isimo se-meniscus
I-meniscus yangaphakathi neyangaphandle.
Ibanga eliphakathi kwezinhlangothi ezimbili ze-meniscus ephakathi likhulu, libonisa isimo "C", futhi unqenqema luxhunywe ku-ilunga i-capsule kanye nongqimba olujulile lwe-medial collateral ligament.
I-meniscus eseceleni inomumo "O". I-tendon ye-popliteus ihlukanisa i-meniscus ne-capsule ehlangene ephakathi nendawo kanye nengxenye engemuva, yakha igebe. I-meniscus eseceleni ihlukaniswe ne-ligament eseceleni.
Isibonakaliso sokuhlinzwa esivamile sei-meniscus sutureukudabuka okude endaweni ebomvu. Ngokuthuthuka kwemishini nobuchwepheshe, ukulimala okuningi kwe-meniscus kungathungwa, kodwa ubudala besiguli, indlela yesifo, kanye nomugqa wamandla wemilenze engezansi nakho kudingeka kucatshangelwe. , ukulimala okuhlangene nezinye izimo eziningi, inhloso enkulu yokuthunga iwukuba nethemba lokuthi ukulimala kwe-meniscus kuzophola, hhayi ukuthungwa kokuthunga!
Izindlela zokuthunga ze-meniscus zihlukaniswe kakhulu ngezigaba ezintathu: ngaphandle-ngaphakathi, ngaphakathi-ngaphandle kanye nangaphakathi. Kuye ngendlela yokuthunga, kuzoba nezinsimbi zokuthunga ezifanele. Ezilula Kunama-spinning pinning noma ama-pinning avamile, futhi kukhona namadivayisi okuthunga akhethekile e-meniscal kanye namadivayisi okuthunga e-meniscal.
Indlela yokungena ngaphandle ingabhobozwa ngenaliti yokubhoboza i-lumbar engu-18-gauge noma inaliti ejwayelekile yokujova ene-gauge engu-12-gauge. Ilula futhi ilula. Zonke izibhedlela zinayo. Vele, kunezinaliti ezikhethekile zokubhoboza. - Ⅱ kanye no-0/2 wesimo sothando. Indlela yokungena ngaphandle idla isikhathi futhi ayikwazi ukulawula ukuphuma kwenaliti ye-meniscus esibayeni. Ifanele uphondo lwangaphambili nomzimba we-meniscus, kodwa hhayi uphondo lwangemuva.
Kungakhathaliseki ukuthi ufaka kanjani izintambo, umphumela wokugcina wendlela yangaphandle yokungena uwukushintsha indlela umthungo ongene ngayo usuka ngaphandle futhi udlule ekudabukeni kwe-meniscus uye ngaphandle komzimba futhi uboshwe endaweni yawo ukuze kuqedwe umthungo wokulungisa.
Indlela yokungena ngaphakathi ingcono futhi iphambene nendlela yokungena ngaphandle. Inaliti nomthofu kudluliswa kusuka ngaphakathi kwejoyinti kuya ngaphandle kwejoyinti, futhi kuqiniswa nefindo ngaphandle kwejoyinti. Ingalawula indawo yokufaka inaliti ye-meniscus ejoyintini, futhi umthungo ucocekile futhi uthembekile. . Kodwa-ke, indlela yokungena ngaphakathi idinga izinsimbi ezikhethekile zokuhlinza, futhi kudingeka ukuhlikihlwa okwengeziwe ukuvikela imithambo yegazi kanye nemizwa ngama-arc baffles lapho kuthungwa uphondo olungemuva.
Izindlela ezisetshenziswa ngaphakathi zihlanganisa ubuchwepheshe be-stapler, ubuchwepheshe be-suture hook, ubuchwepheshe be-suture forceps, ubuchwepheshe be-anchor kanye nobuchwepheshe be-transosseous tunnel. Ifaneleka futhi ekulimaleni kwe-anterior horn, ngakho-ke ihlonishwa kakhulu ngodokotela, kodwa i-intra-articular suturing ephelele idinga amathuluzi okuhlinzwa akhethekile.
1. Indlela yokuhlanganisa i-stapler iyindlela evame ukusetshenziswa kakhulu. Izinkampani eziningi ezifana nomshana kaSmith, uMitek, uLinvatec, u-Arthrex, uZimmer, njll. zikhiqiza ama-stapler azo, ngalinye linezinzuzo nezinkinga zalo. Odokotela ngokuvamile bawasebenzisa ngokwezinto abazithandayo kanye nokujwayelana ukukhetha, esikhathini esizayo, ama-stapler amasha futhi akhiwe ngabantu azovela ngobuningi.
2. Ubuchwepheshe be-suture forceps bususelwa kubuchwepheshe be-arthroscopy yamahlombe. Odokotela abaningi banomuzwa wokuthi i-suture forceps ye-rotator cuff ilula futhi iyashesha ukuyisebenzisa, futhi idluliselwa ku-suture yokulimala kwe-meniscus. Manje sekukhona okucwengekile kakhulu futhi okukhethekilei-meniscus suturesemakethe. Ama-plier ayathengiswa. Ngenxa yokuthi ubuchwepheshe be-suture forceps benza kube lula ukuhlinzwa futhi bufinyeza kakhulu isikhathi sokuhlinzwa, bufaneleka kakhulu ekulimaleni kwempande engemuva ye-meniscus, okunzima ukuyithunga.
3. Ubuchwepheshe bangempela be-anchor kufanele bubhekisele esizukulwaneni sokuqalaukulungiswa kwe-meniscal sature, okuyisisekelo esenzelwe ngokukhethekile i-meniscus suture. Lo mkhiqizo awusatholakali.
Namuhla, ubuchwepheshe be-anchor buvame ukubhekisela ekusetshenzisweni kwama-anchor angempela. U-Engelsohn nabanye babike okokuqala ngo-2007 ukuthi indlela yokulungisa i-suture anchor yayisetshenziselwa ukwelapha ukulimala kwe-medial meniscus posterior root. Ama-anchor afakwa endaweni ephrintiwe bese egoqwa. Ukulungiswa kwe-suture anchor kufanele kube yindlela enhle, kodwa kungakhathaliseki ukuthi ukulimala kwe-medial noma kwe-lateral semilunar posterior root, i-suture anchor kufanele ibe nezinkinga eziningi njengokuntuleka kwendlela efanele, ubunzima bokubekwa, kanye nokungakwazi ukugoqa i-anchor ngendlela eqondile ebusweni bethambo. , ngaphandle kokuthi kukhona ushintsho olukhulu ekwakhiweni kwe-anchor noma izinketho zokufinyelela ezingcono zokuhlinzwa, kunzima ukuba yindlela elula, elula, ethembekile futhi esetshenziswa njalo.
4. Indlela yokuthunga i-transosseous tract ingenye yezindlela zokuthunga eziphelele zangaphakathi kwe-articular. Ngo-2006, i-Raustol yaqala ukusebenzisa le ndlela ukuthunga ukulimala kwezimpande ze-medial meniscus posterior, futhi kamuva yasetshenziswa ngokukhethekile ekulimaleni kwezimpande ze-lateral meniscus posterior kanye nokudabuka komzimba we-meniscus radial endaweni ye-meniscus-popliteus tendon, njll. Indlela yokuthunga i-trans-osseous iwukuklwebha i-cartilage endaweni yokufaka ngemuva kokuqinisekisa ukulimala ngaphansi kwe-arthroscopy, bese usebenzisa i-ACL tibial sight noma i-special sight ukukhomba nokubhoboza umhubhe. Umhubhe onethambo elilodwa noma onethambo eliphindwe kabili ungasetshenziswa, futhi umhubhe onethambo elilodwa ungasetshenziswa. Indlela Umhubhe wethambo mkhulu futhi ukusebenza kulula, kodwa ingaphambili kumele lilungiswe ngezinkinobho. Indlela yomhubhe onethambo eliphindwe kabili idinga ukubhoboza omunye umhubhe wethambo, okungelula kwabaqalayo. Ingaphambili lingaboshwa ngqo ebusweni bethambo, futhi izindleko ziphansi.
Isikhathi sokuthunyelwe: Septhemba-23-2022
