1. Ngokuya ngokuthi i-posterior cruciate ligament igciniwe yini
Ngokuya ngokuthi i-posterior cruciate ligament iyagcinwa yini, i-prosthesis eyinhloko yokufakelwa esikhundleni sedolo ingahlukaniswa ibe yi-posterior cruciate ligament replacement (Posterior Stabilized, PS) kanye ne-posterior cruciate ligament retention (Cruiate Retention, CR). Eminyakeni yamuva nje, i-tibial plateau yalezi zinhlobo ezimbili ze-prostheses yaklanywa ngamazinga ahlukene okuhambisana nobubanzi bekholomu ephakathi ngokuya ngokuzinza kwejoyinti, umsebenzi we-ligament kanye nomqondo kadokotela ohlinzayo, ukuze kuthuthukiswe ukuzinza kwejoyinti futhi kuthuthukiswe ukusebenza kwe-kinematic.
(1) Izici ze-CR kanye ne-PS prostheses:
I-CR prosthesis igcina i-posterior cruciate ligament ye-idolo elihlangenefuthi kunciphisa inani lezinyathelo zokuhlinzwa; kugwema ukunqunywa okwengeziwe kwe-femoral condyle futhi kulondoloza inqwaba yamathambo; ngokombono, kungandisa ukuqina kokugoba, kunciphise ukufuduka kwangaphambili okuphambene, futhi kufeze ukugoqa okungemuva. Kusiza ekugcineni ukuqonda okuqondile.
I-PS prosthesis isebenzisa isakhiwo se-cam-column ukuze ithathe indawo yomsebenzi wesiphambano sangemuva ekwakhiweni, ukuze i-femoral prosthesis ikwazi ukugoqwa ngesikhathi semisebenzi yokugoba. Ngesikhathi sokusebenza, i-i-femoral intercondylarKudingeka i-osteotomy. Ngenxa yokususwa kwe-posterior cruciate ligament, igebe lokugoba likhulu, i-posterior maneuver ilula, kanti ibhalansi ye-ligament ilula futhi iqondile.
(2) Izinkomba ezihlobene ze-CR kanye ne-PS prostheses:
Iningi leziguli ezithola i-primary total knee arthroplasty zingasebenzisa i-CR prosthesis noma i-PS prosthesis, futhi ukukhetha i-prosthesis kuncike kakhulu esimweni sesiguli kanye nolwazi lukadokotela. Kodwa-ke, i-CR prosthesis ifaneleka kakhulu ezigulini ezinomsebenzi ojwayelekile we-posterior cruciate ligament, i-joint hyperplasia emnene, kanye ne-joint deformity encane. I-PS prostheses ingasetshenziswa kabanzi ezindaweni eziningi zokufakelwa kwedolo eziyinhloko, kufaka phakathi iziguli ezine-hyperplasia enzima kanye ne-deformity. Ezigulini ezine-osteoporosis enzima noma amaphutha ethambo, kungadingeka izintambo zokwelula i-intramedullary, futhi kungadingeka ukungasebenzi kahle kwe-collateral ligament. Sebenzisa ama-spacer akhawulelwe.
2. Ipulatifomu eqinile kanye ne-prosthesis yepulatifomu eshukumayo
Okwenziwayoi-prosthesis yamalunga edoloIngahlukaniswa ibe yipulatifomu egxilile kanye nepulatifomu enyakazayo ngokwendlela yokuxhuma ye-gasket ye-polyethylene kanye nethreyi ye-tibial yensimbi. I-prosthesis yepulatifomu egxilile iyingxenye ye-polyethylene enamathele kwi-tibial plateau ngendlela yokukhiya. Ingxenye ye-polyethylene ye-prosthesis yepulatifomu enyakazayo ingahamba e-tibial plateau. Ngaphezu kokwakha i-joint enyakazayo ne-femoral prosthesis, i-polyethylene spacer ivumela nezinga elithile lokunyakaza phakathi kwe-tibial plateau kanye ne-tibial plateau.
I-gasket ye-prosthesis yesikhulumi esiqinile ikhiyiwe ku-bracket yensimbi, eqinile futhi ethembekile, futhi isetshenziswa kabanzi. Ama-geometries ama-fixation spacers angahluka kakhulu kumkhiqizi kuya kumkhiqizi ukuze afane ne-prosthesis yawo ehlukile ye-femoral futhi athuthukise i-kinematics efiselekayo. Ingashintshwa kalula futhi ibe yi-shim evimbelayo uma kudingeka.
Isikhathi sokuthunyelwe: Septhemba-10-2022
