Indlela Yokukhetha I-Hip Implant Elungile

I-hip prosthesis iyisisetshenziswa sezokwelapha esifakelwayo esinezingxenye ezintathu: isiqu sesifazane, ikhanda lesifazane kanye nenkomishi ye-acetabular. Lezi zingxenye ezintathu zithatha indawo ye-hip elimele, ukubuyisela ukuhamba nokukhulula ubuhlungu esigulini.

01. Yiziphi izingxenye ze-a i-hip prosthesis?

I-hip prosthesis iqukethe izingxenye ezintathu eziyinhloko:

Isiqu sesifazane

ngemva kokukhipha ikhanda lesifazane lesiguli, umsele wesifazane wesiguli uvuselelwa kabusha futhi isiqu sesifazane sifakwa. Isiqu se-femoral singase sifakwe usimende noma singagxiliwe (indlela yokucindezela i-press fit) kuye ngeminyaka yesiguli, i-morphology, i-idiosyncrasies yamathambo kanye nemikhuba kadokotela.

Inhloko Yabesifazane

Ikhanda eliyindilinga elenziwe ngensimbi, i-polymer noma i-ceramic libekwa engxenyeni engenhla yesiqu sesifazane esikhundleni sekhanda elidala elimele le-femoral elisusiwe.

I-Acetabular prosthesis (noma i-prosthesis yenkomishi)

i-cartilage eyonakele kusukela phezulu kwe-acetabulum, lapho ikhanda elidala le-femoral lalikhona, liyasuswa. Esikhundleni salo kune-tapered acetabular prosthesis. Izikulufu noma usimende zingase zisetshenziselwe ukuyibamba imile. Ngaphakathi kule nkomishi kunepulasitiki, i-ceramic noma inlay yensimbi ezothintana nekhanda lokufakelwa le-femoral.

02. Yiziphi izinto eziyinhloko ezisetshenziselwa ama-hip prostheses?

Ama-hip prostheses angahlukaniswa ngokuya ngezinto ezisetshenziswa ukuzenza. Njengamanje, lezi zinto zingahlukaniswa ngezinhlobo ezintathu:

Izinsimbi

Izinsimbi ezithile, njengensimbi engagqwali, i-cobalt-chromium alloy noma i-titanium zisetshenziselwa ukwenza iziqu zesifazane.

Ama-polymers

i-polyethylene, ipulasitiki eqinile kakhulu kanye nezinto ezisetshenziswa kakhulu emhlabeni. Kuyinto engasebenzi futhi ehambisana kakhulu ne-biocompatible eyethulwa ku-orthopedics ngeminyaka yo-1960 njengengxenye yokwenziwa kwe-acetabular ehlanganisiwe. Namuhla, le nto isasetshenziswa kwezinye iziguli, kodwa okubi ukuthi ngokuhamba kwesikhathi, kunengozi yokuthi i-prosthesis izoguga epulasitiki, ngakho-ke impilo ye-prosthesis izofinyezwa. Kodwa-ke, lobu bungozi busengancishiswa njengoba ezinye iziguli zingagcina lesi sitho sokufakelwa kuze kube iminyaka engama-30 kanti ezinye iminyaka embalwa kuphela.

▲Isithombe: PROCOTYL® L Acetabular Cup (Imikhiqizo Yamathambo Engena Kancane: Ihambisana ne-Delta Ceramic Liners kanye ne-A-Class Highly Cross-Linked Polyethylene Liners)

Indawo yokunyakaza phakathi kwekhanda lesifazane nendebe yesifazane idala lokho esikubiza ngokuthi umzuzu wokungqubuzana. Iyingxenye ebuthakathaka kakhulu ye-prosthesis, ikakhulukazi mayelana nokuguga. Kukhona ukubhanqa okune okungenzeka:

I-Ceramic-polyethylene

-Ceramic-ceramic

-Metal-polyethylene

-Metal-insimbi

Umbhangqwana ngamunye wokungqubuzana unezinzuzo kanye nokubi, futhi udokotela ohlinzayo wamathambo uzokhetha inhlanganisela yokungqubuzana efaneleke kakhulu ngokusekelwe ezicini eziningana, okuhlanganisa iminyaka yesiguli, ukuvivinya umzimba, kanye nokucaciswa kwamathambo.

Kubalulekile ukuqaphela ukuthi ama-prostheses ensimbi ngokuvamile awanconywa. Ezinye izinkampani ezikhiqiza izimila ezinjalo zanquma ukuyeka ukuzithengisa ngo-2010-2011, futhi ukuze kusizakale iziguli, zanquma ukukhumbula lezo zifakelo ezingazange zisetshenziswe. Inkinga ibangelwa ukungqubuzana phakathi kwezakhi ezihlukahlukene zokufakelwa, futhi lokhu kungqubuzana kungakhipha izinhlayiya zensimbi ezincane ezibe sezingena egazini. Ekuhlanganyeleni kwe-hip, lezi zinhlayiya ezincane zingabangela ukungezwani komzimba, okuholela ebuhlungu bendawo kanye nezilonda.

03 . Yiziphi izindlela eziyinhloko zokulungiswa kwama-hip prostheses?

Ama-prostheses angalungiswa ku-femur noma i-acetabulum ngokufaka u-cement ohlinzayo noma ukuvuselelwa kwamathambo esibili (amasu angafakwanga noma okucindezela). Ngokuvamile, isiqu se-femoral esihlanganisiwe sihlotshaniswa nenkomishi ye-femoral engafakwanga. Izici zale nqubo zichazwe ngezansi:

Kusetshenziswa indlela yokuqinisa amathambo okuhlinza

usimende wethambo osetshenzisiwe yi- i-acrylic polymer . Iqinisa phakathi nemizuzu engu-15 phakathi nenqubo futhi isetha ngokushesha ngemva kokulungiswa.

Kusetshenziswa izindlela ezingafakwanga uncement noma zokucindezelwa

Ama-prostheses angafakiwe (izinduku zokufakelwa noma izinkomishi) azinza ngemva kwamasonto ayisithupha kuya kwayishumi nambili ngenxa yesenzo sokuvuselelwa kwamathambo. Ukuze kuthuthukiswe ukuvuselelwa kwamathambo, ingaphezulu le-prosthesis livame ukumbozwa ungqimba oluncane lwe-hydroxyapatite, ingxenye yamaminerali ethambo. Ithambo eliseduze libona i-hydroxyapatite njengenye yezingxenye zayo bese likhula ngokushesha ongqimbeni lwamathambo we-prosthesis. I-Hydroxyapatite ingakhiqizwa ngamakhemikhali.

04. I-hip prosthesis ihlala isikhathi esingakanani?

Impilo yesevisi ye-prostheses iye yanda eminyakeni yamuva: ezigulini ezingaphansi kweminyaka engama-50 ubudala, ingxenye yeziguli ezinezitho zokwenziwa ezisasebenza ngemva kweminyaka eyishumi yokusetshenziswa cishe zingama-99%.

Izibalo ezifanayo zingabonwa ezigulini ezindala ngakho-ke ezingenzi lutho. Ngakho-ke, ukuhlinzwa esikhundleni se-hip kungenziwa ezigulini zabo bonke ubudala.

Impilo yesevisi ye-prosthesis incike kakhulu kulezi zici ezilandelayo:

-iminyaka yesiguli, inkomba yesisindo somzimba kanye nezinga lomsebenzi

-Ububanzi bekhanda lokufakelwa

-uhlobo lwesikhathi sokungqubuzana

Esimweni sokugcina, kubalulekile ukuqaphela ukuthi isikhathi eside se-prosthesis sincike kakhulu ekubunjweni kwe-prosthesis. Lapho kokubili ikhanda lesifazane kanye nenkomishi yokufakelwa kwenziwa ngensimbi noma nge-ceramic, izinzuzo eziyinhloko yizinga eliphansi kakhulu lokugqoka kanye nethuba lokusebenzisa ikhanda elibanzi lesifazane, okukhawulela ingozi yokuguqa. Kubalulekile ukuqaphela ukuthi kunengozi yokuhlakazeka kwemfucumfucu ezicutshini ezizungeze i-prosthesis lapho ama-prostheses e-metal-to-metal kanye ne-ceramic-to-ceramic ebhanqiwe. Nakuba izitho zokufakelwa ze-ceramic-ceramic ziphuka kancane kunezitho zokufakelwa zensimbi-zensimbi futhi zimelana kakhulu nokuguguleka okushayisanayo kunamapheya ensimbi-ensimbi, kusafanele zisetshenziswe ngokuqapha.

05. Yiziphi izingozi ezihlobene nokufakelwa kwe-hip?

Ngaphezu kwezingozi ezitholakala kunoma yikuphi ukungenelela kokuhlinzwa (izingozi zokubulala izinzwa, izifo ezitholwa esibhedlela), izinkinga zingenzeka:

Ingozi yokukhishwa

lokhu kuyinkinga enkulu ezigulini futhi ingozi iyahlukahluka ngokuhamba kwesikhathi. Iphezulu ikakhulukazi ezinyangeni zokuqala ngemva kokuhlinzwa futhi iyancipha ngemva konyaka wokuqala. Bese ikhula kancane kancane futhi ngokuhamba kwesikhathi. Kunezici eziningana ezingaholela ekuhlukanisekeni, okungenzeka kuhlobane nesiguli, ukuhlinzwa nokufakelwa, noma ukulandelwa kwangemuva kokuhlinzwa. Ingozi yokuphindaphinda iyanda kakhulu ngemva kwesiqephu sokuqala sokuhlukaniswa.

Ingozi yokutheleleka

noma iyiphi inqubo yokuhlinzwa inengozi yokutheleleka, futhi lapho i-prosthesis ifakwe, le ngozi iyanda njengoba umzimba wangaphandle ungena emzimbeni. Ngale ndlela, isimiso somzimba sokuzivikela ezifweni siyaphambukiswa futhi kwakhiwa indawo yendawo ye-immunodeficiency. Amagciwane ngokuvamile angenalo ithuba lokusinda angakhula kulo mzimba wangaphandle. Le ngozi yokutheleleka ingase ibe maningi kakhulu kubantu asebekhulile ngenxa yokuthi banezivikelo zokuzivikela ezibuthakathaka. Ezinye izici, njengokukhuluphala, okwenza kube nzima ukungenelela, noma isifo sikashukela, esehlisa izinga lokuzivikela komzimba, nokubhema, kungandisa ingozi yokutheleleka.

Ingozi yokungezwani komzimba

ezinye zezinto ezisetshenziswa kuma-prostheses zinamandla okubangela ukungezwani komzimba.

Ingozi yokuhlinzwa okubukeziwe

Ukungaphumeleli, ukuguga nokuklebhuka, noma ukugqabuka kwe-prosthesis kungase kudinge ukuhlinzwa okubukeziwe.