I-patella, eyaziwa ngokuba yidolo, lithambo laseSonaid elenziwa kwi-quadriceps kwaye ikwayeyona ithambo leSonaid enkulu emzimbeni. Iflethi kunye ne-millet-mile, ibekwe phantsi kolusu kwaye kulula ukuziva. Ithambo libanzi phezulu kwaye lakhankanya ezantsi, kunye ne-rough ngaphambili kunye nemva egudileyo. Inokuhamba iye phezulu, ngasekhohlo nangasekunene, kwaye ikhusele i-nint edibeneyo. Umva we-patella ugudileyo kwaye ugqunywe yi-cartilage, uqhagamshele kumphezulu we-patellar we-femur. Umphambili rhabaxa, kwaye i-tedriceps idlula kuyo.
I-Catellar Chondromalacia sisifo esiqhelekileyo sedolo. Kwixa elidlulileyo, esi sifo sasiqhelekile kubantu abadala nabadala. Ngoku, ngokuqonda kwezemidlalo kunye nokulunga, esi sifo sikwanenqanaba eliphezulu lemfundo phakathi kwabantu abancinci.
I. Yeyiphi intsingiselo yokwenyani kwaye unobangela weHitdomalacia patella?
I-chondromalacia patellae (CMP) yi-patelloferal osteoarthritis eya kubangelwa ngumonakalo ongapheliyo we-patellar we-patellar we-patellar, obangela ukudumba, ukuqhekeza, ukhuko, kunye nokukhukuliseka, kunye nokukhukuliseka, nokwaphuka, kunye nokukhukuliseka, nokwaphuka, kunye nokukhukuliseka. Okokugqibela, i-conmoral ye-conmoral ye-themoral ye-femoral nayo iphinde yatshintsha. Intsingiselo yenyani ye-CMP yile: Kukho utshintsho lwe-patellar cartilage, kwaye kwangaxeshanye, kukho iimpawu kunye neempawu ezifana nentlungu yePatellar, kunye ne-quadriceps.
Kuba i-Artilage ye-Articulature ayinayo i-nerve ngaphakathi, indlela yentlungu ebangelwa yi-chondromalacia ayisacaci. I-CMP sisiphumo seziphumo ezidityanisiweyo zezinto ezininzi. Izinto ezahlukeneyo ezibangela utshintsho kwi-patelloferal yoxinzelelo zizizathu zangaphandle, ngelixa i-autoimmune, i-carraimmune ye-cartrasostrophy, kunye notshintsho kunobangela wangaphakathi ye-chondromalade.
II.Ika inqaku elibalulekileyo le-chondromalacia patellae lutshintsho oluthile lwendalo. Ke ngoko kwimbono yotshintsho lwendalo, ithini i-chondromalacia patellae emilelweyo?
I-istiwa ichaze amanqanaba amane e-CMP ye-CMP: Inqanaba I-Cartilage ebangelwa yi-Edema, iXabisa II kungenxa yendawo ethambileyo, iqonga III ye-CARTAL CACTAGAGO Inqanaba IV libhekisa kwiinguqu ezikhulayo ze-osteoarthritis kunye nokuvezwa kwethambo le-subchoorral kumgangatho wobugcisa.
Inkqubo yokuhliswa kwe-Outrbridb yeyona iluncedo kakhulu ekuvavanyeni izilonda ze-patellar cartilage phantsi kokuboniswa ngqo okanye i-arthroscopy. Inkqubo yokuhliswa kwe-Outrbridge yile ilandelayo:
Ibanga I: I-Cartilage ye-Articulature isuswe (i-cartilage ivaliweyo). Oku kudla ngokufuna impendulo ye-cuctile ngeprobe okanye esinye isixhobo sokuvavanya.
IBanga II: Ubuninzi obungaphezulu kwenxalenye engagqithanga kwi-1,3 cm (i-0.5 kwi) ubukhulu okanye ukufika kwithambo le-subceralral.
Ibanga III: I-cartilage fissure inkulu kune-1.3 cm (1/2 intshi) ubukhulu kwaye idlulele kwithambo le-subchotral.
Ibanga IV: Ukuvezwa kwethambo le-surchondral.
III. Zombini i-pathology kunye nokuhlelwa zibonisa umxholo we-chondromalacia patella. Ke zeziphi ezona zimpawu zibaluleke kakhulu kunye neemviwo zokuchonga i-chondromalacia patella?
Isifo sokuxilongwa ikakhulu isekwe kwiintlungu emva kwePatella, ebangelwa luvavanyo lokuGcina lePatellar kunye novavanyo lwe-squat. Eyona nto kugxilwe kuyo kufuneka ikwazi ukwahlula ukuba kukho ukulimala kweMentiscus kunye ne-Artimatic Arthritis. Nangona kunjalo, akukho lungelo phakathi kobungakanani be-catellar chondmalacia kunye neempawu zeklinikhi ye-Tonder yeTar. I-MRI yindlela efanelekileyo yokuqonda.
Olona phawu luxhaphakileyo lubuhlungu emva kwePatella ngaphakathi kwedolo kunye nedolo, eliya kuthintela emva kokungena okanye ukuya phambili okanye ezantsi kwizitepsi.
Uvavanyo lomzimba lutyhila isisa esicacileyo kwi-patella, i-Peatella, umda wePatellar kunye nePotellar Patella, enokuthi ihambe kunye ne-patellar enentlungu kunye nesandi se-patellar suts. Kunokubakho iffrion edibeneyo kunye ne-quadriceps atorphy. Kwiimeko ezinzima, idolo eligudileyo kunye nolwandiso zinqongophele kwaye isigulana asikwazi kuma emlenzeni omnye. Ngexesha lovavanyo lokucinezelwa kwePatellar, kukho iintlungu ezinzima emva kwePatella, ebonisa i-patellar cartilage cartilage, ebaluleke kakhulu. Uvavanyo olooyiko luhlala lulungile, kwaye uvavanyo lwe-squat lulungile. Xa idon iguqulwe i-20 ° ukuya kwi-30 °, ukuba uluhlu lwentshukumo yangaphakathi nangaphandle ye-patella idlula i-1/4 yobukhulu be-patella, ibonisa ukuba i-patellar ye-patellar. Ukulinganisa i-Angle ye-q i-90 ° Ukugoba i-90 i-glexion inokubonisa i-abnoclal genermal genesmor.
Olona vavanyo lubuthathaka olunokuthenjwa luyi-MRI, oluphangatha ngokuthe ngcembe i-arthroscopy kwaye yaba yindlela engekhoyo nenokuthenjwa ye-CMP. IIMVIWO ZOKUVUYELA KULE Pageters: Ukuphakama kwePatellar (i-Caton Index, i-PCA), i-PCA), i-PCA), i-PCA, i-PCA), i-PCA, i-PCA, kunye ne-PTA i-PHEALTS ye-Auxiling yangaphambili I-CMP.
I-X-ray kunye ne-MRI isetyenziselwa ukulinganisa ubude bePatellar (Caton Indel, Ph): a. I-Axial X-ray kwi-Bearing ubunzima obumi bomzimba kunye nedolo elitshayelwe kwi-30 °, b. I-MRI ikwindawo enamadolo aguqulwe kwi-30 °. L1 is the patellar inclination angle, which is the distance from the lowest point of the patellofemoral joint surface to the anterior superior angle of the tibial plateau contour, L2 is the length of the patellofemoral joint surface, and Caton index = L1/L2.
I-femoral trochlear groove angle kunye ne-patellar ye-Angle (PCA) yalinganiswa yi-X-ray neMRI: a. I-Axial X-ray ngedolo elifudukele kwi-30 ° ekubani ubunzima bomzimba; b. I-MRI idod iguqulwe kwi-30 °. I-themoral trochlear ye-trochleave groove iqulethe imigca emibini, eyiyona ndawo iphantsi i-trochlear groove, elona nqaku liphezulu le-trochlear, kunye nenqaku eliphezulu le-Frochlear. I-∠bac yi-termoral trochlear engle. I-temoral trochlear groove goove kumfanekiso we-axial wePatella, emva koko i-Bimer Add ye-∠BAC yenziwa. Emva koko i-ae yomgca othe tye watsalwa ukusuka kwindawo esezantsi ye-trochleral groove njengemvelaphi ngeyona ndawo iphantsi yendawo ye-patellar. I-Angle phakathi kwentengiso yomgca othe tye kunye ne-AE (i-∠dae) yi-patellar ye-patellar.
I-X-ray kunye ne-MRI zisetyenziselwa ukulinganisa i-patellar ye-patellar ye-patellar ye-patellar (Pta): a. I-Axial X-ray kwi-Bearing ubunzima obumi bomzimba kunye nedolo elitshayelwe kwi-30 °, b. I-MRI ikwindawo enamadolo aguqulwe kwi-30 °. I-patellar ye-patellar ye-patellar yi-angle phakathi komgca oxhuma olona nyango luphezulu lwe-medial kunye ne-theating themoral kunye ne-axilla engxamisekileyo ye-patella, okt ∠ABC.
I-radiographs kunzima ukufumanisa i-CMP ngamanqanaba ayo okuqala de kube kwinqanaba eliphezulu, xa ilahleko ebanzi ye-cartilage, ilahleko yendawo edibeneyo, kunye notshintsho lwethambo le-subcrasis kunye notshintsho lwethambo le-subcrasis kunye notshintsho lwe-subchollrals sclerosis kunye notshintsho lwethambo le-subcrasis kunye notshintsho lwe-subcrasis. I-Arthroscopy inokufikelela kwi-disnosis ethembekileyo kuba inika umbono ongcono we-patelloferal Jint; Nangona kunjalo, akukho lungelo olucacileyo phakathi kobungakanani be-patellar chondromalacia kunye nenqanaba leempawu. Ke ngoko, ezi mpawu akufuneki zibe luphawu lweArthroscopy. Ukongeza, i-arthrografi, njengendlela yokuxilonga engahlaseli kunye nentlalo, ihlala isetyenziswa kuphela kumanqanaba okuqhubekisileyo kwesi sifo. I-MRI yindlela yokuxilongwa ngokungafihlisiyo ethembisa amandla awodwa okufumanisa izilonda ze-cartilage kunye nezihlalo zangaphakathi ze-cartilage ngaphambi kokulahleka kwe-cartilaji ye-morphological kubonakala kwiliso le-morphologicage.
Iv. I-chondromalacia Patellae isenokuphinda iphinde ibuye okanye iphinde iqhubeke kwi-patelloferal Arthritis. Unyango olusebenzayo lolondolozo kufuneka lunikezwe ngokukhawuleza kumanqanaba okuqala kwesi sifo. Ke, lubandakanya ntoni unyango lolondolozo lubandakanya ntoni?
Kuyakholelwa ngokubanzi ukuba ekuqaleni (inqanaba II ukuya kwi-II), i-catellar cartilage isenokwazi ukulungisa, kunye nonyango olusebenzayo olungahlikiyo kufuneka lwenziwe. Oku ikakhulu kubandakanya ukuthintelwa komsebenzi okanye ukuphumla, kunye nokusetyenziswa kwezinto ezingezizo ze-steroidal anti-insulimal xa kufuneka njalo. Ukongeza, izigulana kufuneka zikhuthazwe ukuba zizenze umthambo phantsi kweliso lonyango lomzimba ukomeleza izihlunu ze-quadriceps kunye nokomeleza ukuzinza kwedolo.
Kufanelekile ukuba ingabambisa i-caltises, i-races yedolo okanye idolophana inxitywe kakhulu, kwaye ukulungiswa kwe-Plaster kuyathintelwa kangangoko kunokwenzeka, njengoko kunokukhokelela ekuhlaleni ukulimala kwe-cartilage ye-artikula; Nangona unyango lwe-bloble lunokuphelisa iimpawu, iihomoni akufuneki zisetyenziswe okanye zisetyenziswe kancinci, njengoko zinikezela nge-syntheris ye-glycoproteins kunye ne-collagen kwaye ichaphazele ukulungisa i-cartilage; Xa uhlangezwe ukudumba kunye nentlungu ngesiquphe, i-Ice craccess inokusetyenziswa, kwaye unyango lomzimba lunokusetyenziswa emva kweeyure ezingama-48.
V. Kwizigulana ezingemva kwexesha, ubuchule bokulungisa i-Cartilage i-Artiature ihlwempu, ke unyango olulondolozo luhlala lungasebenzi kwaye utyando luyafuneka. Unyango lwe-utyando lubandakanya ntoni?
Izalathiso zotyando zibandakanya: Emva kweenyanga ezininzi zonyango olungqongqo olungqongqo, iintlungu zePatellar zisekhona; Ukuba kukho indalo okanye ifunyenwe isiphene, unyango lonyango lungaqwalaselwa. Ukuba i-Outrbridge III-IV Cartilage yenzeka, isiphene asinakuze sizaliswe yi-cartilage yokwenyani. Ngeli xesha, ukucheba nje i-cartilage indawo yokurhweba ngokungapheliyo ayinakuthintela inkqubo yokupheliswa kwe-articular.
Iindlela zoqhaqho ziquka:
(1) Utyando lwe-Arthroscopic yenye yeendlela ezisebenzayo zokuchonga kunye nokunyanga i-chondromalacia patella. Ingaqwalasela ngokuthe ngqo utshintsho kumphezulu we-cartilage phantsi kwe-microscope. Ngamatyala athobekileyo, izilonda ezincipha ezincinane kwi-patellar cartilage cartilage inokupheliswa ukukhuthaza ukulungiswa.
. (3) I-Patellar cartilage. Olu utyando lwenziwa kwizigulana ezinomonakalo omncinci we-cartilage ukukhuthaza ukulungiswa kwe-cartilage; .
Ixesha leposi: UNV-15 ukuya kwi-2024
