Kuyini ukudabuka kwe-ACL?
I-ACL itholakala phakathi kwedolo. Ixhumanisa ithambo lethanga (i-femur) ne-tibia futhi ivimbela i-tibia ukuthi ingasheleli phambili futhi ijikeleze kakhulu. Uma udabula i-ACL yakho, noma yikuphi ukushintsha okungazelelwe kwendlela, njengokunyakaza noma ukujikeleza ohlangothini, ngesikhathi semidlalo efana nebhola lezinyawo, i-basketball, ithenisi, i-rugby noma ubuciko bokulwa, kungabangela ukuthi idolo lakho lingasebenzi.
Iningi lamacala okudabuka kwe-ACL lenzeka ekulimaleni okungathintani okubangelwa ukusonteka kwedolo ngokuzumayo ngesikhathi sokuqeqeshwa noma ukuncintisana. Abadlali bebhola nabo bangaba nenkinga efanayo lapho bewela ibhola amabanga amade, bebeka ingcindezi enkulu emlenzeni omile.
Izindaba ezimbi kubadlali besifazane abafunda lokhu: Abesifazane basengozini enkulu yokudabuka kwe-ACL ngoba amadolo abo awalingani kahle, ubukhulu kanye nesimo.
Abasubathi abadabula i-ACL yabo bavame ukuzwa "ukuqhuma" bese kuba nokuvuvukala kwedolo ngokuzumayo (ngenxa yokopha okuvela kumsipha odabukile). Ngaphezu kwalokho, kukhona uphawu olubalulekile: isiguli asikwazi ukuhamba noma ukuqhubeka nokudlala imidlalo ngokushesha ngenxa yobuhlungu bedolo. Lapho ukuvuvukala kwedolo ekugcineni kuncipha, isiguli singase sizizwe sengathi idolo alizinzile futhi lingakwazi ngisho nokuma, okwenza kube nzima ngesiguli ukudlala umdlalo esiwuthanda kakhulu.
Abasubathi abaningana abadumile bake babhekana nokudabuka kwe-ACL. Lokhu kufaka phakathi: uZlatan Ibrahimovich, uRuud Van Nistelrooy, uFrancesco Totti, uPaul Gascoigne, u-Alan Shearer, uTom Brady, uTiger Woods, uJamal 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. Ngokwelashwa okufanele, nawe ungaba njengabo!
Indlela Yokuthola Ukudabuka Kwe-ACL
Kufanele uvakashele udokotela wakho uma usola ukuthi une-ACL edabukile. Bazokwazi ukuqinisekisa lokhu ngokuxilongwa futhi bancome izinyathelo ezingcono kakhulu zokuqhubekela phambili. Udokotela wakho uzokwenza izivivinyo ezithile ukuze anqume ukuthi une-ACL edabukile yini, okuhlanganisa:
1. Ukuhlolwa ngokomzimba lapho udokotela wakho ezohlola ukuthi idolo lakho lihamba kanjani uma liqhathaniswa nedolo lakho elingalimalanga. Bangase futhi benze ukuhlolwa kwe-Lachman noma ukuhlolwa kwedrowa elingaphambili ukuhlola ububanzi bokunyakaza nokuthi ijoyinti lisebenza kahle kangakanani, bese bekubuza imibuzo mayelana nokuthi lizizwa kanjani.
2. Ukuhlolwa kwe-X-ray lapho udokotela wakho enganquma khona ukuthi ithambo liphukile noma aliphukile.
3.I-MRI scan ezobonisa imisipha yakho nezicubu ezithambile futhi ivumele udokotela wakho ukuthi ahlole ubukhulu bomonakalo.
4. Ukuskena kwe-ultrasound ukuhlola imisipha, imisipha kanye nemisipha.
Uma ukulimala kwakho kuncane kungenzeka ukuthi awuzange uklebhule i-ACL kodwa uyelule kuphela. Ukulimala kwe-ACL kuhlolwa ukuze kutholakale ubukhali bako kanje.
Ingabe i-ACL edabukile ingaziphilisa ngokwayo?
I-ACL ngokuvamile ayilulami kahle ngokwayo ngoba ayinayo igazi eliningi. Ifana nentambo. Uma idabuke ngokuphelele phakathi, kunzima ukuthi iziphetho zombili zixhumane ngokwemvelo, ikakhulukazi njengoba idolo lihlala linyakaza. Kodwa-ke, abanye abasubathi abanokudabuka kwe-ACL okungaphelele bangabuya bazodlala uma nje ijoyinti lizinzile futhi imidlalo abayidlalayo ingabandakanyi ukunyakaza okungazelelwe (njenge-baseball).
Ingabe ukuhlinzwa kokwakhiwa kabusha kwe-ACL kuyindlela yokwelapha kuphela?
Ukwakhiwa kabusha kwe-ACL kuyindlela ephelele yokufaka esikhundleni se-ACL edabukile nge-"tissue graft" (ngokuvamile eyenziwe ngemisipha evela ethangeni langaphakathi) ukuze kuqinisekiswe ukuqina kwedolo. Lena indlela yokwelapha enconywayo kubadlali abanedolo elingazinzile futhi abangakwazi ukuhlanganyela emisebenzini yezemidlalo ngemva kokudabuka kwe-ACL.
Ngaphambi kokucabangela ukuhlinzwa, kufanele uthintane nochwepheshe wezokwelapha ngokomzimba onconywe udokotela wakho ohlinzayo bese wenza ukwelashwa ngokomzimba. Lokhu kuzosiza ukubuyisela idolo lakho ezingeni eliphelele lokunyakaza namandla, kuyilapho kuvumela nokukhululeka ekulimaleni kwamathambo. Abanye odokotela bakholelwa nokuthi ukwakhiwa kabusha kwe-ACL kuhlotshaniswa nengozi ephansi ye-arthritis yasekuqaleni (izinguquko eziwohlokayo) ngokusekelwe ekutholakaleni kwe-x-ray.
Ukulungiswa kwe-ACL kuyindlela entsha yokwelapha yezinhlobo ezithile zokudabuka. Odokotela baphinde banamathisele izingxenye ezidabukile ze-ACL ethanjeni lethanga besebenzisa idivayisi ebizwa ngokuthi i-medial brace. Kodwa-ke, izinyembezi eziningi ze-ACL azifaneleki kule ndlela yokulungisa eqondile. Iziguli ezike zalungiswa zinezinga eliphezulu lokuhlinzwa kokubuyekezwa (1 kwezingu-8, ngokusho kwamanye amaphepha). Okwamanje kunocwaningo oluningi mayelana nokusetshenziswa kwamaseli okuqala kanye ne-plasma ecebile ngama-platelet ukusiza i-ACL ukuthi iphulukise. Kodwa-ke, lawa masu asahlolwa, futhi ukwelashwa "okujwayelekile kwegolide" kusewukuhlinzwa kokwakhiwa kabusha kwe-ACL.
Ubani ongazuza kakhulu ngokuhlinzwa kokwakhiwa kabusha kwe-ACL?
1. Iziguli ezindala ezisebenzayo ezihlanganyela kwezemidlalo ezihilela ukujikeleza noma ukujika.
2. Iziguli ezindala ezisebenzayo ezisebenza emisebenzini edinga amandla amaningi omzimba futhi ehilela ukujikeleza noma ukujikeleza.
3. Iziguli ezindala (ezifana nabantu abaneminyaka engaphezu kwengu-50 ubudala) ezihlanganyela emidlalweni yezinga eliphezulu futhi ezingenazo izinguquko eziwohlokayo edolweni.
4. Izingane noma intsha enezinsila ze-ACL. Amasu alungisiwe angasetshenziswa ukunciphisa ingozi yokulimala kwe-growth plate.
5. Abasubathi abanokulimala kwedolo ngaphandle kokudabuka kwe-ACL, njengokulimala kwe-posterior cruciate ligament (PCL), i-collateral ligament (LCL), i-meniscus, kanye ne-cartilage. Ikakhulukazi kwezinye iziguli ezine-meniscus tears, uma engakwazi ukulungisa i-ACL ngesikhathi esifanayo, umphumela uzoba ngcono.
Yiziphi izinhlobo ezahlukene zokuhlinzwa kokuvuselelwa kwe-ACL?
1. I-Hamstring tendon – Lokhu kungavunwa kalula kusuka ngaphakathi kwedolo ngokusikwa okuncane ngesikhathi sokuhlinzwa (i-autograft). I-ACL edabukile ingashintshwa nge-tendon enikelwe ngomunye umuntu (i-allograft). Abasubathi abane-hypermobility (hyperlaxity), ama-medial collateral ligaments akhululekile kakhulu (i-MCL), noma ama-hamstring tendon amancane bangaba ngcono kakhulu kwi-allograft noma i-patellar tendon graft (bheka ngezansi).
2. I-Patellar tendon – Ingxenye eyodwa kwezintathu ye-patellar tendon yesiguli, kanye nama-bone plugs avela ku-tibia kanye ne-kneecap, ingasetshenziswa ku-patellar tendon autograft. Isebenza kahle njenge-tendon graft, kodwa inengozi enkulu yobuhlungu bedolo, ikakhulukazi lapho isiguli siguqa futhi siphuka idolo. Isiguli sizoba nesilonda esikhulu ngaphambili kwedolo.
3. Indlela yokusondela edolweni eliphakathi nendawo kanye nendlela yokuqondisa i-tibial - Ekuqaleni kokuhlinzwa kokwakhiwa kabusha kwe-ACL, udokotela ohlinzayo ubhoboza umhubhe wamathambo oqondile (umhubhe we-tibial) kusukela ku-tibia kuya ku-femur. Lokhu kusho ukuthi umhubhe wamathambo ku-femur awukho lapho i-ACL yayikhona ekuqaleni. Ngokuphambene nalokho, odokotela abahlinzayo abasebenzisa indlela yokwelapha bazama ukubeka umhubhe wamathambo kanye nokufakelwa eduze nendawo yokuqala (yokwakheka komzimba) ye-ACL ngangokunokwenzeka. Abanye odokotela abahlinzayo bakholelwa ukuthi ukusebenzisa inqubo yomhubhe we-femoral esekelwe ku-tibial kuholela ekungazinzini kokujikeleza kanye namazinga aphezulu okubuyekezwa emadolweni eziguli.
4. Indlela yokunamathisela yonke imisipha/i-graft - Le ndlela yokusebenzisa yonke imisipha isebenzisa ukubhoboza okuphambene ukuze kuncishiswe inani lethambo elidinga ukususwa edolweni. Kudingeka i-hamstring eyodwa kuphela ukudala i-graft lapho kwakhiwa kabusha i-ACL. Isizathu siwukuthi le ndlela ingase ingangeni kakhulu futhi ingabuhlungu kangako kunendlela yendabuko.
5. I-single-bundle vs. i-double-bundle - Abanye odokotela abahlinzayo bazama ukwakha kabusha ama-bundle amabili e-ACL ngokubhoboza imigodi emine edolweni esikhundleni semibili. Akukho mehluko omkhulu emiphumeleni yokwakhiwa kabusha kwe-ACL ye-single-bundle noma ye-double-bundle - odokotela abahlinzayo bathole imiphumela eyanelisayo besebenzisa zombili izindlela.
6. Ukugcina Ipuleti Lokukhula - Amapuleti okukhula ezingane noma intsha elimele i-ACL ahlala evulekile kuze kube yilapho eneminyaka eyi-14 emantombazaneni kanye nengu-16 kubafana. Ukusebenzisa indlela ejwayelekile yokwakha kabusha i-ACL (i-transvertebral) kungalimaza amapuleti okukhula futhi kumise ithambo ekukhuleni (ukuma kokukhula). Udokotela ohlinzayo kufanele ahlole amapuleti okukhula esiguli ngaphambi kokwelashwa, alinde kuze kube yilapho isiguli sesiqedile ukukhula, noma asebenzise indlela ekhethekile yokugwema ukuthinta amapuleti okukhula (i-periosteum noma i-adventitia).
Yisiphi isikhathi esingcono kakhulu sokulungiswa kwe-ACL ngemva kokulimala?
Okungcono kakhulu, kufanele uhlinzwe zingakapheli amasonto ambalwa ulimele. Ukulibazisa ukuhlinzwa izinyanga eziyi-6 noma ngaphezulu kwandisa ingozi yokulimaza i-cartilage nezinye izakhiwo zedolo, njenge-meniscus. Ngaphambi kokuhlinzwa, kungcono uma uthole ukwelashwa ngokomzimba ukunciphisa ukuvuvukala nokubuyisela ukunyakaza okugcwele, nokuqinisa ama-quadriceps akho (imisipha yamathanga angaphambili).
Iyini inqubo yokululama ngemva kokuhlinzwa kokwakhiwa kabusha kwe-ACL?
1. Ngemva kokuhlinzwa, isiguli sizozwa ubuhlungu edolweni, kodwa udokotela uzonikeza imithi enamandla yokudambisa izinhlungu.
2. Ngemva kokuhlinzwa, ungasebenzisa izinduku zokusibekela ukuze ume futhi uhambe ngokushesha.
3. Ezinye iziguli zisesimweni esihle somzimba ukuze zikhishwe esibhedlela ngalolo suku.
4. Kubalulekile ukuthola ukwelashwa ngokomzimba ngokushesha okukhulu ngemva kokuhlinzwa.
5. Kungadingeka usebenzise izinduku zokusibekela kuze kube amasonto ayisithupha
6. Ungabuyela emsebenzini wehhovisi ngemva kwamasonto amabili.
7. Kodwa uma umsebenzi wakho uhilela umsebenzi omningi ongokomzimba, kuzothatha isikhathi eside ukuthi ubuyele emsebenzini.
8. Kungathatha izinyanga eziyi-6 kuya kweziyi-12 ukuqala kabusha imisebenzi yezemidlalo, ngokuvamile izinyanga eziyi-9
Ingakanani intuthuko ongayilindela ngemva kokuhlinzwa kokwakhiwa kabusha kwe-ACL?
Ngokusho kocwaningo olukhulu lweziguli ezingu-7,556 ezavuselelwa yi-ACL, iningi leziguli lakwazi ukubuyela emdlalweni walo (81%). Iziguli ezimbili kwezintathu zakwazi ukubuyela ezingeni lazo lokudlala ngaphambi kokulimala, kanti ezingu-55% zakwazi ukubuyela ezingeni eliphezulu.
Isikhathi sokuthunyelwe: Jan-16-2025
