Yintoni i-ACL drain?
I-ACL ikwindawo ephakathi kwedolo. Idibanisa ithambo lethanga (i-femur) kwi-tibia kwaye ithintela i-tibia ukuba ingatyibiliki phambili kwaye ijikeleze kakhulu. Ukuba ukrazula i-ACL yakho, naluphi na utshintsho olukhawulezileyo kwindlela, olufana nokuhamba ecaleni okanye ukujikeleza, ngexesha lemidlalo efana nebhola ekhatywayo, ibasketball, itenisi, iragbi okanye ubugcisa bokulwa, lunokubangela ukuba idolo lakho lingasebenzi.
Uninzi lweemeko zokukrazuka kwe-ACL zenzeka kwimingxunya engekuko ukuchukumisana okubangelwa kukujijeka kwedolo ngequbuliso ngexesha loqeqesho okanye ukhuphiswano. Abadlali bebhola ekhatywayo nabo banokuba nengxaki efanayo xa benqumla ibhola kumgama omde, bebeka uxinzelelo olukhulu kumlenze omiyo.
Iindaba ezimbi kubadlali basetyhini abafunda oku: Abafazi basengozini enkulu yokukrazuka kwe-ACL kuba amadolo abo awalungelelani, ubukhulu kunye nokuma kwawo.
Abadlali abakrazula i-ACL yabo badla ngokuziva "bedumbile" baze emva koko bavuvuke ngequbuliso idolo (ngenxa yokopha ngenxa yokukrazulwa yi-ligament). Ukongeza, kukho uphawu oluphambili: isigulana asikwazi ukuhamba okanye ukuqhubeka nokudlala imidlalo ngoko nangoko ngenxa yentlungu yedolo. Xa ukudumba kwedolo ekugqibeleni kuyehla, isigulana sinokuziva ngathi idolo alizinzanga kwaye lingakwazi nokubamba, nto leyo eyenza kube nzima ukuba isigulana sidlale umdlalo esiwuthanda kakhulu.
Abadlali abadumileyo abaninzi baye badibana neentlungu ze-ACL. Aba baquka: uZlatan Ibrahimovich, uRuud Van Nistelrooy, uFrancesco Totti, uPaul Gascoigne, uAlan Shearer, uTom Brady, uTiger Woods, uJamal Crawford, kunye noDerrick Rose. Ukuba ukhe wadibana neengxaki ezifanayo, awuwedwa. Iindaba ezimnandi zezokuba aba badlali bakwazile ukuqhubeka ngempumelelo nemisebenzi yabo yobungcali emva kokwakhiwa kwakhona kwe-ACL. Ngonyango olufanelekileyo, nawe ungaba njengabo!
Indlela yokuHlola i-ACL Tear
Kuya kufuneka undwendwele ugqirha wakho ukuba ukrokrela ukuba une-ACL ekrazukileyo. Baya kukwazi ukuqinisekisa oku ngokuxilongwa kwaye bakucebise ngamanyathelo afanelekileyo okuqhubekela phambili. Ugqirha wakho uya kwenza uvavanyo oluthile ukuze abone ukuba unayo na i-ACL drain, kuquka:
1.Uvavanyo lomzimba apho ugqirha wakho eza kujonga indlela idolo lakho elihamba ngayo xa lithelekiswa nedolo lakho elingelona linzakeleyo. Banokwenza uvavanyo lweLachman okanye uvavanyo lwedrowa yangaphambili ukujonga umgama wokunyakaza kunye nendlela elisebenza kakuhle ngayo idolo, baze bakubuze imibuzo malunga nendlela eliziva ngayo.
Uvavanyo lwe-X-ray apho ugqirha wakho anokuqinisekisa ukuba akukho thambo laphukileyo okanye elaphukileyo.
3.I-MRI scan eza kubonisa imisipha yakho kunye nezicubu ezithambileyo kwaye ivumele ugqirha wakho ukuba ajonge ubungakanani bomonakalo.
4.I-ultrasound scan ukuvavanya ii-ligaments, i-tendon, kunye nemisipha.
Ukuba ukwenzakala kwakho kuncinci kusenokwenzeka ukuba awuzange uyikrazule i-ACL kodwa wayinweba kuphela. Ukulimala kwe-ACL kuhlolwa ngokwemigangatho ukuze kuchongwe ubukhali bayo ngolu hlobo lulandelayo.
Ngaba i-ACL ekrazukileyo ingaziphilisa ngokwayo?
I-ACL ayihlali kakuhle yodwa kuba ayinayo igazi elineleyo. Ifana nentambo. Ukuba ikrazukile ngokupheleleyo embindini, kunzima ukuba iziphelo zombini ziqhagamshelane ngokwendalo, ingakumbi kuba idolo lihlala lishukuma. Nangona kunjalo, abanye abadlali abanokukrazuka kwe-ACL okuncinci banokubuya badlale lo gama nje ilungu lizinzile kwaye imidlalo abayidlalayo ayibandakanyi iintshukumo ezijijekileyo (njengebhola yebhola).
Ngaba utyando lokwakha i-ACL lolona khetho lonyango kuphela?
Ukwakhiwa kwakhona kwe-ACL kukutshintsha ngokupheleleyo i-ACL ekrazukileyo nge-"tissue graft" (edla ngokwenziwa ngemisipha evela ethangeni langaphakathi) ukuze kuqinisekiswe uzinzo edolweni. Olu lunyango olucetyiswayo kubadlali abanedolo elingazinzanga kwaye abangakwaziyo ukuthatha inxaxheba kwimisebenzi yezemidlalo emva kokukrazuka kwe-ACL.
Ngaphambi kokuba ucinge ngotyando, kufuneka udibane nogqirha wezonyango oqeqeshiweyo ocetyiswe ngugqirha wakho kwaye wenze unyango lomzimba. Oku kuya kunceda ukubuyisela idolo lakho kwinqanaba elipheleleyo lokushukuma namandla, ngelixa kuvumela ukukhululeka komonakalo wamathambo. Abanye oogqirha bakwakholelwa ekubeni ukwakhiwa kwakhona kwe-ACL kunxulunyaniswa nomngcipheko ophantsi we-arthritis yasekuqaleni (utshintsho oluwohlokayo) ngokusekelwe kwiziphumo ze-x-ray.
Ukulungiswa kwe-ACL yindlela entsha yonyango kwiintlobo ezithile zokukrazula. Oogqirha baphinda bancamathisele iziphelo ezikrazukileyo ze-ACL kwithambo lethanga besebenzisa isixhobo esibizwa ngokuba yi-medial brace. Nangona kunjalo, uninzi lweenkxwaleko ze-ACL azifanelekanga kule ndlela yokulungisa ngokuthe ngqo. Izigulana eziye zalungiswa zinezinga eliphezulu lotyando lokuhlaziya (imeko enye kwezisi-8, ngokutsho kwamanye amaphepha). Okwangoku kukho uphando oluninzi malunga nokusetyenziswa kwee-stem cells kunye ne-plasma etyebileyo kwiiplatelet ukunceda i-ACL iphiliswe. Nangona kunjalo, ezi ndlela zisavavanywa, kwaye unyango "olusemgangathweni wegolide" luselutyando lokwakha kwakhona i-ACL.
Ngubani onokuzuza kakhulu kutyando lokwakhiwa kwakhona kwe-ACL?
1. Izigulane zabantu abadala ezisebenzayo ezithatha inxaxheba kwimidlalo equka ukujikeleza okanye ukujika.
2. Izigulane zabantu abadala ezisebenzayo ezisebenza kwimisebenzi efuna amandla amaninzi emzimbeni kwaye ebandakanya ukujikeleza okanye ukujikeleza.
3. Izigulana ezindala (ezifana nabantu abaneminyaka engaphezu kwama-50 ubudala) abathatha inxaxheba kwimidlalo ye-eletical kwaye abangenalo utshintsho oluwohlokayo edolweni.
4. Abantwana okanye abakwishumi elivisayo abaneentlungu ze-ACL. Iindlela ezilungisiweyo zingasetyenziselwa ukunciphisa umngcipheko wokwenzakala kwepleyiti yokukhula.
5. Abadlali abanezinye iingozi edolweni ngaphandle kokukrazula kwe-ACL, njenge-posterior cruciate ligament (PCL), i-collateral ligament (LCL), i-meniscus, kunye nokwenzakala kwe-cartilage. Ingakumbi kwabanye abaguli abane-meniscus tears, ukuba angayilungisa i-ACL ngaxeshanye, isiphumo siya kuba ngcono.
Ziziphi iintlobo ezahlukeneyo zotyando lokwakha kwakhona i-ACL?
1. I-Hamstring tendon – Oku kunokuqokelelwa lula ngaphakathi edolweni ngokusebenzisa i-incision encinci ngexesha lotyando (i-autograft). I-ACL ekrazukileyo ingatshintshwa ne-tendon enikelwe ngomnye umntu (i-allograft). Abadlali abane-hypermobility (hyperlaxity), ii-medial loose medial collateral ligaments (MCL), okanye ii-hamstring tendons ezincinci banokuba ngabaviwa abangcono kwi-allograft okanye i-patellar tendon graft (jonga ngezantsi).
2. I-Patellar tendon – Isinye kwisithathu se-patellar tendon yesigulana, kunye neeplagi zamathambo ezivela kwi-tibia kunye ne-kneecap, zingasetyenziselwa i-patellar tendon autograft. Isebenza kakuhle njenge-tendon graft, kodwa inomngcipheko omkhulu wentlungu yedolo, ingakumbi xa isigulana siguqa kwaye siqhekeke idolo. Isigulana siya kuba nesilonda esikhulu ngaphambili kwedolo.
3. Indlela yokujongana nedolo eliphakathi kunye nendlela yokulungelelanisa i-tibial femoral tunnel – Ekuqaleni kotyando lokwakha i-ACL, ugqirha ugqobhoza umngxuma wethambo othe tye (umngxuma we-tibial) ukusuka kwi-tibia ukuya kwi-femur. Oku kuthetha ukuba umngxuma wethambo kwi-femur awukho apho i-ACL yayikhona khona ekuqaleni. Ngokwahlukileyo koko, oogqirha abasebenzisa indlela yokujongana ne-medial bazama ukubeka umngxuma wethambo kunye nokufakelwa kufutshane nendawo yokuqala (yokwakheka komzimba) ye-ACL kangangoko kunokwenzeka. Abanye oogqirha bakholelwa ukuba ukusebenzisa inkqubo ye-tibial-based femoral tunnel kukhokelela ekungazinzini kokujikeleza kunye nokunyuka kwamazinga okuhlaziya amadolo ezigulana.
4. Indlela yokuncamathisela yonke imisipha/i-graft - Le ndlela isebenzisa ukubhoboza ngasemva ukunciphisa inani lethambo ekufuneka lisuswe edolweni. Kufuneka i-hamstring enye kuphela ukwenza i-graft xa kwakhiwa kwakhona i-ACL. Isizathu kukuba le ndlela isenokungabi yingozi kangako kwaye ingabi buhlungu kangako kunendlela yendabuko.
5. I-single-bundle vs. double-bundle - Abanye oogqirha bazama ukwakha kwakhona ii-bundles ezimbini ze-ACL ngokugqobhoza imingxunya emine kwi-kneecap endaweni yee-two. Akukho mahluko mkhulu kwiziphumo zokwakhiwa kwakhona kwe-ACL ene-single-bundle okanye ene-double-bundle - oogqirha bafumene iziphumo ezanelisayo besebenzisa zombini ezi ndlela.
6. Ukugcina iPlate yoKhula - Iipleyiti zokukhula zabantwana okanye abakwishumi elivisayo abanokwenzakala kwi-ACL zihlala zivuliwe de kube malunga neminyaka eli-14 kumantombazana kunye ne-16 kumakhwenkwe. Ukusebenzisa indlela eqhelekileyo yokwakhiwa kwakhona kwe-ACL (i-transvertebral) kungonakalisa iipleyiti zokukhula kwaye kuthintele ukukhula kwethambo (ukuma kokukhula). Ugqirha kufuneka ahlole iipleyiti zokukhula zesigulane ngaphambi konyango, alinde de isigulane sigqibe ukukhula, okanye asebenzise indlela ekhethekileyo yokuphepha ukuchukumisa iipleyiti zokukhula (i-periosteum okanye i-adventitia).
Liliphi ixesha elifanelekileyo lokwakha i-ACL emva kokwenzakala?
Okona kulungileyo, kufuneka utyandwe kwiiveki ezimbalwa emva kokwenzakala kwakho. Ukulibazisa utyando kangangeenyanga ezi-6 nangaphezulu kwandisa umngcipheko wokonakalisa i-cartilage kunye nezinye izakhiwo zedolo, njenge-meniscus. Ngaphambi kotyando, kungcono ukuba ufumene unyango lomzimba lokunciphisa ukudumba nokubuyisela uluhlu olupheleleyo lokushukuma, kunye nokuqinisa i-quadriceps yakho (imisipha yamathanga angaphambili).
Iyintoni inkqubo yokubuyisela emva kotyando lokwakha i-ACL?
1. Emva kotyando, isigulana siya kuva iintlungu zedolo, kodwa ugqirha uya kunika amayeza okudambisa iintlungu anamandla.
2. Emva kotyando, ungasebenzisa iintonga zokusila ukuze ume kwaye uhambe ngoko nangoko.
3. Abanye abaguli bakwimeko entle yomzimba ukuba bangakhululwa ngaloo mini inye.
4. Kubalulekile ukufumana unyango lomzimba ngokukhawuleza emva kotyando.
5. Kusenokufuneka usebenzise iintonga ukuya kuthi ga kwiiveki ezi-6
6. Ungabuyela emsebenzini weofisi emva kweeveki ezi-2.
7. Kodwa ukuba umsebenzi wakho ubandakanya umsebenzi omninzi womzimba, kuya kuthatha ixesha elide ukuba ubuyele emsebenzini.
8. Kungathatha iinyanga ezi-6 ukuya kwezili-12 ukuqala kwakhona imisebenzi yezemidlalo, ngesiqhelo iinyanga ezi-9
Ingakanani inkqubela onokuyilindela emva kotyando lokwakhiwa kwakhona kwe-ACL?
Ngokwesifundo esikhulu sezigulane ezingama-7,556 ezazinokulungiswa kwe-ACL, uninzi lwezigulane lukwazile ukubuyela kwimidlalo yazo (81%). Isibini kwisithathu sezigulane sikwazile ukubuyela kwinqanaba lazo lokudlala ngaphambi kokwenzakala, kwaye ama-55% akwazile ukubuyela kwinqanaba eliphezulu.
Ixesha leposi: Jan-16-2025
