Kuyini izinyembezi ze-ACL?
I-ACL itholakala phakathi kwedolo. Ixhuma ithambo lethanga (i-femur) ne-tibia futhi ivimbele i-tibia ukuthi ingasheleli phambili futhi ijikeleze kakhulu. Uma uklebhula i-ACL yakho, noma yikuphi ukuguquka kokuqondisa okungazelelwe, njengokunyakaza kwe-lateral noma ukuzungeza, phakathi nemidlalo efana nebhola lezinyawo, i-basketball, ithenisi, i-rugby noma ubuciko bokulwa, kungabangela ukuba idolo lakho lihluleke.
Amacala amaningi we-ACL izinyembezi avela ekulimaleni okungathintana naye okubangelwa ukusonteka okungazelelwe kwamadolo ngesikhathi sokuqeqeshwa noma ukuncintisana. Nabadlali bebhola bangaba nenkinga efanayo uma bewela ibhola amabanga amade, bafake ingcindezi emlenzeni omile.
Izindaba ezimbi kubasubathi besifazane abafunda lokhu: Abesifazane basengozini enkulu yezinyembezi ze-ACL ngoba amadolo abo awahambisani nokuqondanisa, ubukhulu kanye nokuma.
Abasubathi abadabula i-ACL yabo bavame ukuzwa "i-pop" bese kuba nokuvuvukala okungazelelwe kwedolo (ngenxa yokopha emlenzeni odabukile). Ngaphezu kwalokho, kunesibonakaliso esiyinhloko: isiguli asikwazi ukuhamba noma ukuqhubeka nokudlala imidlalo ngokushesha ngenxa yobuhlungu bamadolo. Lapho ukuvuvukala kwedolo ekugcineni kuncipha, isiguli singase sibe nomuzwa wokuthi idolo alizinzile futhi alikwazi nokubambelela, okwenza isiguli singakwazi ukudlala umdlalo esiwuthanda kakhulu.
Abasubathi abaningana abadumile bathole izinyembezi ze-ACL. Laba bahlanganisa: Zlatan Ibrahimovich, Ruud Van Nistelrooy, Francesco Totti, Paul Gascoigne, Alan Shearer, Tom Brady, Tiger Woods, Jamal Crawford, noDerrick Rose. Uma uke wabhekana nezinkinga ezifanayo, awuwedwa. Izindaba ezinhle ukuthi laba basubathi bakwazile ukuqhubeka ngempumelelo nemisebenzi yabo yobungcweti ngemuva kokwakhiwa kabusha kwe-ACL. Ngokuphathwa okufanele, nawe ungafana nabo!
Indlela Yokuxilonga I-ACL Tear
Kufanele uvakashele udokotela wakho uma usola ukuthi une-ACL edabukile. Bazokwazi ukuqinisekisa lokhu ngokuxilongwa futhi bancome izinyathelo ezingcono kakhulu zokuya phambili. Udokotela wakho uzokwenza ezinye izivivinyo ukuze anqume ukuthi unayo izinyembezi ze-ACL, kuhlanganise:
1.Ukuhlolwa komzimba lapho udokotela wakho ezohlola ukuthi idolo lakho lihamba kanjani uma liqhathaniswa nelinye, idolo elingalimali. Bangase futhi benze ukuhlolwa kwe-Lachman noma ukuhlolwa kwekhabethe langaphambili ukuze bahlole ububanzi bokunyakaza nokuthi ilunga lisebenza kahle kangakanani, futhi bakubuze imibuzo mayelana nokuthi lizwakala kanjani.
I-2.X-ray ukuhlolwa lapho udokotela wakho engakwazi ukukhipha ukuphuka noma ithambo eliphukile.
Iskena se-3.MRI esizobonisa imisipha yakho nezicubu ezithambile futhi sivumele udokotela wakho ukuba ahlole izinga lomonakalo.
I-4.I-Ultrasound scan ukuhlola imigqa, imisipha, nemisipha.
Uma ukulimala kwakho kuncane kungenzeka ukuthi awuzange uyidabule i-ACL futhi uyelule kuphela. Ukulimala kwe-ACL kulinganiswa ukuze kunqunywe ukuqina kwabo ngale ndlela elandelayo.
Ingabe i-ACL edabukile ingaziphilisa yodwa?
I-ACL imvamisa ayiphili kahle iyodwa ngoba ayinalo igazi elihle. Kufana nentambo. Uma iklebhukile ngokuphelele phakathi, kunzima ukuthi iziphetho ezimbili zixhumane ngokwemvelo, ikakhulukazi njengoba idolo lihlala lihamba. Kodwa-ke, abanye abasubathi abanezinyembezi ze-ACL eziyingxenye kuphela bangabuya bazodlala inqobo nje uma ukujoyina kuzinzile futhi imidlalo abayidlalayo ingabandakanyi ukunyakaza okuzumayo (njenge-baseball).
Ingabe ukuhlinzwa kabusha kwe-ACL ukuphela kwendlela yokwelapha?
Ukwakhiwa kabusha kwe-ACL kungukushintshwa okuphelele kwe-ACL edabukile "nge-graft yezicubu" (ngokuvamile ezenziwe ngama-tendon asuka ethangeni elingaphakathi) ukuze kunikeze ukuzinza emadolweni. Lokhu kuyindlela yokwelapha enconyiwe kubasubathi abanamadolo angazinzile futhi abakwazi ukuhlanganyela emisebenzini yezemidlalo ngemva kokukhala kwe-ACL.
Ngaphambi kokucabangela ukuhlinzwa, kufanele uthintane nochwepheshe wezokwelapha ngokomzimba onconywe udokotela wakho ohlinzayo futhi ulashwe ngokomzimba. Lokhu kuzosiza ukubuyisela idolo lakho uhla olugcwele lokunyakaza namandla, kuyilapho futhi kuvumela ukukhululeka kokulimala kwamathambo. Abanye odokotela bakholelwa nokuthi ukwakhiwa kabusha kwe-ACL kuhlotshaniswa nengozi ephansi ye-arthritis yokuqala (izinguquko eziguquguqukayo) ngokusekelwe ekutholweni kwe-x-ray.
Ukulungiswa kwe-ACL kuyindlela entsha yokwelashwa kwezinye izinhlobo zezinyembezi. Odokotela baphinde banamathisele iziphetho ezidabukile ze-ACL ethanjeni lethanga besebenzisa idivayisi ebizwa ngokuthi i-medial brace. Kodwa-ke, izinyembezi eziningi ze-ACL azifanelekile kule ndlela yokulungisa ngokuqondile. Iziguli eziye zalungiswa zinezinga eliphezulu lokuhlinzwa okubukeziwe (1 ezimweni ezingu-8, ngokusho kwamanye amaphepha). Njengamanje kunocwaningo oluningi mayelana nokusetshenziswa kwama-stem cell kanye ne-plasma ecebile ngamaplatelet ukusiza i-ACL ilulame. Kodwa-ke, lezi zindlela zisahlolwa, futhi ukwelashwa "okujwayelekile kwegolide" kusengukuhlinzwa kabusha kwe-ACL.
Ubani ongazuza kakhulu ngokuhlinzwa kokwakhiwa kabusha kwe-ACL?
1. Iziguli zabantu abadala ezisebenzayo ezibamba iqhaza kwezemidlalo ezibandakanya ukuzungezisa noma ukuzungeza.
2. Iziguli ezikhulile ezikhuthele ezisebenza emisebenzini edinga amandla amaningi omzimba futhi ehilela ukuzungezisa noma ukuzungeza.
3. Iziguli ezindala (ezifana neminyaka engaphezu kwengu-50 ubudala) ezibamba iqhaza emidlalweni ye-elite futhi ezingenazo izinguquko eziwohlokayo emadolweni.
4. Izingane noma intsha enezinyembezi ze-ACL. Amasu alungisiwe angasetshenziswa ukunciphisa ingozi yokulimala kwepuleti lokukhula.
5. Abasubathi abanokunye ukulimala kwamadolo ngaphandle kwezinyembezi ze-ACL, njenge-posterior cruciate ligament (PCL), i-collateral ligament (LCL), i-meniscus, nokulimala kwe-cartilage. Ikakhulukazi kwezinye iziguli ezinezinyembezi ze-meniscus, uma ekwazi ukulungisa i-ACL ngesikhathi esifanayo, umphumela uzoba ngcono.
Yiziphi izinhlobo ezahlukene zokuhlinzwa kokwakhiwa kabusha kwe-ACL?
1. I-Hamstring tendon - Lokhu kungavunwa kalula ngaphakathi kwedolo ngokusebenzisa i-incision encane ngesikhathi sokuhlinzwa (i-autograft). I-ACL edabukile ingase ithathelwe indawo ithoni enikelwe ngomunye umuntu (allograft). Abasubathi abane-hypermobility (hyperlaxity), imigqa eqinile ye-medial collateral ligaments (MCL), noma izintambo ezincane ze-hamstring bangase babe abantu abangcono kakhulu be-allograft noma i-patellar tendon graft (bona ngezansi).
2. I-Patellar tendon - Ingxenye eyodwa kwezintathu ye-patellar tendon yesiguli, kanye namapulaki amathambo asuka ku-tibia ne-kneecap, ingasetshenziselwa i-patellar tendon autograft. Isebenza kahle njenge-graft ye-tendon, kodwa ithwala ingozi enkulu yobuhlungu bedolo, ikakhulukazi lapho isiguli siguqa futhi siphuka idolo. Isiguli sizophinde sibe nesibazi esikhulu ngaphambili edolweni.
3. Indlela yokuguqa phakathi kwamadolo kanye ne-tibial alignment femoral tunnel technique - Ekuqaleni kokuhlinzwa kokwakhiwa kabusha kwe-ACL, udokotela ohlinzayo ushayela umhubhe wamathambo oqondile (umhubhe we-tibial) kusukela ku-tibia kuya ku-femur. Lokhu kusho ukuthi umhubhe wethambo ku-femur awukho lapho i-ACL yayitholakala khona ekuqaleni. Ngokuphambene, odokotela abahlinzayo abasebenzisa i-medial approach technique bazama ukubeka umhubhe wamathambo kanye ne-graft eduze nendawo yokuqala (i-anatomical) ye-ACL ngangokunokwenzeka. Abanye odokotela abahlinzayo bakholelwa ukuthi ukusebenzisa inqubo yomhubhe we-femoral esekelwe e-tibial kuholela ekungazinzi kokujikeleza kanye nokwenyuka kwamazinga okubuyekezwa emadolweni eziguli.
4. Indlela yokunamathisela ye-All-medial/graft - Isu le-medial yonke isebenzisa ukubhola okuhlanekezela ukunciphisa inani lethambo elidinga ukususwa edolweni. Kudingeka i-hamstring eyodwa kuphela ukudala i-graft lapho kwakhiwa kabusha i-ACL. Isizathu siwukuthi le ndlela ingase ingahlaseli futhi ingabi buhlungu kunendlela evamile.
5. I-Single-bundle vs. double-bundle - Abanye odokotela abahlinzayo bazama ukwakha kabusha izinyanda ezimbili ze-ACL ngokubhoboza izimbobo ezine ku-kneecap esikhundleni sezimbili. Awukho umehluko obalulekile emiphumeleni yokwakhiwa kabusha kwe-ACL ye-single-bundle noma kabili - odokotela abahlinzayo bathole imiphumela egculisayo besebenzisa izindlela zombili.
6. Ukulondoloza Ipuleti Lokukhula - Amapuleti okukhula ezingane noma intsha enokulimala kwe-ACL ahlala evuliwe kuze kube iminyaka yobudala eyi-14 emantombazaneni kanye ne-16 kubafana. Ukusebenzisa indlela evamile yokwakha kabusha i-ACL (transvertebral) ingase ilimaze amapuleti okukhula futhi imise ithambo ekukhuleni (ukuboshwa kokukhula). Udokotela ohlinzayo kufanele ahlole amapuleti okukhula esiguli ngaphambi kokwelashwa, alinde kuze kube yilapho isiguli sesiqedile ukukhula, noma asebenzise inqubo ekhethekile yokugwema ukuthinta amapuleti okukhula (periosteum noma i-adventitia).
Yisiphi isikhathi esingcono kakhulu sokwakhiwa kabusha kwe-ACL ngemva kokulimala?
Okufanelekile, kufanele uhlinzwe emasontweni ambalwa okulimala kwakho. Ukulibazisa ukuhlinzwa izinyanga ezingu-6 noma ngaphezulu kwandisa ingozi yokulimaza uqwanga nezinye izakhiwo zedolo, njenge-meniscus. Ngaphambi kokuhlinzwa, kungcono kakhulu uma uthole ukwelashwa ngokomzimba ukuze unciphise ukuvuvukala futhi uphinde uthole uhla olugcwele lokunyakaza, futhi uqinise ama-quadriceps akho (imisipha yethanga langaphambili).
Iyini inqubo yokutakula ngemva kokuhlinzwa kabusha kwe-ACL?
1. Ngemva kokuhlinzwa, isiguli sizozwa ubuhlungu bamadolo, kodwa udokotela uzonikeza amaphilisi ezinhlungu anamandla.
2. Ngemva kokuhlinzwa, ungasebenzisa izinduku ukuze ume futhi uhambe ngokushesha.
3. Ezinye iziguli zisesimweni esihle ngokwanele somzimba ukuba zikhishwe ngosuku olufanayo.
4. Kubalulekile ukuthola ukwelashwa ngokomzimba ngokushesha ngangokunokwenzeka ngemva kokuhlinzwa.
5. Kungase kudingeke ukuthi usebenzise izinduku kuze kube amasonto angu-6
6. Ungabuyela emsebenzini wasehhovisi ngemva kwamaviki ama-2.
7. Kodwa uma umsebenzi wakho uhilela ukusebenza kanzima ngokomzimba, kuzokuthatha isikhathi eside ukuthi ubuyele emsebenzini.
8. Kungase kuthathe izinyanga eziyisi-6 kuya kweziyi-12 ukuqalisa kabusha imisebenzi yezemidlalo, ngokuvamile izinyanga eziyi-9
Ingakanani intuthuko ongayilindela ngemva kokuhlinzwa kokwakhiwa kabusha kwe-ACL?
Ngokocwaningo olukhulu lweziguli eziyi-7,556 ezakhiwe kabusha i-ACL, iningi leziguli likwazile ukubuyela emdlalweni wazo (81%). Iziguli ezimbili kwezintathu zikwazile ukubuyela ezingeni labo lokudlala langaphambi kokulimala, kanti ama-55% akwazile ukubuyela ezingeni eliphezulu.
Isikhathi sokuthumela: Jan-16-2025
