Yintoni i-ACL iinyembezi?
I-ACL ibekwe phakathi kwedolo. Idibanisa ithambo lethanga (i-femur) kwi-tibia kwaye ikhusela i-tibia ukuba iqhube phambili kwaye ijikeleze kakhulu. Ukuba ukrazula i-ACL yakho, nayiphi na inguqu yesiquphe yesalathiso, njengokuhamba ngasemva okanye ukujikeleza, ngexesha lemidlalo efana nebhola ekhatywayo, basketball, tennis, umbhoxo okanye ubugcisa bokulwa, kunokubangela ukuba idolo lakho lingaphumeleli.
Uninzi lweemeko ze-ACL iinyembezi zenzeke ngokulimala okungadibananga okubangelwa ukuguqulwa ngokukhawuleza kwamadolo ngexesha loqeqesho okanye ukhuphiswano. Abadlali bebhola ekhatywayo nabo banokuba nengxaki efanayo xa bewela ibhola kwimigama emide, bebeka uxinzelelo olumandla kumlenze omileyo.
Iindaba ezimbi kubadlali ababhinqileyo abafunda oku: Abasetyhini basengozini enkulu yeenyembezi ze-ACL ngenxa yokuba amadolo abo awahambelani nokulungelelaniswa, ubukhulu kunye nokuma.
Abadlali abakrazula i-ACL yabo bahlala beziva "i-pop" kwaye emva koko ukuvuvukala kwedolo ngokukhawuleza (ngenxa yokopha kwi-ligament ekrazukileyo). Ukongezelela, kukho uphawu oluphambili: isigulane asikwazi ukuhamba okanye ukuqhubeka nokudlala imidlalo ngokukhawuleza ngenxa yeentlungu zedolo. Xa ukuvuvukala emadolweni ekugqibeleni kuncipha, isigulane sinokuvakalelwa kukuba idolo alizinzile kwaye lingakwazi ukubambelela, okwenza kube nzima ukuba isigulane sidlale umdlalo esiwuthanda kakhulu.
Iimbaleki ezininzi ezidumileyo ziye zafumana iinyembezi ze-ACL. Ezi ziquka: Zlatan Ibrahimovich, Ruud Van Nistelrooy, Francesco Totti, Paul Gascoigne, Alan Shearer, Tom Brady, Tiger Woods, Jamal Crawford, kunye noDerrick Rose. Ukuba ukhe waneengxaki ezifanayo, akuwedwa. Iindaba ezimnandi zezokuba aba badlali bakwazile ukuqhubeka ngempumelelo nomsebenzi wabo wobugcisa emva kokwakhiwa ngokutsha kwe-ACL. Ngonyango olululo, ungafana nabo, nawe!
Indlela yokufumanisa i-ACL Tear
Kufuneka undwendwele ugqirha wakho ukuba ukrokrela ukuba une-ACL ekrazukileyo. Baza kukwazi ukuqinisekisa oku ngoxilongo kwaye bacebise amanyathelo angcono ukuya phambili. Ugqirha wakho uya kwenza ezinye iimvavanyo ukufumanisa ukuba unayo i-ACL izinyembezi, kuquka:
I-1.Uvavanyo lomzimba apho ugqirha wakho uya kujonga ukuba idolo lakho lihamba njani xa kuthelekiswa nelinye, idolo elingenakulimala. Basenokwenza uvavanyo lwe-Lachman okanye uvavanyo lwangaphambili lwedrowa ukujonga uluhlu lwentshukumo kunye nendlela edibeneyo esebenza ngayo, kwaye bakubuze imibuzo malunga nendlela evakalelwa ngayo.
Uvavanyo lwe-2.X-ray apho ugqirha wakho angakhupha i-fracture okanye ithambo eliphukile.
I-3.MRI scan eya kubonisa imisipha yakho kunye nezicubu ezithambileyo kwaye uvumele ugqirha wakho ukuba ahlole ubungakanani bomonakalo.
I-4.I-Ultrasound scan ukuvavanya i-ligaments, i-tendon, kunye nemisipha.
Ukuba umonzakalo wakho unobulali usenokungayikrazula i-ACL kwaye uyolule kuphela. Ukulimala kwe-ACL kuhlelwe ukuba kunqunywe ubukhali babo ngolu hlobo lulandelayo.
Ngaba i-ACL ekrazukileyo inokuziphilisa?
I-ACL ngokuqhelekileyo ayiphili kakuhle ngokwayo ngenxa yokuba ayinalo unikezelo lwegazi olulungileyo. Kufana nentambo. Ukuba idlakazwe ngokupheleleyo phakathi, kunzima ukuba iziphelo ezimbini zidibanise ngokwemvelo, ngakumbi ekubeni idolo lihlala lihamba. Nangona kunjalo, abanye abadlali abaneenyembezi ze-ACL kuphela banokubuyela kumdlalo nje ukuba i-joint izinzile kwaye imidlalo abayidlalayo ayibandakanyi ukunyakaza ngokukhawuleza (njenge-baseball).
Ngaba utyando lokwakhiwa ngokutsha lwe-ACL lukhetho lonyango kuphela?
Ukwakhiwa kwakhona kwe-ACL kukutshintshwa okupheleleyo kwe-ACL ekrazukileyo kunye "ne-graft ye-tissue" (ngokuqhelekileyo yenziwe ngeetoni ukusuka kwithanga langaphakathi) ukubonelela ngokuzinza emadolweni. Olu lunyango olucetyiswayo lwabadlali abanamadolo angazinzanga kwaye abakwazi ukuthatha inxaxheba kwimisebenzi yezemidlalo emva kokukrazula kwe-ACL.
Ngaphambi kokuba ucinge ngotyando, kufuneka udibane nengcali yonyango yomzimba ecetyiswa ngugqirha wakho kwaye ufumane unyango lomzimba. Oku kuya kunceda ukubuyisela idolo lakho kuluhlu olupheleleyo lokunyakaza kunye namandla, ngelixa uvumela ukukhululeka komonakalo wethambo. Abanye oogqirha bakholelwa ukuba ukwakhiwa kwakhona kwe-ACL kuhambelana nomngcipheko ophantsi we-arthritis yokuqala (utshintsho oluphazamisayo) ngokusekelwe kwiziphumo ze-x-ray.
Ukulungiswa kwe-ACL lukhetho olutsha lonyango kwezinye iintlobo zeenyembezi. Oogqirha baphinda bafake iziphelo ezikrazukileyo ze-ACL kwithambo lethanga besebenzisa isixhobo esibizwa ngokuba yi-medial brace. Nangona kunjalo, iinyembezi ezininzi ze-ACL azifanelekanga kule ndlela yokulungisa ngokuthe ngqo. Izigulane eziye zalungiswa zinezinga eliphezulu lokuhlinzwa ngokutsha (i-1 kwiimeko ze-8, ngokutsho kwamanye amaphepha). Ngoku kukho uphando oluninzi malunga nokusetyenziswa kweeseli ze-stem kunye ne-platelet-rich plasma ukunceda i-ACL iphilise. Nangona kunjalo, ezi ndlela zisazama, kwaye unyango "lwegolide" luselutyando lokuvuselela i-ACL.
Ngubani onokuzuza kakhulu kutyando lokwakhiwa ngokutsha kwe-ACL?
1. Izigulane zabantu abadala ezisebenzayo ezithatha inxaxheba kwimidlalo ebandakanya ukujikeleza okanye ukujikeleza.
2. Izigulane zabantu abadala ezisebenzayo ezisebenza kwimisebenzi efuna amandla amaninzi omzimba kwaye ibandakanya ukujikeleza okanye ukujikeleza.
3. Izigulane ezindala (ezifana neminyaka engaphezu kwe-50 ubudala) ezithatha inxaxheba kwimidlalo ye-elite kwaye ezingenalo utshintsho oluguquguqukayo emadolweni.
4. Abantwana okanye abafikisayo abaneenyembezi ze-ACL. Iindlela ezilungelelanisiweyo zingasetyenziselwa ukunciphisa umngcipheko wokulimala kweplate yokukhula.
5. Abadlali abanokulimala kwamanye amadolo ngaphandle kweenyembezi ze-ACL, ezifana ne-posterior cruciate ligament (PCL), i-collateral ligament (LCL), i-meniscus, kunye nokulimala kwe-cartilage. Ngokukodwa kwezinye izigulane ezine-meniscus iinyembezi, ukuba unako ukulungisa i-ACL ngexesha elifanayo, umphumo uya kuba ngcono.
Ziziphi iintlobo ezahlukeneyo zotyando lokwakhiwa ngokutsha kwe-ACL?
1. I-tendon ye-Hamstring - Oku kunokuvunwa ngokulula ukusuka ngaphakathi kwedolo ngokusebenzisa i-incision encinci ngexesha lotyando (i-autograft). I-ACL ekrazukileyo inokuthi ithathelwe indawo nge-tendon enikezelwe ngomnye umntu (allograft). Iimbaleki ezine-hypermobility (hyperlaxity), i-loose medial collateral ligaments (MCL), okanye i-tendon encinci ye-hamstring ingaba ngabaviwa abangcono kwi-allograft okanye i-patellar tendon graft (jonga ngezantsi).
2. I-tendon ye-Patellar - Ingxenye yesithathu ye-patellar tendon yesigulane, kunye neeplagi zethambo ezivela kwi-tibia kunye ne-kneecap, zingasetyenziselwa i-patellar tendon autograft. Isebenza njenge-tendon graft, kodwa inomngcipheko ophezulu weentlungu zedolo, ngakumbi xa isigulane siguqa kwaye siphuke idolo. Isigulana siya kuba nesiva esikhulu phambi kwedolo.
3. Indlela yokuguqa ngamadolo kunye ne-tibial alignment femoral tunnel technique - Ekuqaleni kokuhlinzwa ngokutsha kwe-ACL, ugqirha uqhuba i-tunnel yethambo echanekileyo (i-tibial tunnel) ukusuka kwi-tibia ukuya kwi-femur. Oku kuthetha ukuba itonela yethambo kwi-femur ayikho apho i-ACL yayikuyo ekuqaleni. Ngokwahlukileyo, oogqirha abasebenzisa i-medial approach technique bazama ukubeka i-tunnel yethambo kunye ne-graft ngokusondeleyo kwindawo yokuqala (i-anatomical) ye-ACL ngokusemandleni. Abanye oogqirha bakholelwa ukuba ukusebenzisa inkqubo ye-tunnel ye-femoral esekelwe kwi-tibial ikhokelela ekungazinzini okujikelezayo kunye nokunyuka kwamazinga okuhlaziywa kwamadolo ezigulane.
4. I-All-medial / i-graft attachment technique - I-All-medial technique isebenzisa i-reverse drilling ukunciphisa inani lethambo elifuna ukususwa emadolweni. I-hamstring enye kuphela efunekayo ukudala i-graft xa ukwakhiwa kwakhona kwe-ACL. Ingqiqo kukuba le ndlela inokuthi ingabikho kwaye ibe buhlungu kakhulu kunendlela yendabuko.
5. I-Single-bundle vs. i-double-bundle - Abanye oogqirha botyando bazama ukuphinda baqulunqe iinyanda ezimbini ze-ACL ngokubhoboza imingxuma emine kwi-kneecap endaweni emibini. Akukho ntlukwano ebalulekileyo kwiziphumo ze-single-bundle okanye i-double-bundle ACL reconstruction - oogqirha bogqirha baye bafumana iziphumo ezanelisayo besebenzisa iindlela zombini.
6. Ukugcina iPlate yokuKhula - Iipleyiti zokukhula zabantwana okanye abafikisayo abanokwenzakala kwe-ACL bahlala bevulekile kude kube malunga ne-14 yobudala kumantombazana kunye ne-16 kumakhwenkwe. Ukusebenzisa indlela yokwakhiwa ngokutsha kwe-ACL (i-transvertebral) inokonakalisa iiplate zokukhula kwaye imise ithambo ekukhuleni (ukubanjwa kokukhula). Ugqirha wotyando kufuneka ahlole iipleyiti zokukhula zesigulane ngaphambi kokuba unyango, ulinde de isigulane sigqibe ukukhula, okanye usebenzise ubuchule obukhethekileyo ukuphepha ukubamba amacwecwe okukhula (i-periosteum okanye i-adventitia).
Liliphi elona xesha lifanelekileyo lokuba nokwakhiwa kwakhona kwe-ACL emva kokulimala?
Ngokufanelekileyo, kufuneka wenze utyando kwiiveki ezimbalwa zokwenzakala kwakho. Ukulibazisa utyando kwiinyanga ze-6 okanye ngaphezulu kwandisa umngcipheko wokonakalisa i-cartilage kunye nezinye izakhiwo zamadolo, njenge-meniscus. Ngaphambi kotyando, kungcono ukuba ufumene unyango lomzimba ukunciphisa ukudumba kwaye uphinde ufumane uluhlu olupheleleyo lwentshukumo, kwaye uqinise i-quadriceps yakho (izihlunu zethanga langaphambili).
Iyintoni inkqubo yokubuyisela emva kokuhlinzwa ngokutsha kwe-ACL?
1. Emva kokuhlinzwa, isigulane siya kuziva ubuhlungu bedolo, kodwa ugqirha uya kumisela i-painkillers enamandla.
2. Emva kotyando, ungasebenzisa iintonga ukuma kwaye uhambe ngokukhawuleza.
3. Ezinye izigulana zikwimeko entle ngokwaneleyo yomzimba ukuba zikhutshwe kwangolo suku lunye.
4. Kubalulekile ukufumana unyango lomzimba ngokukhawuleza emva kokuhlinzwa.
5. Kusenokufuneka usebenzise iintonga ukuya kutsho kwiiveki ezi-6
6. Ungabuyela emsebenzini 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 kwezi-12 ukuqalisa kwakhona imisebenzi yezemidlalo, ngokuqhelekileyo iinyanga ezili-9
Ingakanani impucuko onokuyilindela emva kotyando lokwakhiwa ngokutsha kwe-ACL?
Ngokophando olukhulu lwezigulane ze-7,556 eziye zakhiwa ngokutsha kwe-ACL, uninzi lwezigulane zakwazi ukubuyela kumdlalo wazo (81%). Isibini kwisithathu sezigulane zikwazi ukubuyela kwinqanaba lokudlala ngaphambi kokulimala, kwaye i-55% yakwazi ukubuyela kwinqanaba elite.
Ixesha lokuposa: Jan-16-2025
