ukwakheka kwe-meniscus
I-meniscus yangaphakathi nangaphandle.
Ibanga phakathi kweziphetho ezimbili ze-Medial Meniscus likhulu, libonisa ukwakheka kwe- "C", kanti umphetho uxhumeke ku-indawo yokuhlangana I-Capsule kanye nongqimba olujulile lwe-Medial Collateral Ligament.
I-meniscus elandelayo ingu- "O" abunjiwe. I-poplites tendon ihlukanisa ama-maniscus kusuka ku-capsule ehlangene phakathi nendawo futhi ephambi kwangemva kuka-1/3, akha igebe. I-meniscus yamuva ihlukaniswe ne-lateral collatal ligament.
Inkomba yokuhlinzwa yakudala yeSusure Meniscusyi-endeitudinal izinyembezi endaweni ebomvu. Ngokwephuculwa kwemishini nobuchwepheshe, iningi elilimele laseMeniscus lingahlelwa, kepha iminyaka yesiguli, inkambo yesifo, kanye nomugqa wamandla we-Lowermy Force nayo kudingeka icatshangwe. , ukulimala okuhlanganisiwe nezinye izimo eziningi, inhloso yokugcina ye-suture ukuthemba ukuthi ukulimala kwe-meniscus kuzophulukisa, hhayi ukuthunjwa kwe-suture!
Izindlela ze-Meniscus Suture zihlukaniswe izigaba ezintathu: ngaphandle - ngaphakathi, ngaphakathi nangaphakathi nangaphakathi. Ngokuya ngendlela yokuhlukumeza, kuzoba khona izinsimbi ezihambisanayo zokuvuselela. Okulula kakhulu kunanaliti yokubhoboza ama-lumbar noma izinaliti ezijwayelekile, futhi kukhona namadivayisi akhethekile okuthuthumela namadivayisi ashukumisayo.
Indlela engaphandle-engaphandle ingafakwa inaliti yokubhoboza ye-lumbar engu-18-geage noma inaliti ejwayelekile evamile engu-12. Kulula futhi kulula. Sonke isibhedlela sinayo. Vele, kunezinaliti ezikhethekile zokubhoboza. - ⅱ no-0/2 wesimo sothando. Indlela yangaphandle edla isikhathi futhi ayikwazi ukulawula inaliti ephumayo yama-meniscus ekuhlanganiseni. Ilungele uphondo lwangaphandle nomzimba we-meniscus, kepha hhayi ngophondo lwangemva kwalokho.
Akunandaba ukuthi uthathwa kanjani okuholela, umphumela wokuphela kwendlela yangaphandle ukudedela ukuthutha okungena ngaphandle nange-meniscus adabula izinyembezi emzimbeni futhi efakwe endaweni yokugcwalisa i-suture yokulungisa.
Indlela yangaphakathi ephumayo ingcono futhi iphambene nendlela engaphandle. Inaliti nokuhola kudluliswa kusuka ngaphakathi kokuhlanganiswa kuya ngaphandle kokuhlangana, futhi kulungiswe ngefindo ngaphandle kokuhlangana. Ingalawula indawo yenaliti yokufaka i-Meniscus ekuhlanganiseni, futhi ukuthunjwa kuhlanzekile futhi kunokwethenjelwa. . Kodwa-ke, indlela engaphakathi ephumayo idinga amathuluzi akhethekile okuhlinza, futhi ukufakwa okwengeziwe kuyadingeka ukuvikela imithambo yegazi nezinzwa nge-arc ezixakile lapho kubhekwa uphondo lwangemuva.
Izindlela ezisetshenziswayo zonke zifaka ubuchwepheshe be-stapler Technology, ubuchwepheshe be-suture Hook, ubuchwepheshe be-suture ForcePS, ubuchwepheshe be-anchor kanye neTransosnel Technolnel Technology. Ilungele futhi ukulimala kophondo lwama-anterior, ngakho-ke kuhlonishwa ngokwengeziwe odokotela, kepha kugcwele ukuhlukunyezwa kwe-intra-articular kudinga amathuluzi okuhlinza akhethekile.
1. Indlela ye-Stapler yindlela esetshenziswa kakhulu egcwele. Izinkampani eziningi ezinjengomshana we-Smith, i-MITEK, LINVATEC, i-Arthrex, iZimmer, njll. Ziveze ama-staplers abo, ngalinye linezinzuzo zalo kanye nobubi. Odokotela ngokuvamile bazisebenzisa ngokwezinto ezizithandayo futhi bajwayele ukukhetha, esikhathini esizayo, abatshali bama-meniscus abasha nabangaphakathi bavele baphume ngamanani amakhulu.
2.Ubuchwepheshe be-suture Forceps buthathwe ubuchwepheshe be-arthroscopy ehlombe. Odokotela abaningi banomuzwa wokuthi ama-sututure Forceps we-rotator cuff alungele futhi esheshayo ukuyisebenzisa, futhi adluliselwa kusutha yokulimala kwe-meniscus. Manje kuhlanjululwe okuningi futhi okukhethekileAma-Meniscus Stutereemakethe. Amapuleti athengiswayo. Ngoba ubuchwepheshe be-suture ForcePS lula ukusebenza futhi bufumeza kakhulu isikhathi sokusebenza, kufanelekile ukulimala kwempande yangemuva le-meniscus, okunzima ukugcwala.
3. Ubuchwepheshe bangempela be-anchor kufanele babhekise esizukulwaneni sokuqalaUkulungiswa Kwe-Meniscal Heature, okuyisisekelo esenzelwe ngokukhethekile i-meniscus suture. Lo mkhiqizo awusatholakali.
Kulezi zinsuku, ubuchwepheshe be-anchor ngokuvamile bubhekisela ekusetshenzisweni kwezikhonkwane zangempela. I-Engelsohn et al. Okokuqala kubikwe ngo-2007 ukuthi indlela yokulungisa i-suture anchor yasetshenziselwa ukwelashwa kokulimala kwezimpande zaseMedicus ngemuva. Ama-anchors afakwa endaweni ephrintiwe futhi asuswe. Ukulungiswa kwe-suture anchor kufanele kube yindlela enhle, kepha noma ngabe kungukulimala kwezimpande okuphakathi nendawo noma okulandelanayo kufanele kube nezinkinga eziningi njengokuntuleka kwendlela efanelekile, ubunzima bokubekwa, nokungakwazi ukukopela , ngaphandle kokuthi kukhona ushintsho lwezinguquko e-anchor facrication noma izinketho ezingcono zokufinyelela okuhlinzwa, kunzima ukuba yindlela elula, elula, ethembekile futhi esetshenzisiwe.
I-4. I-Transtestere Fourt Technorque ingenye yezindlela eziphelele ze-intra-articular suture. Ngo-2006, i-raustol yaqala yasebenzisa le ndlela yokuhudula i-Medial Meniscus Preterior ukulimala kwezimpande, futhi kamuva yasetshenziselwa ukulimala kwe-meniscus-meniscus ye-meniscus ukubona kwe-tibial noma umbono okhethekile wokuhlose futhi ushaye umhubhe. I-canal yethambo elilodwa noma amathambo amabili ingasetshenziswa, futhi i-canal yethambo elilodwa ingasetshenziswa. Indlela Umhubhe we-Bone ukhula futhi ukusebenza kulula, kepha ngaphambili kufanele kulungiswe ngezinkinobho. Indlela ethambekele ethanjeni ephindwe kabili idinga ukumba umhubhe we-bone eyodwa, okungeyona into elula kubaqalayo. Ingaphambili lingabhalwa ngqo ethanjeni lamathambo, futhi izindleko ziphansi.
Isikhathi sePosi: Sep-23-2022
