Ekuqaleni kweminyaka yoo-1990, iingcali zamanye amazwe zakhokela ekusebenziseni ii-suture anchors ukulungisa izakhiwo ezifana ne-rotator cuff phantsi kwe-arthroscopy. Le ngcamango yavela kumgaqo wokuxhasa "into etshonayo" engaphantsi komhlaba eMzantsi Texas, e-USA, oko kukuthi, ngokutsala ucingo lwentsimbi engaphantsi komhlaba kwi-engile yokutshonayo engama-45° emhlabeni, isakhiwo esingaphantsi komhlaba siqiniswe ngokuqinileyo "kwinto etshonayo" kwelinye icala locingo lwentsimbi.
Unyango lwezemidlalo luvela kwi-orthopedic traumatology. Lusetyenziso olusisiseko nolubanzi lwezonyango kunye nemidlalo olusetyenziswa kwiinkalo ezahlukeneyo. Injongo kukufumana ukulungiswa okuphezulu kokusebenza kunye nokulimala okuncinci, kubandakanya ukwenzakala kwe-meniscus, ukwenzakala kwe-cruciate ligament, ukukrazuka kwe-rotator cuff, ukungazinzi kokukhubeka kwegxalaba, ukwenzakala kwe-SLAP, njl.njl. zonke ezi zinto ziphantsi konyango lwezonyango lwezemidlalo.
I-Anchor sisixhobo sezonyango esisetyenziswa kakhulu kunyango lwezemidlalo kunye notyando lwamathambo. Isetyenziswa kakhulu ekuqiniseni izicubu ezithambileyo (ezifana nemisipha, ii-ligaments, njl.njl.) emathanjeni ukukhuthaza ukuphiliswa kunye nokuphola kwezicubu. I-Anchor zihlala zenziwe ngezinto ezihambelana ne-bio ukuqinisekisa ukhuseleko kunye nokuzinza emzimbeni.
Ngokwendlela izinto ezihlelwe ngayo ezi anchors, kukho iindidi ezimbini eziphambili: ii anchors ezingaboliyo kunye nee anchors eziboliyo.
Izinto eziphambili zeentsika ezingonakalisiyo yi-titanium, i-nickel-titanium alloy, intsimbi engatyiwayo, i-titanium kunye ne-poly-L-lactic acid; uninzi lwee-ankora ze-suture ezisetyenziswa kwizonyango zenziwe ngezinto zesinyithi, ezineenzuzo zokubamba kakuhle, ukufakelwa lula kunye novavanyo lwe-X-ray olulula.
Izinto eziphambili ze-anchors ezibolayo yi-poly-D-lactic acid, i-poly-L-lactic acid, i-polyglycolic acid, njl. Xa kuthelekiswa ne-anchors ezibolayo, ii-anchors ezibolayo kulula ukuzihlaziya, azinazo iingxaki ezininzi kwimifanekiso, kwaye ziyafunxwa. Zingasetyenziselwa nabantwana.
Izinto eziphambili zee-ankile
1. Iiankile zesinyithi
• Izinto: Ngokuyintloko zizinto zesinyithi ezifana ne-titanium alloy.
• Iimpawu: Zomelele kwaye zihlala ixesha elide, ziyakwazi ukubonelela ngesiphumo sokuqina esizinzileyo. Nangona kunjalo, izinto zobugcisa zomfanekiso zinokwenzeka kwaye kukho umngcipheko wokuwa.
2. Iiankile ezifunxwayo
• Izinto: izinto ezifunxwayo ezifana ne-polylactic acid (PLLA).
• Iimpawu: Ukuwohloka kancinci kancinci emzimbeni, akukho mfuneko yotyando lwesibini ukuze kususwe. Nangona kunjalo, izinga lokuwohloka lisenokungazinzi, kwaye amandla okuqina anokwehla ngokuhamba kwexesha.
3. Iiankile zePolyetheretherketone (PEEK)
• Izixhobo: iipolymers ezisebenza kakuhle ezifana ne-polyetheretherketone.
• Iimpawu: Inika amandla aphezulu omzimba wezipikili kunye neempawu zoomatshini, ngelixa ine-biocompatibility elungileyo kunye nemiphumo efanelekileyo yomfanekiso emva kotyando.
4. Iiankile ezifakwe yonke into
• Ulwakhiwo: Ngokuyintloko yenziwe ngesixhobo sokufaka, i-anchor kunye ne-suture.
• Iimpawu: Zincinci kakhulu ngobukhulu, zithambile ngokwendlela ezibukeka ngayo, zifanelekile kwiimeko apho ubunzima bethambo lendalo bulahlekile okanye indawo efakelweyo inqongophele.
Ngokweempawu zoyilo lwee-ankile, zingahlulwa zibe ziindidi ezimbini: ii-knotted anchors kunye nee-knotless (ezifana ne-full suture) anchors:
1. Iiankile eziqhiniweyo
Ii-ankile ezikrunekileyo ziintlobo ze-ankile zemveli, ezibonakaliswa yinxalenye yomthungo eqhagamshelwe emsileni we-ankile. Ugqirha kufuneka adlulise umthungo kwizicubu ezithambileyo ngenaliti aze abophe iqhina ukuze aqinise izicubu ezithambileyo kwi-ankile, oko kukuthi, umphezulu wethambo.
• Izinto: Ii-anchors eziqhiniweyo zihlala zenziwe ngezinto ezingafunxwayo (ezifana ne-titanium alloy) okanye izinto ezifunxwayo (ezifana ne-polylactic acid).
• Indlela yokusebenza: I-ankile iqiniswe ethanjeni ngemisonto okanye amaphiko okwandisa, ngelixa i-suture isetyenziselwa ukudibanisa izicubu ezithambileyo kwi-ankile, kwaye isiphumo sokuzinza esizinzileyo senziwa emva kokubopha iqhina.
• Iingenelo kunye nokungalungi: Inzuzo yee-knotted anchors kukuba isiphumo sokubopha sithembekile kwaye sifanelekile kwiintlobo ngeentlobo zokwenzakala kwezicubu ezithambileyo. Nangona kunjalo, inkqubo yokubopha i-knot inokunyusa ubunzima kunye nexesha lokusebenza, kwaye ubukho be-knot bunokukhokelela ekuxinaniseni uxinzelelo lwendawo, okwandisa umngcipheko wokuqhekeka kwe-suture okanye ukukhululeka kwe-anchor.
2. Iiankile ezingenamaqhina
Ii-knotless anchors, ingakumbi ii-full suture anchors, luhlobo olutsha lwe-anchor oluphuhliswe kwiminyaka yakutshanje. Uphawu lwayo kukuba yonke i-anchor yenziwe ngee-sutures, kwaye ukuqiniswa kwezicubu ezithambileyo kunokufezekiswa ngaphandle kokubopha amaqhina.
• Izinto: Ii-anchors ze-suture ezipheleleyo zihlala zisebenzisa izinto ze-suture ezithambileyo neziqinileyo, ezifana neefayibha ze-polyethylene ezinobunzima be-molecular (UHMWPE) eziphezulu kakhulu.
• Indlela yokusebenza: Ii-ankile ze-suture ezipheleleyo zinokufakwa ngqo kwizicubu zethambo ngesakhiwo sazo esikhethekileyo se-suture kunye nendlela yokufaka, ngelixa kusetyenziswa uxinzelelo lwe-suture ukubambelela ngokuqinileyo kwizicubu ezithambileyo kumphezulu wethambo. Ekubeni kungekho mfuneko yokubopha amaqhina, ubunzima kunye nexesha lokusebenza ziyancitshiswa, kwaye umngcipheko wokuqhekeka kwe-suture kunye nokukhululeka kwe-ankile nawo uyancitshiswa.
• Iingenelo kunye nokungalungi: Iingenelo zee-anchors ze-suture ezipheleleyo kukusebenza okulula kotyando, isiphumo sokuqina esithembekileyo kunye nomonakalo omncinci kwizicwili ezithambileyo. Nangona kunjalo, ngenxa yesakhiwo sayo esikhethekileyo, ineemfuno eziphezulu zobugcisa botyando kunye nendawo yokufaka. Ukongeza, ixabiso lee-anchors ze-suture ezipheleleyo linokuba phezulu, nto leyo eyonyusa umthwalo wemali kwizigulana.
Ii-ankile zisetyenziswa kakhulu kwiindlela ezahlukeneyo zokwenza utyando lwezemidlalo, ezifana nokulungiswa kwe-rotator cuff, ukulungiswa kwe-tendon, ukwakhiwa kwakhona kwe-ligament, njl. Oku kulandelayo kukwazisa ngokusetyenziswa kwe-ankile ngotyando kusetyenziswa i-rotator cuff repair njengomzekelo:
• Amanyathelo otyando: Okokuqala, ugqirha uza kucoca aze alungiselele indawo yokwenzakala kwe-rotator cuff; emva koko, afake i-ankile kwindawo efanelekileyo; emva koko, asebenzise imithungo ukuze alungise izicubu ze-rotator cuff kwi-ankile; ekugqibeleni, afake umthungo kunye nebhandishi.
• Isiphumo sotyando: Ngokuqiniswa kwe-ankile, ukuzinza nokusebenza kwezicubu ze-rotator cuff kunokubuyiselwa, okukhuthaza ukuchacha kwesigulana.
Iingenelo, iingxaki kunye namanyathelo okhuseleko eeAnkile
Iingenelo
• Ibonelela ngokuqina okuzinzileyo.
• Isebenza kwiintlobo ngeentlobo zeengozi zezicubu ezithambileyo.
• Ezinye ii-ankile ziyafunxwa kwaye azidingi utyando lwesibini ukuze zisuswe.
Iingxaki
• Ii-ankile zesinyithi zinokwenza imifanekiso yezinto zakudala.
• Izinga lokuwohloka kwee-ankile ezinokufunxwa lisenokungazinzi.
• Kukho umngcipheko wokuqhekeka kwe-ankile okanye ukwaphuka komthungo.
Ii-anchors zonyango lwezemidlalo zingasetyenziselwa olu tyando lulandelayo:
1. I-epicondylitis ephindaphindayo ecaleni (i-tennis elbow) engakhange inyangwe ngokufanelekileyo amaxesha amaninzi: Xa unyango olugcinwe lungaphumeleli, unyango lotyando lunokukhethwa, kwaye i-anchor ingasetyenziselwa ukuphinda idibanise indawo yokufaka ye-radial extensor carpi brevis kwi-lateral epicondyle ye-humerus.
2. Ukukrazuka kwemisipha ye-biceps ekude: Iinyembezi ezibangelwa kukuhamba okungaqhelekanga, ukutsala, ukungqubana, njl. zinokunyangwa ngee-wire anchors. Ii-anchors ezimbini zigqunywe kwi-radial tuberosity, kwaye ucingo lomsila lufakwe kwi-biceps tendon stump.
3. Ukuqhekeka kwe-elbow collateral ligament: Ukuqhekeka kwe-elbow emva kudla ngokuhamba kunye nokwenzakala kwe-ulnar collateral ligament, ngakumbi ukwenzakala kwe-anterior bundle. Kwi-elbow collateral ligament yokwenzakala, uninzi lwabaphengululi luthanda ukunyanga kwangoko utyando. Indlela ye-wire anchor isetyenziselwa ukurhawuzelela umphezulu wethambo apho i-ligament inamathele khona. Emva kokopha okutsha, i-anchor ifakwa kwi-screw kumphezulu wethambo apho i-ligament inamathele khona, kwaye ucingo olugobileyo olusekupheleni kwesikhonkwane lusetyenziselwa ukuluka i-ligament stump nokuyiqinisa okanye ukulungisa i-ligament ngenaliti.
4. Ukwaphuka kwe-inferior attachment point ye-cruciate ligament: I-Anterior cruciate ligament (ACL) tibial attachment point avulsion fracture luhlobo olukhethekileyo lokulimala kwe-ACL kwaye kufuneka ilungiswe kwangethuba. Ukusetyenziswa kwendlela ye-wire anchor kuneempawu ezininzi kwaye akuthintelwanga bubungakanani be-fracture fragment. Akudingi i-fluoroscopy yangaphakathi kotyando ukuze kulungiswe indlela ye-screw. Umsebenzi ulula kwaye ixesha lokusebenza lifutshane ngokufanayo.
5. Ukungazinzi kwe-Patellar: okubangelwa kukungasebenzi kakuhle kwe-anatomiki yamathambo kunye nokunqongophala kwezicubu ezithambileyo. Uninzi lwabaphengululi lukhuthaza unyango olusebenzayo lotyando olusebenzisa ii-wire anchors.
6. Ukuqhekeka kwe-Patellar inferior pole: Itekhnoloji ye-wire anchor ingasetyenziselwa ukunyanga ukuqhekeka kwe-patellar inferior pole. Ngokulungisa ukuqhekeka kwe-patellar inferior pole kunye nokuluka kunye nokuthungela i-patellar ligament, ukuthembeka kwendlela yokwandisa idolo kunokubuyiselwa kwaye ubude obusebenzayo bomzimba wendlela yokwandisa idolo bunokugcinwa.
7. Ifanelekile ukudityaniswa nokuqiniswa kwamathambo kunye nezicubu ezithambileyo edolweni, emgogodleni, egxalabeni, engqinibeni, eqatheni, ezinyaweni, esihlahleni nasezandleni: I-anchor inoyilo lwentambo egobileyo, elula ukuyifakela kwaye inika ukumelana okunamandla kokutsalwa, kwaye ifanelekile kwiindlela zotyando kwiindawo ezahlukeneyo.
Ukulumkela
• Imeko yethambo lesigulana kunye nolwakhiwo lomzimba kwindawo yotyando kufuneka kuhlolwe ngokupheleleyo ngaphambi kotyando.
• Khetha uhlobo lwe-ankile olufanelekileyo kunye neenkcukacha ukuqinisekisa isiphumo sotyando.
• Kufuneka kwenziwe imithambo efanelekileyo yokubuyisela umzimba emva kotyando ukuze kukhuthazwe ukuphiliswa kwezicubu nokubuyisela ukusebenza kwazo.
Ngamafutshane, ii-ankile zidlala indima ebalulekileyo kunyango lwezemidlalo. Ngokukhetha uhlobo olufanelekileyo lwe-ankile kunye neenkcukacha kunye nokulandela amanyathelo otyando afanelekileyo kunye nezilumkiso, umphumo wotyando unokuqinisekiswa kwaye ukuchacha kwesigulana kunokukhuthaza.
Ixesha leposi: Disemba-17-2024
