ukumila kwe-meniscus
I-meniscus yangaphakathi nangaphandle.
Umgama phakathi kweziphelo ezimbini ze-meniscus yangaphakathi mkhulu, ubonisa i-"C" imilo, kwaye umgca udityaniswengokubambisana i-capsule kunye ne-deep layer ye-medial collateral ligament.
I-meniscus esecaleni imile "O".Ithenda ye-popliteus ihlukanisa i-meniscus kwi-capsule edibeneyo phakathi kunye ne-1/3 yangasemva, yenza i-gap.I-meniscus yecala ihlukaniswe kwi-lateral collateral ligament.
Isalathiso sotyando lwakudala lwei-meniscus suturekukukrazuka kwelongitudinal kwindawo ebomvu.Ngokuphuculwa kwezixhobo kunye nobuchwepheshe, ininzi yokulimala kwe-meniscus inokuthi ifakwe i-sutured, kodwa iminyaka yesigulane, ikhosi yesifo, kunye nomgca wamandla angaphantsi nawo kufuneka aqwalaselwe., ukulimala okudibeneyo kunye nezinye iimeko ezininzi, injongo yokugqibela ye-suture kukuba nethemba lokuba ukulimala kwe-meniscus kuya kuphilisa, kungekhona i-suture ye-suture!
Iindlela ze-meniscus suture zihlulwe kakhulu zibe ngamacandelo amathathu: ngaphandle-ngaphakathi, ngaphakathi nangaphakathi-ngaphakathi.Ngokuxhomekeke kwindlela yokufaka i-suturing, kuya kubakho izixhobo ezihambelanayo ze-suturing.Eyona ilula kakhulu Kukho iinaliti zokuhlatywa kwe-lumbar okanye iinaliti eziqhelekileyo, kwaye kukho izixhobo ezikhethekileyo zokuthunga i-meniscal kunye nezixhobo zokuthunga i-meniscal.
Indlela yangaphandle inokugqojozwa ngenaliti ye-18-gauge lumbar puncture okanye i-12-gauge beveled naliti eqhelekileyo.Ilula kwaye ifanelekile.Isibhedlele ngasinye sinaso.Kakade ke, kukho iinaliti ezikhethekileyo zokugqobhoza.- Ⅱ kunye ne-0/2 yesimo sothando.Indlela yangaphandle ichitha ixesha kwaye ayikwazi ukulawula i-needle outlet ye-meniscus kwi-joint.Ifanelekile uphondo lwangaphambili kunye nomzimba we-meniscus, kodwa kungekhona uphondo lwangasemva.
Kungakhathaliseki ukuba udibanisa njani izikhokelo, umphumo wokugqibela wendlela yokuphuma ngaphandle kukubuyisela kwakhona i-suture engena ngaphandle kunye ne-meniscus ikrazula ngaphandle komzimba kwaye ifakwe kwi-knotted endaweni yokugqiba i-suture yokulungisa.
Indlela yangaphakathi-ngaphandle ingcono kwaye ichasene nendlela yangaphandle.Inaliti kunye nelothe zigqithiswa ukusuka ngaphakathi kwijoyinti ukuya ngaphandle komdibaniso, kwaye iphinde ilungiswe ngeqhina ngaphandle kwendawo edibeneyo.Iyakwazi ukulawula indawo yokufaka inaliti ye-meniscus kwi-joint, kwaye i-suture icocekile kwaye ithembekile..Nangona kunjalo, indlela yangaphakathi-yangaphandle idinga izixhobo ezikhethekileyo zotyando, kwaye izithintelo ezongezelelweyo ziyafuneka ukukhusela imithambo yegazi kunye nemithambo-luvo ene-arc baffles xa ufaka uphondo lwangasemva.
Iindlela ezingaphakathi kuzo zonke ziquka iteknoloji ye-stapler, iteknoloji ye-suture hook, iteknoloji ye-suture forceps, iteknoloji ye-anchor kunye ne-transosseous tonnel technology.Ikwafanelekele ukwenzakala kophondo lwangaphambili, ngoko ihlonitshwa ngakumbi ngoogqirha, kodwa i-intra-articular suturing iyonke ifuna izixhobo ezikhethekileyo zotyando.
1. Ubuchule be-stapler yeyona ndlela ixhaphakileyo isetyenziswa ngokupheleleyo.Iinkampani ezininzi ezinjengomtshana kaSmith, uMitek, uLinvatec, uArthrex, uZimmer, njl.Oogqirha ngokubanzi bazisebenzisa ngokwezinto abazithandayo kunye nokuqhelana ukukhetha, kwixesha elizayo, i-meniscus staplers entsha kunye neyobuntu iya kuvela ngamanani amakhulu.
2.I-teknoloji ye-suture forceps ivela kwi-teknoloji ye-arthroscopy yamagxa.Oogqirha abaninzi banomuvo wokuthi i-suture forceps ye-rotator cuff ilula kwaye ikhawuleza ukuyisebenzisa, kwaye idluliselwa kwi-suture yokulimala kwe-meniscus.Ngoku kukho ezisulungekisiweyo ngakumbi nezikhethekileyoi-meniscus sutureskwimarike.Iipliers ziyathengiswa.Ngenxa yokuba iteknoloji ye-suture forceps ilula ukusebenza kwaye inciphisa kakhulu ixesha lokusebenza, ifaneleke ngokukodwa ukwenzakala kwengcambu yangasemva ye-meniscus, ekunzima ukuyithunga.
3. Iteknoloji ye-anchor yangempela kufuneka ibhekisele kwisizukulwana sokuqalaukulungiswa kwe-meniscal sature, eyona nto isisiseko eyenzelwe ngokukodwa i-meniscus suture.Le mveliso ayisafumaneki.
Kule mihla, itekhnoloji ye-anchor ngokubanzi ibhekisa kusetyenziso lweeankile zokwenyani.Engelsohn et al.okokuqala kuchazwe kwi-2007 ukuba indlela yokulungisa i-anchor ye-suture yayisetyenziselwa unyango lwe-meniscus yangemva kokulimala kweengcambu.Ii-anchors zifakwe kwindawo eprintiweyo kunye ne-sutured.Ukulungiswa kwe-anchor ye-Suture kufuneka ibe yindlela efanelekileyo, kodwa ingaba i-medial okanye i-lateral semilunar ingcambu yokulimala kwengcambu yangasemva, i-anchor ye-suture kufuneka ibe neengxaki ezininzi ezifana nokungabikho kwendlela efanelekileyo, ubunzima bokubeka, kunye nokungakwazi ukukrazula i-anchor kwi-perpendicular to. umphezulu wethambo., ngaphandle kokuba kukho ukuguqulwa kwenguqu kwi-anchor fabrication okanye ukhetho olungcono lokufikelela kokuhlinzwa, kunzima ukuba kube yindlela elula, efanelekileyo, enokwethenjelwa kunye nesetyenziswa ngokuqhelekileyo.
4. I-transosseous tract technique yenye yeendlela zizonke ze-intra-articular suture.Kwi-2006, i-Raustol yaqala ukusebenzisa le ndlela yokuthunga i-meniscus yokulimala kwengcambu yangasemva, kwaye kamva isetyenziswe ngokukodwa kwi-lateral meniscus emva kokulimala kweengcambu kunye ne-meniscus ye-radial yokukrazula kunye nokukrazula kwi-tendon ye-meniscus-popliteus, njl. -i-osseous suture iqala ukukrazula i-cartilage kwindawo yokufaka emva kokuqinisekisa ukulimala phantsi kwe-arthroscopy, kwaye usebenzise i-ACL tibial sight okanye umbono okhethekileyo wokujolisa kunye nokubhobhoza itonela.Ithambo elinye okanye umjelo onamathambo amabini angasetyenziswa, kwaye umjelo onethambo elinye ungasetyenziswa.Indlela Itonela yethambo inkulu kwaye umsebenzi ulula, kodwa umphambili kufuneka ulungiswe ngamaqhosha.Indlela yetonela yamathambo amabini idinga ukugrumba enye itonela yethambo, engelula kubaqalayo.Umphambili unokudityaniswa ngokuthe ngqo kwithambo, kwaye ixabiso liphantsi.
Ixesha lokuposa: Sep-23-2022
