Yiziphi Izikulufo Zokuphazanyiswa kanye Nendima Yazo Ekuhlinzeni Kwamathambo?

Usebenzisa izikulufu zokugxambukela ukuze ubambe ama-graft aqine emhubheni wamathambo ngesikhathi sokuhlinzwa kwamathambo. Lezi zikulufu zibalulekile ekulungiseni izicubu ezithambile, ikakhulukazi ekulungiseni i-acl, ngoba zigcina izinto zizinzile. Ucwaningo lubonisa ukuthi zombili izikulufu zokuphazanyiswa kwe-bioabsorbable kanye ne-titanium zisebenza ngokufana, ngakho zombili ziyizinketho ezinhle zomsebenzi wakho. Amasistimu amasha, afana ne-Ligament Fixation System ngo XC Medico , letha imibono emisha ekuhlinzeni kwakho futhi ikusize uthole imiphumela engcono yeziguli.

Okuthathwayo Okubalulekile

• Izikulufu zokugxambukela zisiza ukugcina izixhumi ziqinile emhubheni wamathambo ngesikhathi sokuhlinzwa. Zibaluleke kakhulu ekulungiseni imigqa.

• Izikulufu ze-Bioabsorbable nezikulufu ze-titanium zombili zisebenza kahle ekuhlinzeni kwe-ACL. Basiza iziguli zelaphe ngendlela efanayo.

• Ukukhetha usayizi wesikulufa ongcono kakhulu kanye nokokusebenza kubaluleke kakhulu. Isiza abantu ukuphulukisa kangcono futhi kwehlisa amathuba okuba nezinkinga.

• Imibono emisha efana ne I-Ligament Fixation System ye-XC Medico yenza ukuhlinzwa kube ngcono. Basebenzisa izinto eziqinile kanye nemiklamo ehlakaniphile.

• Odokotela kudingeka babheke iziguli ngemva kokuhlinzwa. Lokhu kusiza ukuthola izinkinga kusenesikhathi futhi kuqinisekisa ukuphulukiswa kuhamba kahle.

Ukubuka konke Kwezikulufu Zokuphazamiseka

Ziyini Izikulufo Zokuphazanyiswa

Izikulufu eziphazamisayo zisiza ukubamba ama-graft aqine emhubheni wamathambo ngesikhathi sokuhlinzwa. Zibalulekile ekulungiseni imigqa nezicubu ezithambile. Odokotela bavame ukuwasebenzisa ekulungiseni i-ACL. Lezi zikulufu zigcina i-graft izinzile ngokuyicindezela ngokumelene nethambo. Lokhu kusiza i-graft ilulame futhi ihlangane nezicubu ezizungezile.

Odokotela bathi izikulufu zokuphazanyiswa ziyindlela evamile yokulungisa ukulimala kwe-ACL. Basebenzela kokubili ukulungisa ithambo kuya ethanjeni kanye nokulungisa izicubu ukuya ethanjeni. Izikulufu zibamba i-graft endaweni futhi zivumele odokotela balawule indawo yayo nokuqina. Lokhu kulawula kusiza iziguli zelaphe kahle futhi zilulame ngokushesha.

Qaphela: Izikulufu zokuphazanyiswa ziyathenjwa futhi zifundelwa ukulungiswa kwemisipha. Ucwaningo oluningi lubonisa ukuthi lusebenza kahle ekuhlinzeni kwe-bone-patellar tendon-bone ACL.

Indlela Izikulufa Zokuphazanyiswa Zisebenza Ngayo

Okokuqala, odokotela benza umhubhe ethanjeni lapho i-ligament idinga ukulungiswa. Okulandelayo, bafaka i-graft kulo mhubhe. Isikulufu siphusha i-graft odongeni lomhubhe. Lokhu kugcina i-graft inganyakazi.

Nakhu okwenzekayo phakathi nokuhlinzwa:

• Odokotela bamba umhubhe ethanjeni, ngokuvamile ongaba ngu-8 mm ububanzi.

• Bafaka i-graft emhubheni.

• Babeka isikulufu sokuphazanyiswa eduze kwe-graft bese beyicindezela ngokuqinile.

• Okungenani u-20 mm we-graft uhlala ngaphakathi emhubheni ukuze uthole amandla.

• Odokotela bangasebenzisa izikulufu ezidonsayo noma zensimbi, kuye ngecala.

Imisebenzi eyinhloko yezikulufu zokuphazanyiswa yilezi:

• Ukugcina i-graft isendaweni efanele kanye nasekuqineni kwesokudla.

• Ukubamba ngamandla lapho isikulufu sithinta ithambo.

• Ubambe i-graft kuze kube yilapho ithambo liphola.

Kukhona nezinhlobo ezintsha zezikulufu zokuphazanyiswa futhi. Ezinye zenziwe nge-magnesium ephuka emzimbeni. Ezinye zixuba i-magnesium nezinye izinsimbi ukuze zibe namandla engeziwe. Abanye baye benza kanjalo amajamo amasha ukuze ubambe kangcono . Lezi zinguquko zisiza izikulufu ukuthi zisebenze kangcono futhi zisize amathambo aphole.

Ucwaningo lubonisa ukuthi izikulufu ezicijile ziqinile futhi zigcina isixhumi siqinile kunezikulufu ezivamile. Lokhu kusho ukuthi iziguli ziba ngcono futhi amadolo aqine ngokuhamba kwesikhathi.

Odokotela bathembele kuzikulufu zokuphazanyiswa ukuze bagcine amagrafti ephephile ngenkathi ephulukiswa. Idizayini nezinto zokwakha zisiza odokotela ukuthi bathole imiphumela emihle lapho belungisa imigqa.

Izinhlobo Nezisetshenziswa Zezikulufu Zokuphazamiseka

Izinketho ze-Metal kanye ne-Bioabsorbable

Kunezinhlobo ezahlukene zezikulufu zokuphazanyiswa zokulungisa imigqa. Izinto ezisetshenziswa kakhulu yilezi:

• I-Titanium

• Insimbi engagqwali

• I-polymer

• Ingilazi ye-Bioactive

Izikulufu zensimbi, njenge-titanium, ziqinile kakhulu futhi zihlala isikhathi eside. I-Titanium ayigqwali, ngakho ihlala ilungile ngaphakathi emzimbeni. Odokotela basebenzisa izikulufu ze-titanium kumakesi aqinile ngoba ziqine kakhulu kunezikulufu ezikwazi ukumuncwa. Izikulufu ze-Titanium zingaba namandla esivuno angaba ngu-1130 MPa. Lokhu kucishe kube ngokuphindwe kashumi kunezikulufu ezikwazi ukumuncwa izinto eziphilayo, njenge-PLA. Ngakho-ke, izikulufu ze-titanium zinikeza ukwesekwa okuqinile lapho ukudinga kakhulu.

Izikulufu ze-Bioabsorbable zenziwe ngezinto ezifana ne-PLA noma i-magnesium. Lezi zikulufu ziphuka kancane kancane emzimbeni. I-Magnesium iyinsimbi elula eqinile futhi ingamuncwa umzimba. Lezi zikulufu zingabamba izinto endaweni yokuhlinzwa okuningi. Izikulufu ezintsha ze-bioabsorbable zicishe ziqine njengezikulufi ze-titanium, ezingafika ku-90%. Kodwa, azikaqini njengezikulufu zensimbi. Noma kunjalo, ucwaningo lubonisa ukuthi zombili izinhlobo zisebenza kahle ekuzinzeni kwamadolo ngemva kokuhlinzwa kwe-ACL. Azikho izinkinga eziningi ngohlobo olulodwa kunolunye.

Izici Zokuklama kanye Nokusungulwayo

Izikulufu zokuphazanyiswa zilokhu ziba ngcono ngemiklamo emisha. Izikulufu manje zinezimo ezihlukene, izintambo, nezinto ezisetshenziswayo ukuzisiza ukuthi zibambe futhi ziphole kangcono. Isibonelo, umumo we-conical or tapered core wenza isikulufu sibambe siqine. Lokhu kusiza isikulufu ukugcina i-graft isendaweni. Ithebula elingezansi libonisa ukuthi umumo wesikulufu uwashintsha kanjani amandla okukhipha:

Umumo omusha wochungechunge namathiphu angcono ngezikulufu akwenza kube lula ukufaka isikulufu. Benza futhi ukuthi kuthathe amandla amancane. Izikulufu zeHybrid zisebenzisa izingxenye zezinto ezahlukahlukene ukuze zibe namandla futhi ziphephe emzimbeni. I-Titanium ne-PEEK yizinketho ezinhle ngoba ziphephile futhi zisiza ukukhula kwamathambo. Le mibono emisha isiza odokotela ukugcina i-graft izinzile futhi isize iziguli zelaphe kangcono.

I-ACL Interference Screws Ekuhlinzeni

Izicelo Zokwakhiwa Kabusha kwe-ACL

Izikulufu zokuphazanyiswa kwe-ACL zibamba ama-grafts endaweni ngesikhathi sokuhlinzwa kwe-ACL. Lezi zikulufu zicindezela i-graft emhubheni wamathambo. Lokhu kugcina i-graft iqinile ukuze ikwazi ukuphola kahle. I-graft ibopha nezicubu ezizungezile. Ungakhetha izikulufu zensimbi noma ze-bioabsorbable zokuhlinzwa kwe-ACL. Zombili izinhlobo zisebenza kahle futhi zinikeza imiphumela efanayo.

Uma ukhetha izikulufu zokuphazanyiswa kwe-ACL, ufuna ukuxhunyelelwa kunganyakazi. Akufanele inyakaze ngenkathi iphulukisa. Ucwaningo lubonisa izikulufu ezikwazi ukumuncwa nge-bioabsorbable ezine-hydroxyapatite zisebenza kahle kakhulu. Ababangeli imiphumela emibi. Lezi zikulufi ziyisinqumo esihle esikhundleni sezikulufi ze-titanium. Izikulufu zensimbi neze-bioabsorbable ziyehluleka cishe ngenani elifanayo. Iziguli zenza kahle ngazo zombili izinhlobo.

Kwesinye isikhathi, odokotela basebenzisa amadivaysi okulungisa okumiswa okulungisekayo. Lawa madivaysi aphinde anikeze imiphumela emihle futhi agcine idolo lizinzile. Izinga lokwehluleka liphansi, njengamanye amadivaysi. Izikulufu zokugxambukela ze-ACL zinikeza ukuqiniswa kwethambo kuya ethanjeni okuqinile kanye nezicubu ezithambile ezisuka ethanjeni. Lokhu kusiza iziguli zelaphe ngokushesha futhi zibuyele emisebenzini yazo.

Ithiphu: Qinisekisa ukuthi ukuxhunyelelwa okungenani kungama-20 mm ngaphakathi komhubhe wamathambo. Lokhu kusiza i-graft ukuthi ihlale iqinile futhi iphole kangcono.

Okunye Ukusetshenziswa Kwe-Ligament Fixation

Izikulufu zokuphazanyiswa akuzona nje ezokuhlinzwa kwe-ACL. Odokotela bawasebenzisela okunye ukulungisa imisipha, njenge-PCL ne-MPFL. Lezi zikulufu zisiza ukulungisa imigqa nezicubu ezithambile ezindaweni eziningi. Basebenzela kokubili ukulungisa ithambo kuya ethanjeni kanye nokulungisa izicubu ukuya ethanjeni.

I-Ligament Fixation System ka-XC Medico inezici ezintsha zalokhu kuhlinzwa. Isebenzisa i-PEEK, ephephile emzimbeni futhi ingabangeli ukusabela okubi. Izikulufu ziza ngosayizi abaningi ukuze zilingane nezidingo ezihlukene. Izikulufu ze-PEEK zivumela odokotela babone izithombe ezicacile ngemva kokuhlinzwa. Kulula ukuzifaka, okugcina isikhathi ekamelweni lokusebenza. Uhlelo luphephile ekuhlolweni kwe-MRI, ngakho odokotela bangabheka ukuphulukiswa ngaphandle kwezinkinga.

Nali itafula elinezici ezibalulekile ze-Ligament Fixation System nge-XC Medico:

Odokotela basebenzisa izikulufu zokuphazanyiswa ekuhlinzeni okuningi kwe-ACL. Izikulufu ze-Bioabsorbable yizona ezivame kakhulu zokubamba i-graft ku-tibia. Ezinye iziguli, ikakhulukazi abasubathi abasebasha, zingase zizwe ubuhlungu lapho kukhona isikulufu. Ama-cyst angakheka kufika ku-5% wezimo ngemva kokuhlinzwa kwe-ACL ngezikulufu ezingaba khona. Lokhu kwenzeka ngoba umzimba uphendula isikulufu, ngakho odokotela babhekisisa iziguli.

Odokotela bakhetha izikulufu zokugxambukela ngoba zisebenza kahle ekuhlinzweni kwezicubu eziningi ezithambile nezithambile. Bathemba lezi zikulufu ukuthi zizobamba i-graft ziqine futhi zisize iziguli zelaphe kahle.

Ukukhetha Izikulufa Zokuphazanyiswa

Ukukhetha Okubalulekile Nosayizi

Lapho ukhetha izikulufo zokuphazanyiswa, kufanele ucabange ngezinto ezibonakalayo nosayizi. Isikulufu esifanele sisiza iziguli zelaphe kangcono. Ukuhambisana kwezinto kubalulekile ezicutshini zomzimba. Ufuna ukumisa ukusabela okubi ukuthi kungenzeki. Izinto ezisetshenziswa yi-Biocompatible, njengama-polymers abambekayo noma i-titanium, zivame ukusetshenziswa. Lezi zinto zisiza ukugcina umzimba uphephile.

Kufanele futhi ubheke izikulufo ezenziwe ngokunemba machining. Lokhu kusho ukuthi isikulufu silingana kahle futhi sibambe isixhumi siqine. Ukulingana okuhle kungenza ukuhlinzwa kusebenze kangcono.

Usayizi wesikulufa ubalulekile, futhi. Amadayimitha esikulufu amakhulu anikeza amandla amaningi okulungisa. Lokhu kusiza ukuthi i-graft ihlale endaweni. Ithebula elingezansi libonisa ukuthi usayizi wesikulufa uyishintsha kanjani imiphumela:

Ukucatshangelwa Kwesiguli Nokuhlinzwa

Kufanele ngaso sonke isikhathi ucabange ngesiguli ngasinye lapho ukha izikulufo. Ikhwalithi yethambo ibaluleke kakhulu. Uma isiguli sinamathambo aqinile, ungasebenzisa isikulufu esihlukile kunesamathambo abuthakathaka. Izinga lomsebenzi libalulekile, futhi. Abasubathi bangase badinge izikulufu eziqinile.

Nali ithebula elizokusiza ukuthi wazi ukuthi yini okufanele uyihlole:

Ukufanisa isikulufu nokuhlinzwa kubaluleke kakhulu. Ucwaningo lubonisa isikulufu esifanele sisiza iziguli zelaphe ngokushesha nangcono. Ungasiza iziguli ngokugxila emininingwaneni yecala ngalinye. Le ndlela ecophelelayo ikusiza ukuthi unikeze ukunakekelwa okungcono kakhulu kwe-acl nokunye ukuhlinzwa kwe-ligament.

Izingozi Nezinyathelo Zokuqapha

Izinkinga Ezingenzeka

Lapho odokotela besebenzisa izikulufu zokuphazanyiswa, kufanele babheke izinkinga. Lezi zinkinga zingashintsha kahle indlela ukuhlinzwa okufana nomsebenzi wokwakha kabusha i-acl. Ezinye izinkinga ezijwayelekile yilezi:

• Isikulufu singaphuka.

• Umzimba ungasabela futhi uvuvuke.

• I-graft ingasikwa.

• Isikulufu singase singabi sendaweni efanele noma siqine ngokwanele.

Cishe isiguli esisodwa kweziyi-10 singase sibe nezimpawu ngemva kokuhlinzwa. Cishe u-5% weziguli zidinga okunye ukuhlinzwa ukuze kulungiswe lezi zinkinga. Abantu abaningi bangadlala ezemidlalo futhi ngemva kokukhishwa kwesikulufu. Izikulufu zingaxega noma zephuke uma kunomnyakazo omningi noma ingcindezi. Lokhu kungabangela ukuthi isikulufu siqhekeke. Kwezinye izifundo, izikulufu zisuke endaweni ukuya phezulu -16.9% . Amacala angu Izikulufu ezifakwe nge-engeli zikhishwe ngaphezu kwezikulufu eziqondile.

Qaphela: Ithuba lezinkinga lingashintsha ngohlobo lwe-screw kanye nokuthi ukuhlinzwa kwenziwa kanjani.

Ukuphepha Nemikhuba Engcono Kakhulu

Odokotela banganciphisa izingozi ngokulandela imithetho yokuphepha nemikhuba emihle. Nawa amanye amathiphu okusiza ukuthola imiphumela engcono ngezikulufa zokuphazamiseka:

• Khetha usayizi wesikulufu esifanele kanye nokokusebenza kwesiguli ngasinye.

• Faka isikulufu ngokucophelela ukuze i-graft ingalimali.

• Qinisekisa ukuthi ukuxhunyelelwa okungenani ku-20 mm ngaphakathi komhubhe wamathambo.

• Buka iziguli ukuze uthole izimpawu zokuthi isikulufu asikhululekile noma sihambile ngemva kokuhlinzwa.

Odokotela kufanele futhi balandele noma yiziphi izenzakalo ezimbi futhi bahlole iziguli njalo. Zombili izikulufu ze-bioabsorbable nezensimbi zisebenza cishe ngokufanayo ebuhlungu, ukunyakaza, kanye nokuthi ilunga lisebenza kahle kangakanani. Uma isikulufu siphuka ngenkathi usifaka, asihlali sibangeli inkinga, kodwa odokotela kusafanele bahlole isiguli.

Ithiphu: Ukuhlela ngokucophelela nokunaka imininingwane kusiza ukwehlisa ubungozi futhi kwenze imiphumela yesiguli ibe ngcono uma usebenzisa izikulufu zokuphazanyiswa.

Usebenzisa izikulufu zokuphazanyiswa ukuze ugcine izixhumi ziqinile ekuhlinzweni kwe-acl ne-ligament. Ucwaningo lubonisa izikulufu ezikwazi ukumuncwa nezinto ezintsha zisiza iziguli zelaphe kangcono ngemva kokulungiswa kwe-acl. I-Ligament Fixation System ye-XC Medico inikeza ukwesekwa okuqinile, isiza ukuphulukisa, futhi yehlisa izinkinga. Odokotela abaningi babona amandla ahlangene angcono kanye nemiphumela emihle yesikhathi eside ngalolu hlelo.

• I-XC Medico ilandela imithetho yekhwalithi ephezulu.

• Uthola ukulethwa okusheshayo nosizo ngemibuzo.

• Uhlelo lukusiza ukuthi uthole imiphumela emihle yeziguli zakho.

Khetha i-XC Medico njengenkampani yakho ethembekile yezikulufo zokuphazamiseka neminye imikhiqizo.

FAQ

Iyini injongo eyinhloko yesikulufu sokuphazanyiswa?

Usebenzisa isikulufu sokuphazamisa ukuze ubambe igraft ngokuqinile emhubheni wamathambo. Lokhu kugcina i-graft izinzile ngesikhathi sokwelashwa. Isikulufu sisiza umsipha omusha ukuba unamathele ethanjeni.

Ungasikhetha kanjani isikulufu sokuphazanyiswa sikasayizi olungile?

Ufanisa usayizi wesikulufu nomhubhe we-graft kanye nethambo. Isikulufu esikhulu sinikeza ukubamba okwengeziwe. Njalo hlola izinga lethambo lesiguli kanye nohlobo lokuhlinzwa oluhlelayo.

Ingabe izikulufu ze-bioabsorbable ziphephile kuzo zonke iziguli?

Izikulufu ze-Bioabsorbable ziphephile ezigulini eziningi. Kufanele uhlole ukungezwani komzimba nezinto ezithile noma izimo zempilo ezikhethekile. Lezi zikulufu ziyaphuka emzimbeni ngokuhamba kwesikhathi.

Ungakwazi yini ukusebenzisa izikulufu zokuphazamiseka ekuhlinzeni ngaphandle kokwakhiwa kabusha kwe-ACL?

Yebo, ungasebenzisa izikulufu zokuphazanyiswa kokunye ukulungisa imisipha, okufana nokuhlinzwa kwe-PCL noma i-MPFL. Basiza futhi ngokulungiswa kwezicubu ezithambile ezinkambisweni eziningi zamathambo.