I.Isu lokugcwalisa likasimende wethambo
Indlela yokugcwalisa kasimende yamathambo ilungele iziguli ezinohlobo oluncane lwe-aori ine amaphutha nemisebenzi engasebenzi.
Ubuchwepheshe obulula be-Bone Cument Technology budinga ukuhlanzwa ngokuphelele kwesimo sethambo, futhi usimende wamathambo ugcwalisa isiphepho sethambo ngesikhathi senhlama, ukuze kufakwe izikhala emakhoneni wecala ngangokunokwenzeka, ngaleyo ndlela uzuze i-Interice ye-Host Bone.
Indlela ethile yeBokukodwaCU-Ement +SUbuchwepheshe be-Crew ukugeza ngokuphelele isici sethambo, bese ulungisa isikulufa kwithambo le-Host, bese uqaphela ukuthi ungavumeli isikulufa se-cap cap yedlula indawo ehlanganyelwe ngemuva kwe-osteotomy; Bese uxuba i-Bone Cement, gcwalisa isici sethambo esiteji senhlama, bese usonga isikulufa. Ritter ma et al. wasebenzisa le ndlela ukwakha kabusha isici sethafa leTibial Plateau, futhi ubukhulu bafika ku-9mm, futhi kwakungekho kukhulula iminyaka emi-3 ngemuva kokuhlinzwa. Ubuchwepheshe bokugcwalisa kasimende bone bususa ithambo elincane, bese usebenzisa ukubuyekezwa okujwayelekile kwe-prosthesis, ngaleyo ndlela kunciphisa izindleko zokwelashwa ngenxa yokusetshenziswa kwezinto zokubukeza, ezinenzuzo ethile ebonakalayo.
Indlela ethile ye-Bone Cement + Cream Technology ukugeza kahle isici sethambo, lungisa isikulufa kwithambo le-hone, bese unaka ukuthi isikulufa cap cap akufanele idlule indawo yesikhulumi ngemuva kwe-osteotomy; Bese uxuba i-Bone Cement, gcwalisa isici sethambo esiteji senhlama, bese usonga isikulufa. Ritter ma et al. usebenzise le ndlela ukwakha kabusha isici sethafa leTibial Plateau, futhi ubukhulu bafika ku-9mm, futhi kwakungekho kukhulula iminyaka emi-3 ngemuva kokuhlinzwa. Ubuchwepheshe bokugcwalisa kasimende bone bususa ithambo elincane, bese usebenzisa ukubukelwa okujwayelekile kwe-prosthesis, ngaleyo ndlela kunciphisa izindleko zokwelashwa ngenxa yokusetshenziswa kokubuyekezwa kwe-prosthesis, okunenani elithile elisebenzayo (isithombeI-1).
IsibaloI-1Ukugcwaliswa kwesithambisi sethambo kanye nokuqiniswa kwesikulufa
II.Amasu wokuxhufalwa amathambo
Ukuxhunyelelwa kwamathambo okuxhumeka kungasetshenziselwa ukulungisa amathambo afakiwe noma angahlanganisi e-Knee Revenuon Surgery. Ilungele kakhulu ukwakhiwa kabusha kokwakhiwa kabusha kohlobo lwe-Aroi ku-III amathambo. Ngokuhlinzekwa kabusha kwesibuyekezo, ngoba ubukhulu bezinkinga zamathambo ngokuvamile bunzima, inani lethambo le-autolovous litholwe lincane futhi iningi lethambo le-sclerotic lapho kususwa i-prosthesis kanye ne-prosthesis ngenkathi i-prosthesis kanye nesimende sethambo selisuswa ngesikhathi sokuhlinzwa ukuze silondoloze amathambo. Ngakho-ke, ithambo le-granurar allogeneic livame ukusetshenziselwa ukuxhumeka ithambo ngokuxhunyelelwa ngesikhathi sokuvuselelwa kabusha.
Izinzuzo zokuxhunyelelwa kwamathambo okucindezela yilezi: Ukugcina inqwaba yethambo lethambo le-hot; ukulungisa amaphutha amakhulu alula noma ayinkimbinkimbi.
Okubi kwalobu buchwepheshe yilezi: Ukusebenza kudla isikhathi; Ubuchwepheshe bokwakhiwa kabusha bufuna (ikakhulukazi lapho usebenzisa amakheji amakhulu ama-mesh); Kunethuba lokudluliselwa kwezifo.
Ukuxhunyelelwa okulula kwamathambo:Ukuxhunyelelwa okulula kwamathambo okuxhumeka kuvame ukusetshenziselwa amathambo amathambo ahlanganisiwe. Umehluko phakathi kokuxhunyelelwa kwamathambo okucindezela kanye nokuxhunyelelwa kwamathambo enhlaka ukuthi i-granular boned impahla yokuxhunyelelwa okwenziwe ngokuxhunyelelwa kwamathambo amathambo ingashesha futhi iphinde izembozwe ngokuphelele.
I-Mesh Metal Cage + I-Compression Bone Frafting:Ukuphazamiseka kwamathambo okungahlanganisiwe kuvame ukudinga ukwakhiwa kabusha kusetshenziswa amakheji we-mesh ngensimbi ukuze kugxile ithambo elikhanyisa. Ukwakhiwa kabusha kwe-femur kuvame ukuba nzima ukwedlula ukwakhiwa kabusha kwe-tibia. I-X-Rays ikhombisa ukuthi ukuhlanganiswa kwamathambo kanye nokubumba amathambo okwenziwa kancane kancane kancane kuqediwe (isithombeII-1-1, IsithombeII-1-2).
IsibaloII-1-1I-Mesh Cage Yangaphakathi I-Compryncry Prepry Ithambo Ukulungiswa Kokulungisa Isimo Sezimbotshana zeTibial. I-intraoperative; B i-x-ray esebenzayo
Isiporke ii-1-2Ukulungiswa kwamathambo we-femoral ne-tibia anezinkinga nge-titanium mesh yangaphakathi yokucindezela kwamathambo. I-intraoperative; B i-x-ray esebenzayo
Ngesikhathi sokubukeza i-knee arthroplasty, ithambo lesakhiwo se-allogeneic ikakhulukazi lisetshenziselwa kabusha kabusha ukwakha kabusha uhlobo lwe-Aori hlobo II noma ama-III amathambo. Ngaphezu kokuthola amakhono okuhlinza aphezulu kakhulu kanye nesipiliyoni esicebile ekushintshelweni kwedolo eliyinkimbinkimbi, udokotela ohlinzayo kufanele futhi asebenzise izinhlelo ezinobuhlakani ngokucophelela nangolwazi. Ukuxhunyelelwa kwamathambo amathambo kungasetshenziselwa ukulungisa amaphutha amathambo we-cortical futhi kwandise isisindo sethambo.
Izinzuzo zalobu buchwepheshe zibandakanya: Kungenziwa noma yiluphi usayizi kanye nokwakheka ukuze uvumelanise nezimo zethambo lezimo ezahlukahlukene zejometri; Inomthelela omuhle oxhasayo ekubuyekezweni kwezicelo; Futhi ukuhlanganiswa kwemvelo okuhlala isikhathi eside kungatholakala phakathi kwethambo le-allogeneic nethambo lokusingathwa.
Okubi kubandakanya: isikhathi sokusebenza isikhathi eside lapho usika ithambo le-allogeneic; imithombo ekhawulelwe yethambo le-allogeneic; ubungozi be-nonunion kanye nenyunyana ebambezelekile ngenxa yezici ezifana nokuhlelwa kabusha kwamathambo kanye nokuqhekeka kokukhathala ngaphambi kwenqubo yokuhlanganiswa kwamathambo sekuqediwe; Izinkinga zokumuncwa kanye nokutheleleka kwezinto ezitshaliwe; amandla okudluliselwa kwezifo; futhi ukuqina kokuqala kokuqina kwethambo le-allogeneic. I-allogeneic yesakhiwo samathambo avunwa kusuka ku-distal femur, i-proximal tibia, noma inhloko yabesifazane. Uma impahla yokufakelwa inkulu, ukusetha kabusha okuphelele kuvame ukungaveli. Amakhanda we-allogeneic femoral angasetshenziswa ukulungisa i-Femol Conferal and Tibial Plateau Amathambo Amathambo, ikakhulukazi ukulungisa amathambo amakhulu wethambo, futhi ahlelwe ngokufanelekile ngemuva kokuncipha nokubumba. Imiphumela yokuqala emtholampilo yokusebenzisa ithambo lesakhiwo se-allogeneic ukulungisa amathambo amathambo akhombise izinga eliphezulu lokupholisa le-Transplantid Bone (isithombeII-1-3, IsithombeII-1-4).
IsibaloII-1-3Ukulungiswa kwe-feoseral ithambo phutha nge-allogeneic femolief head dengwane graft
IsibaloII-1-4Ukulungisa iphutha le-tibial bone nge-allogeneic femor head bone graft
III.Ubuchwepheshe bokugcwalisa insimbi
Ubuchwepheshe bezobuchwepheshe be-modular modular busho ukuthi ama-filler wensimbi angaqoqwa ngezifo ezihlekisayo neziqu ezingejwayelekile. Ama-filler afaka amamodeli ahlukahlukene ukwenza lula ukwakhiwa kabusha kweziphambeko zamathambo ngosayizi abahlukahlukene.
-Temale -Okuphathelene nokuphamba Okhulayo:I-modular metal spacer ilungele kakhulu uhlobo lwe-Aori hlobo II olungewona iziphene zamathambo ezingekho ngaphansi kokuqina okufika ku-2 cm.Ukusetshenziswa kwezinto zensimbi ukulungisa iziphambeko zamathambo zilula, zilula, futhi zinemiphumela ethembekile yemitholampilo.
Ama-Metal Spacers angaba porous noma aqinile, futhi amajamo awo afaka ama-wedger noma amabhlokhi. Izikhala zensimbi zingaxhunywa kwi-prosthesis ehlanganyelwe ngezikulufo noma ezilungiselelwe ngosimende wamathambo. Ezinye izazi zikholelwa ukuthi ukulungiswa kwamathambo amathambo kungakugwema ukugqoka phakathi kwezinsimbi nokuncoma ukulungiswa kwamathambo. Ezinye izazi ziphinde zivumele indlela yokusebenzisa i-Bone Cement kuqala bese igcizelela ngezikulufo phakathi kwe-spacer kanye ne-prosthesis. Iziphambeko zowesifazane zivame ukwenzeka ezingxenyeni zangemuva nezide ze-somerd towle, ngakho-ke ama-spacers wensimbi avame ukubekwa ezingxenyeni zangemuva nasekude kwe-somerd towle. Ngezinkinga zamathambo e-tibial, ama-wedges noma amabhlokhi angakhethwa ukwakhiwa kabusha ukuze akwazi ukuzivumelanisa nezimo ezihlukile zezinkomo. Imibiko yezincwadi yokuthi amanani amahle kakhulu futhi amahle aphakeme ngo-84% kuya ku-98%.
Kusetshenziswa amabhlogo abunjwe nge-wedge lapho isici sethambo simise okwenziwe nge-wedge, esingagcina ithambo eliningi lokusingathwa. Le ndlela idinga i-osteotomy eqondile ukuze indawo ye-osteotomy ifane nebhulokhi. Ngaphezu kwengcindezi ecindezelayo, kukhona ne-shear Force phakathi kokuxhumana kokuxhumana. Ngakho-ke, i-angle ye-wedge akufanele idlule ku-15 °. Uma kuqhathaniswa namabhulokhi abunjwe nge-wedge, amabhlogo wensimbi we-cylindrical anokungabi nabika kokwandisa inani le-osteotomy, kepha ukusebenza ngokuhlinzwa kulula futhi kulula, futhi umphumela wemishini useduze kokujwayelekile (III-1-1A, b).
IsibaloIII-1-1Ama-Metal Spacers: I-Spacer emise okwenziwe nge-wedge yokulungisa iziphambeko ze-tibial; B I-Spacer Ebunjwe Ikholomu Ukulungisa Izinkinga Ze-Tibial
Ngenxa yokuthi ama-spacers wensimbi aklanywe ngezinhlobo ezahlukahlukene nosayizi, asetshenziswa kabanzi ekulimaleni kwamathambo angenazo kanye namathambo ezinhlamvu ezahlukahlukene, futhi anikeze ukuqina okuhle okwenziwe ngomshini. Kodwa-ke, izifundo zesikhathi eside zithole ukuthi ama-spacers wensimbi ahluleka ngenxa yokuvikelwa kwengcindezi. Uma kuqhathaniswa nemifantu yamathambo, uma ama-spaker wensimbi ehluleka ukuvuselelwa, azokwenza ukuthi kube nezinkinga zamathambo amakhulu.
Isikhathi Sokuthumela: Oct-28-2024
