-bone kapa sekhahla se tlase sa ho hloleha ho tsa bongaka. Liphetho tsa laboratori li lokela ho nahanoa hammoho le bopaki ba kliniki le kaho e felletseng ea opereishene.
Seo Bopaki ba Clinical bo se Bontšang
Tlhahlobo e hlophisitsoeng ea lisebelisoa tsa ho emisoa tsa 'loop femoral cortical suspension' li fumane phapang lipakeng tsa liphuputso tsa laboratori le tsa bongaka: liphuputso tse 'maloa tsa laboratori li tlalehile bolelele ba loop tlas'a cyclic loading, athe lithuto tsa kliniki tse hlahlobiloeng ha lia ka tsa bontša phapang e hlakileng pakeng tsa lihlopha tse feto-fetohang le tse tsitsitseng ka botsitso, lintlha tsa mangole kapa ho hlōleha ha graft. Bangoli ba ile ba kopa liteko tsa kliniki tse matla haholoanyane.
Ka hona, ha ho na sehlopha sa loop se lokelang ho hlalosoa e le se phahameng ka ho fetesisa. Khetho e lokela ho ikarabella bakeng sa moralo oa graft, leano la kotopo, litaelo tsa sesebelisoa, tsebo ea ngaka e buoang le bopaki bo nepahetseng ba kliniki.
Likopo tse Tloaelehileng tsa ho Buoa tsa Cortical Button Fixation
Meetso ea likonopo tsa cortical e sebelisoa lits'ebetsong tse 'maloa tsa masapo, empa sesupo se ipapisitse le mongolo o nepahetseng oa sesebelisoa. Konopo e hlakotsoeng kapa e ngolisitsoeng bakeng sa ts'ebetso e le 'ngoe ha ea lokela ho nkoa e lumelloa bakeng sa tendon e' ngoe le e 'ngoe, ligament kapa manonyeletso.
Ho tsosolosoa ha ACL le PCL
Cortical suspensory fixation e tloaelehile ho sebelisoa ka lehlakoreng la basali la mekhoa e khethiloeng ea kaho ea ACL hape e ka kenyelletsoa ho PCL e khethiloeng kapa meaho eohle ea kahare. Konopo e ts'ehetsa ho hlomathiseletsoa ka loop ha graft e ntse e le kotopong e lokisitsoeng kapa sokete.
Sephetho sa kliniki se itšetlehile ka ho feta konopo. Boemo ba kotopo, mofuta oa graft le ho itokisa, ho lokisa mahlakoreng ka bobeli, tsitsipano, likotsi tse amanang le tsona, ho tsosolosa le lintlha tsa mokuli kaofela li kenya letsoho. Babali ba ka hlahloba karolo e batsi ea Sistimi ea ho lokisa bekapo ea ACL le tataiso e amanang le eona e hlalosang kamoo bekapo fixation e tshehetsang kaho botjha ACL.
Distal Biceps Tendon Tokiso
Litsamaiso tse ikhethileng tsa cortical li ka sebelisoa ho boloka tendon ea distal biceps ho radius. Bopaki bo tsoang ho opereishene ena bo ke ke ba fetisetsoa ka ho toba ho tsosoloso ea ACL hobane li-anatomy, loading, ho pepeseha ha opereishene le boemo ba mathata li fapane.
Litlhahlobo tse hatisitsoeng li tlaleha ka kakaretso liphetho tse ntle tsa ts'ebetso empa hape li hlalosa kotsi ea methapo, ho se sebetse hantle ha konopo kapa ho kheloha, heterotopic ossification, ho phatloha le mathata a maqeba. Likotsi tsena li lokela ho lula li bonahala neng kapa neng ha ho buisanoa ka bopaki ba distal biceps.
Ankle Syndesmosis le Tse ling tsa Soft-Tissue Fixation
Lisebelisoa tse khethiloeng tsa suture-button li ka 'na tsa ngoloa bakeng sa ho tsitsisa ha syndesmosis kapa mekhoa e meng ea ho lokisa lisele tse bonolo. Hangata lihahi tsena li sebelisa likonopo tse peli tse kopantsoeng ke suture e matla haholo, empa sepheo sa bona sa ho buoa le mechini li fapana le ho emisoa ha ACL ea botšehali.
Likopo tse ling tse ikhethileng tsa ts'ebetso li ka kenyelletsa li-ligament kapa tendon reconstruction tse khethiloeng lehetleng, setsoe, leoto kapa leqaqailaneng. Lipontšo tse sebetsang, li-contraindication le lisebelisoa li tlameha ho hlahlojoa bakeng sa sehlahisoa se nepahetseng le 'maraka oa moo u eang teng.
Latarjet le Mekhoa e meng e Khethehileng
Suture-button fixation e boetse e batlisisitsoe bakeng sa ho lokisa coracoid graft ka mokhoa oa Latarjet. Bopaki ba ho bapisa bo bontša li-tradeoffs ho e-na le bophahamo ba bokahohle: ho lokisa screw ho ka bonts'a ho hloka botsitso ho tlase khafetsa ho litlhahlobo tse ling tse kopaneng, athe ho lokisa likonopo ho ka bonts'a tšebetso e fokolang e amanang le Hardware. Mathata a felletseng le liphetho tse ling li kanna tsa se fapane ka ho hlaka.
Ka lebaka leo, lintlha tsa Latarjet ha lia lokela ho sebelisoa e le bopaki ba hore li-buttons tsa cortical li lula li sireletsehile, li tsitsitse kapa li molemo bakeng sa pholiso ho pholletsa le mekhoa e sa amaneng.
Kamoo Likonopo tsa Cortical li Tšehetsang Pholiso ea Tendon-to-Bone
Konopo ea cortical e fana ka tokiso ea mochine e reretsoeng ho boloka boemo bo reriloeng ba graft kapa tendon ha pholiso ea likokoana-hloko e ntse e tsoela pele. Ha e iketse pholiso ka bo eona. Ho kopanya ha tendon-to-bone ho susumetsoa ke ho kopana le graft, ho sisinyeha ha sebopeho, boleng ba masapo le lisele, ho lokisoa ha kotopo, ho haha botsitso, ho tsosolosa le baeloji ea mokuli.
Mechanics le biology li fapane: tokiso e matla ea mantlha ke sepheo sa bohlokoa sa boenjineri, empa ha e fane ka tiisetso ea ho kenyeletsoa ho kenyellelitsoeng, ho imolla bohloko, botsitso ba manonyeletso, ho khutlela papaling kapa ho lokoloha ho tsoa opereishene ea ntlafatso.
Kakaretso ea Ho Buoa Mosebetsi
Ts'ebetso ea ho buoa e fapana ho ea ka mokhoa le tsamaiso. E latelang ke tlhaloso ea boemo bo holimo ea cortical suspensory graft fixation, eseng mokhoa oa ho buuoa kapa litaelo tsa mokuli.
Boemo ba konopo bo fosahetseng kapa ho kenella ha lisele tse bonolo pakeng tsa konopo le cortex ho ka sitisa ho lokisoa. Ponahalo ea intraoperative, litšoantšo kapa mekhoa e meng ea netefatso e itšetlehile ka mokhoa. Konopo ha ea lokela ho nkoa e behiloe ka nepo ho latela maikutlo a tactile feela.
Cortical Button vs Mekhoa e meng ea ho Lokisa
Lipapiso tsa ho lokisa li na le moelelo feela ha li kenyelletsa ts'ebetso e tšoanang, graft, sebaka sa anatomical le sephetho. Hoa khelosa ho bapisa konopo ea femoral ACL cortical le distal biceps suture ankora kapa screw ea Latarjet le ho hlahisa sephetho e le boemo ba bokahohle.
| Mokhahlelo oa ho lokisa | Mechini e akaretsang | Mehato e ikhethileng ea ts'ebetso |
|---|---|---|
| Konopo ea cortical | E emisa lesela kapa lesela le bonolo ho tloha konopo e tšehetsoeng ke cortical bone | Litulo tsa likonopo, boits'oaro ba loop, cortical integrity, jiometry ea kotopo le ho kenella ha lisele tse bonolo |
| Sekoti sa tšitiso | E fana ka ho lokisa aperture ka ho hatella graft ka har'a kotopo | Screw material le boholo, tshenyo ya graft, ho lekana ha thanele, boleng ba masapo le ho tloswa kapa dintlha tsa botjha |
| Suture ankora | E kopanya lithane tse bonolo lesapo ka sehaho sa ankora-le-suture | Thepa ea anchor, angle ea ho kenya, boleng ba masapo, moralo o se nang lefito kapa oa mafito le paterone ea linama |
| Tokisetso ea mantlha kapa bekapo | E fana ka tokiso ea tlatsetso kapa ea holim'a metsi ho latela moralo oa implant | Anatomy ea lehae, boemo ba graft, ho hlahella, tatellano ea ho lokisa le hore na ke tokiso ea mantlha kapa ea bekapo |
Konopo ea Cortical vs Screw Interference in ACL Reconstruction
Mekhoa ena e lokisa graft ka litsela tse fapaneng 'me e ka sebelisoa mahlakoreng a fapaneng a kaho e tšoanang. Konopo ea cortical e fana ka suspensory fixation, ha sekoti sa ho kena-kenana le sona se lokisa haufi le kotopo ea kotopo. Lipapiso tsa meriana li itšetlehile ka mokhoa oohle oa ACL ho e-na le ho kenngoa ka thōko.
Konopo ea Cortical vs Suture Anchor ho Tokiso ea Tendon
Lithuto tsa biomechanical li ka bapisa mojaro le ho hlōleha kapa ho falla, empa khetho ea kliniki e boetse e itšetlehile ka ho pepeseha ha opereishene, maoto a anatomical, masapo a masapo, kotsi ea methapo e haufi, ho tsosolosoa le pontšo e fumanehang ea lisebelisoa. Lihlopha tsa XC Medico lia arohana suture anchor system hobane ankora ha se lebitso le leng feela la konopo ea cortical.
Ntlha ea mantlha vs Tokiso ea bekapo
Konopo ea cortical e ka 'na ea e-ba eona ntho e ka sehloohong ea ho emisa ts'ebetsong e le' ngoe, athe staple, screw kapa implant e 'ngoe e ka sebetsa e le mokhoa oa ho lokisa ho o mong. The Ka hona, ligament fixation staple system ke sehlopha se ikhethileng sa sehlahisoa ho fapana le karolo ea konopo ea cortical.
Likotsi le Meeli ea Theknoloji
Ha ho tsamaiso ea konopo ea cortical e lokolohileng kotsing. Mathata a amehang a ipapisitse le anatomy le ts'ebetso, empa lintlha tse latelang li ka hloka ho nahanoa:
- Maemo a konope: se kentsoeng se kanna sa se lule khahlano le bokaholimo ba cortical.
- Soft-tissue interposition: lisele li ka qabelloa pakeng tsa konopo le lesapo.
- Ho falla kapa ho arohana: tahlehelo ea boemo ba konopo e reriloeng e ka senya mohaho.
- Loop elongation kapa graft motion: ho falla tlas'a cyclic loading ho ka ama tikoloho ea ho lokisa.
- Katoloso ea kotopo: liphetoho tsa kotopo li na le lintho tse ngata 'me li ka amahanngoa le motsamao oa graft, biology le mokhoa.
- Cortical compromise: ho tsoa ka kotopo e sa lekaneng, ho phatloha ha cortical kapa boleng bo tlase ba masapo ho ka ama tšehetso.
- Kotsi ea methapo ea kutlo: kotsi e ipapisitse le mokhoa oa ho buuoa, tataiso ea ho cheka, anatomy le ts'ebetso.
- Tšoaetso, ho satalla kapa ho hloleha ha lisele: mathata a akaretsang le a khethehileng a ho buuoa a ntse a ka khoneha.
Bopaki bo tlameha ho lula bo le teng ka mokhoa o tobileng: litekanyetso tsa mathata ho tloha ho lokisoa ha li-biceps tsa distal ha lia lokela ho hlahisoa e le litekanyetso tsa mathata a ACL, 'me lintlha tsa ho pheta-pheta ha Latarjet kapa ts'ebetsong ha lia lokela ho sebelisoa ho bolela esale pele pholiso ea tendon-to-bone ka lengole kapa setsoe.
Lingaka li Khetha Konopo ea Cortical Joang?
Khetho e ipapisitse le moralo o felletseng oa kaho bocha ho fapana le tseko ea papatso mabapi le matla. Lintlha tsa bohlokoa li kenyelletsa:
- e lumelletsoeng pontšo ea anatomical le ngoliso ea 'maraka oa moo ho eang;
- Lulu e tsitsitseng kapa mokhoa o feto-fetohang oa loop;
- litekanyo tsa likonopo le maoto a cortical;
- lisebelisoa tsa loop, bolelele ba bolelele le mokhoa oa ho lokisa;
- mofuta oa graft, bophara le bolelele bo lokiselitsoeng;
- kotopo kapa bophara ba sokete, botebo le botšepehi ba cortical;
- boleng ba masapo le boemo ba ntlafatso;
- li-drill tse lumellanang, litataiso, li-sutures tse fetang le lisebelisoa tsa tsitsipano;
- ho lokisoa ho reriloeng ka lehlakoreng le leng la ho aha bocha;
- koetliso ea ngaka e buoang le mokhoa o ikhethileng oa tšebetso.
Litokomane tsa lisebelisoa tsa FDA bakeng sa tsamaiso ea cortical fixation li thathamisa boleng bo sa lekaneng ba cortical bone kapa bongata e le ntho e ka 'nang ea etsahala. Ka hona, li-contraindication tse amanang le sehlahisoa li tlameha ho hlahlojoa ho fapana le ho nka hore cortical fixation e loketse mokuli e mong le e mong.
Cortical Fixation Systems bakeng sa Lipetlele le Bahlahisi
Lipetlele, baphatlalatsi le balekane ba OEM/ODM ba lokela ho lekola potefolio e felletseng ea ligament fixation, eseng feela konopo e bonahalang ea titanium. XC Medico's tsamaiso ea meriana ea masapo le ea lipapali e kenyelletsa mekhahlelo e mengata ea ho lokisa bakeng sa tšebeliso ea litsebi.
The Ligament fixation plate ea titanium le lihlopha tsa likonopo li lokela ho hlahlojoa ka nomoro ea lethathamo, tšebeliso e reretsoeng, thepa, litlhaloso tsa loop le lisebelisoa tse lumellanang. Lihlopha tsa ho reka thepa li lokela ho kopa litokomane tsa hajoale bakeng sa tlhophiso e nepahetseng le 'maraka.
| Procurement checkpoint | Seo o lokelang ho se netefatsa |
|---|---|
| Pontsho | Ts'ebeliso e nepahetseng ea ligament, tendon, manonyeletso le fixation e boletsoeng ho ngolisoeng ha sehlahisoa sa hajoale |
| Tokiso ea sesebelisoa | Litekanyo tsa likonopo, mofuta oa lupu, mofuta oa loop, thepa ea suture le mefuta e meng e fumanehang |
| Lisebelisoa | Liboro tse tsamaellanang, litataiso tsa lithanele, litekanyo tsa botebo, ba fetang le lisebelisoa tsa tsitsipano |
| Bopaki ba mechine | Ho kenya tšebetsong cyclic, ho falla le liteko tsa ho hloleha bakeng sa tokiso ea ho qetela ea sesebelisoa |
| Litokomane | Litifikeiti, litaelo tsa ts'ebeliso, ts'ebetso, boemo bo nyopa le tlhaiso-leseling ea bophelo ba sethala |
| Ho fihlella 'marakeng | Ngoliso le likopo tse lumelletsoeng tsa naha kapa sebaka seo u eang ho sona |
Bakeng sa ho reka ka litsebi: kopa lethathamo la hona joale la ho lokisa li-ligament, litlhaloso tsa lisebelisoa, lenane la lisebelisoa tse lumellanang le litokomane tsa taolo tse khethehileng tsa 'maraka pele u khetha mokhoa oa ho lokisa cortical.
Lipotso Tse Botsoang Hangata ka Cortical Button Fixation
Ho lokisa konopo ea cortical ke eng?
Ke mokhoa oa ho lokisa o emisang moo konopo e lutseng khahlano le lesapo la cortical mme e hokahana ka loop kapa suture e hahiloeng ho tendon graft, ligament graft kapa lisele tse bonolo tse lokisoang.
Na konopo ea cortical e ts'oana le screw ea cortical?
Che. Konopo ea cortical hangata e sebetsa e le karolo ea 'suspensory' button-and-loop construct. Sekurufu sa cortical se sebelisa likhoele ho kopanya lesapo 'me ke sa sehlopha se fapaneng sa ho lokisa.
Phapang ke efe lipakeng tsa li-buttons tsa loop tse tsitsitseng le tse fetolehang?
Sesebelisoa sa loop se tsitsitseng se na le bolelele bo reriloeng esale pele. Sesebelisoa sa loop se feto-fetohang se lumella bolelele ba loop hore bo fetoloe ho latela mokhoa o ikhethileng oa ho tsamaisa le mokhoa oa ho tsitsipana.
Na ho lokisa konopo ea cortical ho etsa hore ACL graft e fole kapele?
E fana ka tokiso ea mochini ha pholiso ea tlhaho e ntse e tsoela pele, empa ha e fane ka tiiso ea ho kenyeletsoa ka potlako. Pholiso e itšetlehile ka ho tsosolosoa ka ho feletseng, biology ea lisele, ho lokisoa ha kotopo, botsitso, ho tsosolosa le lintlha tsa mokuli.
Na konopo ea loop e feto-fetohang e molemo ho feta konopo e tsitsitseng ea loop?
Eseng hohle. Liphuputso tsa laboratori li fumane liphapang tsa biomechanical, athe lithuto tsa meriana ha lia ka tsa bontša ka mokhoa o hlakileng bophahamo bo hlakileng ba botsitso, lintlha tsa mangole kapa ho hlōleha ha graft. Khetho e lokela ho ba ka mokhoa o ikhethileng le mokhoa o ikhethileng.
Ke mathata afe a ka hlahang?
Lintho tse ka 'nang tsa e-ba teng li kenyelletsa ho se sebetse hantle, ho kenngoa ha lisele tse bonolo, ho falla, ho lelefatsa ha loop, ho atolosoa ha kotopo, ho hloleha ho lokisa le mekhoa e itseng ea methapo, methapo, tšoaetso kapa mathata a thata.
Litšupiso tsa Bongaka le tsa Taolo
- Lisebelisoa tsa Adjustable Loop Femoral Cortical Suspension for ACL Reconstruction: Tlhahlobo e hlophisitsoeng.
- Tsoelo-pele ea Kaho ea ACL e nang le Suspensory Cortical Button Fixation: Tlhahlobo e hlophisitsoeng le Tlhahlobo ea Meta.
- Liphello tsa Tleliniki le Mathata a ho Lokisoa ha Cortical Button Distal Biceps: Tlhahlobo e Hlophisitsoeng.
- Screw Fixation khahlano le Suture-Button Fixation bakeng sa Mokhoa oa Latarjet: Tlhahlobo e hlophisitsoeng le Tlhahlobo ea Meta.
- US FDA 510(k) Documentation: Cortical Fixation System Re Rereted Use and Contraindications.
