Ukubuyekezwa kobufakazi · Ukulungiswa kwe-Rotator Cuff
I-Suture tape ingathuthukisa izici zokuqala zemishini yesakhiwo sokulungisa, kodwa ubufakazi bamanje bomtholampilo abubonisi njalo ukuphulukiswa okusheshayo, ukusebenza okungcono, noma izinga eliphansi lokuhlehla kunama-sutures avamile anamandla aphezulu.
Impendulo emfushane: Itheyiphu ye-Suture ingase inikeze ingcindezi enkulu yokuxhumana yesikhathi-ziro, ukuqina, nomthwalo ekwehlulekeni kumamodeli aselabhorethri. Kodwa-ke, lezi zinzuzo ze-biomechanical azizange zihunyushwe ngokungaguquki ekuphulukiseni i-tendon ephakeme noma ukuhlehla okumbalwa kweziguli. Izici zezinyembezi, izicubu kanye nekhwalithi yamathambo, ukungezwani kokulungisa, indlela yokulungisa, izici zesiguli, nokuvuselelwa kuhlala kuyizingxenye ezibalulekile zomphumela.
Okuthathwayo Okubalulekile
Itheyiphu eyisicaba isakaza amandla endaweni ebanzi ye-tendon kune-suture eyindilinga yokusetshenziswa okuhlosiwe okufanayo.
Izifundo ze-Biomechanical ngokuvamile zibika ingcindezi ephezulu yokuxhumana, ukuqina, noma umthwalo wokuhluleka.
Izifundo zomtholampilo zokuqhathanisa ngokuvamile zithole amazinga afanayo ahlehlayo kanye nemiphumela ebikwe isiguli.
Ukukhethwa kwezinto ezibonakalayo kuwukuhluka okukodwa ngaphakathi kokwakhiwa okuphelele kokulungisa kanye nendlela yokunakekelwa kwangemva kokuhlinzwa.
Iyini i-Suture Tape?
I-Suture tape iyimpahla ye-suture eyisicaba, ephothiwe, engamuncwa esetshenziswa ekulungiseni izicubu ezithambile. Uma kuqhathaniswa nomthungo ojwayelekile oyindilinga wamandla aphezulu, iphrofayili yayo efana neribhoni yandisa indawo engaphezulu ethinta ithoni. Isizathu esihlosiwe sokusebenza siwukusabalalisa umthwalo endaweni ebanzi futhi kuncishiswe ingcindezi egxilile kusixhumi esibonakalayo se-suture-tendon.
Igama elithi suture tape lichaza ifomethi yezinto ezibonakalayo, hhayi umkhiqizo owodwa omisiwe. Ububanzi betheyiphu, ukwakheka kwefayibha, umluko, ukunamathela, izici zokubamba, indlela yokuvala inzalo, nokuhambisana nehange kungahluka ngomkhiqizi. Ubufakazi obutholwe ngetheyiphu eyodwa enophawu noma ukwakhiwa kokukhanda akufanele kusetshenziswe ngokuzenzakalelayo kuyo yonke inhlanganisela yetheyiphu nehange.
I-XC Medico Ama-sutures emithi yezemidlalo ye-UHMWPE ahlinzeka ngolwazi lwezinga lomkhiqizo ukuze luhlolwe ngochwepheshe. Ukucaciswa komkhiqizo kufanele kubuyekezwe ngokwehlukana nobufakazi bomtholampilo obufingqiwe kulesi sihloko.
Isetshenziswa Kanjani I-Suture Tape Ekulungiseni I-Rotator Cuff?
Ngesikhathi sokulungiswa kwe-cuff ye-arthroscopic rotator, i-tendon edabukile iyahlanganiswa futhi ibuyiselwe endaweni yayo ye-humeral. Udokotela ohlinzayo udlula i-suture noma i-tape nge-tendon futhi ayivikele ngehange elilodwa noma ngaphezulu. Itheyiphu ingase ifakwe kumugqa owodwa, umugqa okabili, okulingana-transosseous, noma ukwakhiwa kwebhuloho le-suture.
Impahla ayikwazi ukuhlolwa ngaphandle kokwakhiwa. Inombolo nendawo yamahange, iphethini yokudlula itheyiphu, ukungezwani kwemigqa emaphakathi, ukulungiswa kwezinhlangothi, ukulunywa kwezicubu, ukuhamba kwe-tendon, nokuthengwa kwehange ethanjeni konke kungathinta izinsimbi zokulungisa. Okubalulekile okuqinile akunxeshezeli ikhwalithi yezicubu ezibuthakathaka, ukungezwani kokulungisa okudlulele, noma ukungaqinisi ihange okwanele.
- Ukulungisa umugqa owodwa: amahange ngokuvamile abekwe emgqeni owodwa eduze nendawo.
- Ukulungiswa kwemigqa emibili: amaphuzu okulungisa aphakathi nendawo asetshenziselwa ukubuyisela i-tendon-to-bone footprint ebanzi.
- Ukulungiswa kwebhuloho le-Suture: i-suture noma i-tape ihlanganisa i-tendon futhi ivikelwe eceleni, ngokuvamile ngaphandle kwamafindo emigqa ye-lateral.
- Ukucushwa kwe-Rip-stop: itheyiphu ingase ibe yingxenye yesakhiwo sokwabelana ngokulayisha okuhloswe ukumelana nokunqanyulwa kwezicubu.
Bubonisani Ubufakazi Be-Biomechanical?
Izifundo zaselabhorethri ngokuvamile zisekela i-logic yemishini ye-tape. Kumodeli ye-ovine ebikwe ngu-Liu kanye nozakwabo, ukulungiswa kwetheyiphu kukhiqize ingcindezi enkulu yokuthintana nonyawo kanye nomthwalo wokugcina wokuhluleka okuphezulu kunokulungiswa kwe-suture engu-No. 2 kusetshenziswa isistimu yehange efanayo engenamafindo. Ingxenye yomuntu yalolo cwaningo, nokho, ayizange ibonise izinga eliphansi lezinyanga eziyisithupha lokuhlehla.
| I-Study | Model | Main Ukuthola | lokho okungakufakazeli |
|---|---|---|---|
| Liu et al., 2017 Laboratory + cohort |
Amahlombe angama-ovine ayi-16 okuhlolwa kwemishini | Ingcindezi yokuxhumana: 0.33 ± 0.03 MPa ene-tape ngokumelene no-0.11 ± 0.03 MPa nge-suture. Umthwalo wokuhluleka kokugcina: 217 ± 28 N uma kuqhathaniswa no-144 ± 14 N. | Ayisunguli ukuphulukiswa kwebhayoloji okusheshayo noma izinga eliphansi lokuhlehla kwesiguli. |
| Huntington et al., 2018 Laboratory |
Izakhiwo ze-Ovine suture-bridge | Okunye ukucushwa kwetheyiphu kukhiqize ukucindezela kokuxhumana okuphezulu, indawo yokuxhumana, noma amandla aqinile. | Imiphumela yahlukahluka ngokucushwa kwehange futhi iphuma kumodeli yesilwane. |
| Borbas et al., 2021 Cadaveric |
Ukuhlolwa kwezinto ezibonakalayo kanye nemisipha yomuntu ye-cadaveric cuff | Njengeqembu, amateyipu abonise ukuqina okuphezulu nokusebenza okuhlobene nomthwalo kunama-round sutures. | Ukuhlolwa kwe-Time-zero cadaveric akukwazi ukukala ukuphulukiswa kwe-tendon-to-bone ezigulini eziphilayo. |
Ukuphakama kwe-Biomechanical kuyimpahla yesakhiwo esihloliwe ngesikhathi esinguziro; akubona, ngokwako, ubufakazi bokuphulukiswa komtholampilo okuphakeme.
Kungani I-Wider Tape Ingase Yehlise Ukucindezelwa Kwezicubu Kwasendaweni
Itheyiphu ebanzi ingasakaza amandla endaweni engaphezulu ye-tendon. Lokhu kungase kwenyuse ukumelana nokunqamula kwezinye izimo zokuhlola. Noma kunjalo, ukusabela kwezicubu kuncike kububanzi betheyiphu, iphethini yokudlula, ukungezwani okusetshenzisiwe, ukuwohloka kwezicubu, ukulayisha ngomjikelezo, nokwakhiwa okuphelele kokulungisa. Kunembile kakhulu ukusho ukuthi i-tape ingase ithuthukise ukusatshalaliswa komthwalo kunokufuna ukuthi njalo ibangela ukulimala kwezicubu ezincane.
Ingabe I-Biomechanics Engcono Ikhiqiza Ukuphulukiswa Okungcono Komtholampilo?
Hhayi ngokungaguquki. Izincwadi zomtholampilo ziqaphe kakhulu kunolimi lwamanje lokumaketha oluvame ukusetshenziswa eduze kwe-tape. Ucwaningo lokuqhathanisa ngokuvamile lubonisa ukuthi i-tape ingasetshenziswa ngempumelelo, kodwa ayizange isungule ukunciphisa okuthembekile kokuphindaphinda noma ukuthuthukiswa okungaguquki emiphumeleni ebikwe isiguli.
| Ubufakazi Bemitholampilo Amaqembu kanye | Yokulandelela | Kwemiphumela | Nokutolikwa |
|---|---|---|---|
| Liu et al., 2017 | Itheyiphu n=50; i-suture n=100; ultrasound ezinyangeni ezingu-6 | Ukuhlehla: 16% nge-tape uma kuqhathaniswa no-17% nge-suture. | Amazinga afanayo ahlehlayo naphezu komshini ongcono waselabhorethri; i-retrospective, iqoqo likadokotela ohlinzayo oyedwa. |
| Ukubuyekezwa okuhlelekile nokuhlaziywa kwe-meta, 2021 | 681 ukulungiswa komtholampilo kuzo zonke izifundo zomtholampilo eziyisithupha | Ukuhlehla: 16% nge-tape uma kuqhathaniswa no-20% nge-suture evamile; P=.26. Awukho umehluko wekhwalithi emiphumeleni ebikwe isiguli. | Ayikho inzuzo ebalulekile yomtholampilo ngokwezibalo; izifundo ezisezingeni eliphezulu bezisadingeka. |
| Nie et al., 2025 | Iqembu le-tape-anchor n=36; iqembu le-Traditional-anchor n=50; ubuncane bezinyanga eziyi-12 zokulandela | Ukuhlehla: 11.1% ngokumelene ne-12.0%; awukho umehluko obalulekile. Iqembu le-tape-ancho libonise izinzuzo ezithile kugqinsi lwe-tendon namandla emisipha. | Okutholiwe okwesibili okuthembisayo, kodwa idizayini ye-retrospective kanye neziphetho zembangela yesampula encane. |
Umkhawulo wobufakazi: Ucwaningo luqhathanisa imikhiqizo yamateyipu ehlukene, amahange, amaphethini amaphaseji, izakhiwo zokulungisa, osayizi bezinyembezi, izindlela zokuthwebula izithombe, kanye nezikhathi zokulandelela. Izifundo eziningi zomtholampilo zibuyela emuva. Ngakho-ke akulungile ukwethula iphesenti elilodwa njengomphumela olindelekile kuso sonke isiguli noma isistimu yedivayisi ngayinye.
Kuthiwani Ngobuhlungu, Ukusetshenziswa Kwe-Opioid, Nokubuyela Ezemidlalo?
Ubufakazi bamanje abuthetheleli ukumangalela ukuthi i-suture tape iyodwa inciphisa ubuhlungu obungemuva kokuhlinzwa, ukusetshenziswa kwe-opioid, noma isikhathi sokubuyela emdlalweni. Le miphumela ithonywa kakhulu yi-anesthesia, izinqubo zokudambisa izinhlungu, izinqubo ezihambisanayo, izici zokudabula, ukuvuselelwa, okulindelwe yisiguli, kanye nezidingo zomsebenzi. Ngaphandle kokuthi ucwaningo luqhathanise ngokuqondile i-tape kanye ne-suture evamile ngenkathi kulawulwa lezi ziguquguqukayo, idatha yayo yobuhlungu noma yokutakula akufanele ifakwe ku-suture material.
I-Suture Tape kanye nama-Knotless Anchors
Amahange angenamafindo angavikela i-suture noma itheyiphu ngaphandle kwefindo elivamile eliboshiwe kuleyo ndawo yokulungisa. Kuye ngesistimu namasu, lokhu kungase kwenze ukungezwani kube lula, kunciphise inqwaba ehlobene namafindo, noma kugweme ukuminyanisa kwefindo lomugqa omaphakathi. Ukuze uthole incazelo evamile yamadivayisi okulungisa, bheka ukuthi amahange e-suture asebenza kanjani.
I-Knotless ayisho ngokuzenzakalelayo ukuthi unamandla, uphephile, noma uphakeme ngokomtholampilo. Ukubuyekezwa okuhlelekile kwamahlombe angu-1,411 akutholanga mehluko obalulekile kuwo wonke amanani okuhlehla phakathi kokubopha ifindo nokulungisa imigqa emibili engenamafindo, nakuba ukusatshalaliswa kwamaphethini okuhlehla kuhlukile. Okunye ukuhlaziywa kwe-meta nakho akutholanga inzuzo enkulu yezinga lokuhlehla eliphelele lanoma iyiphi indlela.
I-anchor material iyisinqumo esihlukile kunefomethi ye-suture. Isihloko on I-PEEK kanye namahange ensimbi yensimbi axoxa ngesithombe, ukubuyekezwa, nokucatshangelwa kwezinto ezibonakalayo ngaphandle kokuphatha into eyodwa njengento ethandeka emhlabeni wonke.
Isexwayiso esiqondene nedivayisi: Ukulungiswa kweso, indlela yokukhiya, indlela yokufaka, ukulungiswa kwe-drill noma ukubhoboza, ukusebenzisana kwetheyiphu, nokucindezela okunconyiwe kuqondene nomkhiqizo. Hlala ubheka imiyalelo esebenzayo ukuze uyisebenzise kanye nezidingo zokulawula zendawo.
Yiziphi Izinto Ezithonya Ukuphulukiswa Kwe-Rotator Cuff?
I-suture material iyingxenye eyodwa kuphela yokuphulukiswa kwe-rotator cuff. Izinqumo zomtholampilo kanye nokuchazwa kwemiphumela kufanele futhi kucabangele:
Usayizi wezinyembezi, ukungaguquguquki, ukuhlehla, inani lemisipha ehilelekile, nokulungisa ukungezwani kuthinta ukubikezela.
Ukujiya kwe-tendon, ukuwohloka, ukungena kwamafutha, ukuwohloka kwemisipha, nokuqina kunomthelela wokunyakaza.
Ikhwalithi yethambo, ukubekwa kwehange, indlela yokufaka, nokumisa kokwakha kuthinta ukuthengwa kwehange.
Iminyaka yobudala, ukubhema noma ukuchayeka ku-nicotine, impilo ye-metabolic, izimfuno zomsebenzi, kanye nendaba yokubambelela ekubuyiseleni esimweni esihle.
Ukulungiswa okuklanywe kahle kufanele kulinganise ukucindezelwa nokuzinza nokuvikelwa kwethenda kanye nokunikezwa kwegazi. Ukucindezeleka okwedlulele noma ukulayisha okungalungile kokuvuselela kungase kufake engozini ukulungiswa kungakhathaliseki ukuthi i-tape noma i-round suture iyasetshenziswa.
Ochwepheshe Kufanele Baluhlole Kanjani Uhlelo Lwe-Tape-and-Anchor?
Kodokotela abahlinzayo, izibhedlela, nabasabalalisi, ukuhlola okuwusizo kudlula inani elilodwa lokwehluleka. Ubufakazi nokubuyekezwa kokuthengwa kwempahla kufanele kubhekane nohlelo oluphelele.
| Indawo yokuhlola | Imibuzo okufanele iqinisekiswe |
|---|---|
| Okubalulekile | Ithini i-fiber, ububanzi betheyiphu, i-braid, i-coating, indlela yokuvala inzalo, nezinkomba ezinelebula? |
| Ukuhambisana kwehange | Yimaphi amasayizi wehange kanye neso noma izindlela zokukhiya ezigunyazwe itheyipu? |
| Yakha ukuhlola | Ingabe ukufuduka okujikelezayo, ukuphuma, ukunqamula, kanye nemodi yokwehluleka kuhlolwe njengokwakhiwa okuphelele? |
| Izinsimbi | Ingabe abadlulayo, ama-punch, ama-drill, abafakayo, nezinyathelo zokucindezela kuhambisana ngokucacile nesistimu? |
| Amadokhumenti | Ingabe imiyalelo yokusetshenziswa, ukulandeleka, ulwazi lokupakisha, impilo yeshalofu, kanye nemibhalo efanele yokulawula iyatholakala? |
| Ubufakazi bomtholampilo | Ingabe ubufakazi obucashuniwe busebenza ezintweni ezifanayo, ihange, amasu, kanye nokusetshenziswa okuhlosiwe? |
Lapho kuhlolwa umnikelo wenqubo ophelele, okutholakalayo Isethi ye-arthroscopic shoulder suture passer ingase ibuyekezwe eceleni kokuhamba komsebenzi okuhleliwe kokulungisa. Ukuhambisana nokusetshenziswa okuhlosiwe kufanele kuqinisekiswe kusukela kumadokhumenti womkhiqizo kunokuba kuthathwe ku-athikili yokufundisa.
imibuzo ejwayelekile ukubuzwa
Ingabe i-suture tape inamandla kune-suture evamile?
Izifundo eziningi zaselabhorethri zibika ukuqina okuphezulu, ingcindezi yokuxhumana, noma umthwalo wokuhluleka kwetheyiphu. Umphumela uncike emikhiqizweni ethile, imodeli ye-tendon, amafindo noma amahange, kanye nokulungiswa kokulungisa. Amandla emishini ewodwa awakhombisi ukuphulukiswa okungcono ezigulini.
Ingabe i-suture tape inciphisa izinga lokuhlehla kwe-rotator cuff?
Ubufakazi bamanje bokuqhathanisa abukabonisi ngokuqhubekayo ukuncipha okubalulekile kwezibalo. Amaqembu e-tape kanye namaqembu e-suture anamandla aphezulu ngokuvamile abonise amazinga afanayo ahlehlayo, nakuba ucwaningo luqhubeka nokuhlola ukwakhiwa okuthile kanye namaqenjana esiguli.
Ingabe i-suture tape iyasheshisa ukululama?
Abukho ubufakazi obanele bokuthi ukululama ngokushesha ku-tape ngokwayo. Ukululama kuncike ekukhaleni kwezinyembezi, ikhwalithi yezicubu, izinqubo ezihambisanayo, ukuvikelwa kwangemva kokuhlinzwa, ukubuyisela esimweni, nezici zesiguli ngasinye.
Ingabe amahange angena-knotless angcono ekulungiseni amakhafu e-rotator?
Amahange angenayo i-knotless anikeza izinketho ezithile zokwakha nokugeleza komsebenzi, kodwa ukubuyekezwa okuhlelekile akuzange kusungule isilinganiso sokuhlehla esiphelele noma inzuzo yokusebenza ngaphezu kokulungiswa kwemigqa ephindwe kabili. Ukukhethwa kwesu kuhlala kuncike esimweni nakuhlelo.
Ingabe yonke i-suture tape ingasetshenziswa nehange ngalinye?
Cha. Ububanzi betheyiphu, indlela yokukhiya, idizayini yeso, indlela yokufaka, nokuhambisana okunelebula kungahluka. Sebenzisa kuphela izinhlanganisela ezisekelwa imibhalo efanele yomkhiqizo nemiyalo yokusetshenziswa.
Isiphetho
I-Suture tape iyindlela ethembekile yokulungisa ikhabethe ejikelezayo futhi ibonise ubunjiniyela besikhathi esivumayo kuzilungiselelo eziningi zokuhlola. Isiphetho somtholampilo esivikeleke kakhulu, noma kunjalo, akukhona ukuthi i-tape iphulukisa ngokuzenzakalelayo i-rotator cuff kangcono. Izifundo zokuqhathanisa ezitholakalayo ngokuvamile zibika izilinganiso zokuhlehla ezifanayo kanye nemiphumela yokusebenza kuma-sutures avamile anamandla aphezulu, ngocwaningo oluthile olusha olukhomba ukutholwa kwesakhiwo sesibili noma amandla okudinga ukuqinisekiswa okwengeziwe.
Ngakho-ke ukukhethwa kwezinto ezibonakalayo kufanele kwenziwe ngaphakathi komongo wephethini yezinyembezi, i-tendon nekhwalithi yamathambo, ukulungiswa kokulungisa, amahange ahambisanayo nezinsimbi, isipiliyoni sikadokotela ohlinzayo, kanye nephrothokholi esebenzayo yangemva kokuhlinzwa.
Izithenjwa
- Liu RW, Lam PH, Shepherd HM, Murrell GAC. I-Tape Versus Suture in Arthroscopic Rotator Cuff Repair: Ukuhlaziywa kwe-Biomechanical kanye nokuhlolwa kwezilinganiso zokuhluleka ku-6 Izinyanga ze . -Orthop J Sports Med . 2017;5(4):2325967117701212.
- Huntington L, et al. Ukusetshenziswa kwe-suture-tape kanye ne-suture-wire ekulungiseni i-cuff rotator ye-arthroscopic: Ucwaningo oluqhathaniswayo lwe-biomechanics . Ukulimala . 2018;49(11):2047–2052.
- Boksh K, Haque A, Sharma A, Divall P, Singh H. Ukusetshenziswa kwe-Suture Tapes Versus Normal Sutures for Arthroscopic Rotator Cuff Repairs: Ukubuyekezwa Okuhlelekile kanye nokuhlaziywa kwe-Meta . Am J Sports Med . 2022;50(1):264–272.
- Borbas P, et al. I-High-Strength Suture Tapes Inamandla Nge-Biomechanically Kune-High-Strength Sutures Esetshenziswa Ekulungiseni I-Rotator Cuff . I-Arthrosc Sports Med Rehabil . 2021.
- Nie S, et al. Amahange etheyiphu ye-Suture okuthuthukisa ukuphulukiswa ezinyembezini ze-rotator cuff: isifundo se-retrospective cohort . BMC Musculoskelet Disord . 2025;26:470.
- Izinhlobo Zokubuya Ngemva Kokubopha Ifindo kanye ne-Knotless Suture Bridge Rotator Cuff Repair: Ukubuyekezwa Okuhlelekile kanye nokuhlaziywa kwe-Meta . 2022.
- Figueiredo JAF, et al. Izilinganiso zokuhlehla zekhafu ezijikelezayo ezinamafindo noma ezingenafindo: ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta kwe- . JSES Rev Rep Tech . 2023.
Isaziso sezokwelapha nesokulawula: Le ndatshana ihloselwe imfundo yobungcweti kanye nezinjongo ezijwayelekile zokuhlola umkhiqizo. Ayihlinzeki ngokuxilongwa, izincomo zokwelashwa, iziyalezo zokuhlinzwa, noma isiqinisekiso somphumela womtholampilo. Ukutholakala komkhiqizo, izinkomba, isimo sokulawula, kanye nemiyalelo yokusetshenziswa kuyahlukahluka ngokwemakethe. Izinqumo zomtholampilo kufanele zenziwe ochwepheshe bezempilo abaqeqeshiwe besebenzisa ukwahlulela okuqondene nesiguli kanye nemibhalo esebenzayo yomkhiqizo.
Ukuhlola I-Sports Medicine Suture kanye ne-Anchor System?
Xhumana ne-XC Medico ukuze uthole imininingwane etholakalayo yomkhiqizo, ulwazi lokucushwa kwesistimu, imininingwane yokupakisha, kanye nemibhalo eqondene nemakethe ukuze kubuyekezwe ngochwepheshe.
Xhumana ne-XC Medico
