Umxholo wokutshintshwa kwegxalaba lokufakelwa okokuqala waqaliswa yi-histocles gluck ngo-1891. i-arthroplatty. I-Prosphesis yenziwa ngugqirha wamazinyo u-G. Porter Michaels ukusuka kwiParis, kunye ne-humeralisiquyenziwa nge-platinam inyibiliki kwaye iqhotyoshelwe kwintloko yerabha yeparafini yi-wire ukwenza into ethintelweyo. Iziphumo zokuqala zesigulana zanelisa, kodwa i-Prosphesis yasuswa emva kweminyaka emi-2 ngenxa yokuphindaphinda isifo sephepha. Eli lilinge lokuqala elenziwa ngabantu kwigxalaba legxalabala.
Ngo-1951, uFrederick Krueer uxele ukusetyenziswa kwe-prostyhes ebaluleke kakhulu ye-prostyhes yenziwe ngeevithamini kwaye ubunjiwe kwi-proximal humersus ye-cadaver. Oku bekusetyenziswa ngempumelelo ukuphatha isigulana esincinci nge-osteonecrosis yentloko ye-humeral
Kodwa umntu oqondayo wale ntsholongwane wawuyilwe kwaye waphuhliswa yigxalaba gurlu charle charles. Ngo-1953, ukuze kucombulule iziphumo ezingonelisiyo zonyango lwe-proximal yefreyimu, i-Neer iphucule i-proximal ye-proximal ye-proximal ye-proximal prosthes yokuqhekezwa kwentloko ye-hititral, ngokwahlukeneyo. Yenza i-protyheses yesibini neyesibini.
Ekuqaleni kweminyaka yo-1970, ukuze kucombulule igxalamane kwizigulana ezinesigulo i-rotor cuff ye-rought, ingcinga yokubuyela umva kwi-arthroplast (i-RTSA) yaqala ukucetywayo kwicandelo le-gilenoid, umxholo wawushiywe kamva. Ngo-1985, uPaul Grammont uphuculwe ngokwembono ecetywayo yi-Neer, eshukumisa iziko lokujikeleza nangaphakathi, etshintsha i-Demonid kwaye ngokucombulula ingxaki ye-Chuftor Cuff Umsebenzi we-rouffer cuff droy.
Imithetho-siseko yoyilo ye-tristheis
Ukubuyela umva kwi-arthroplasty (RTSA) kubushushu kubudlelwane be-anatomical ye-anatomical ye-anatomical yendalo ukubuyisela uzinzo lwegxa. I-RTSA idala i-rescrum kunye neZiko lokujikeleza (i-Cor) ngokwenza i-Glenoid icala le-glenoid kunye nentloko yentloko yentloko. Umsebenzi we-biomechachachanical wale mboleko kukuthintela intloko ye-humeral ukuba ibuyele phezulu xa izivumelwano zemisipha yedreyini yokuthintela ingalo ephezulu. Inqaku le-RTSA kukuba iziko lokujikeleza kwegxalaba elidibeneyo kunye nesikhundla sentloko ye-humeral Live kwigxala yendalo singena ngaphakathi nangaphantsi. Uyilo lwe-RTSA eyahlukileyo ye-Prosthesis yahlukile. Intloko ye-humeral ishiywe nge-25 ~ 40mm kwaye ihamba ngaphakathi nge-5 ~ 20mm.
Xa kuthelekiswa negxalaba lendalo lomzimba womntu, inzuzo ebonakalayo ye-shif engaphakathi kukuba i-Deduction I-Demoid inyukele kwi-30mm, kunye ne-Demonid Force Sernes. I-torque efanayo, kwaye eli nqaku lenza ukuba ukuthathwa kwentloko ye-humeral ayisaxhomekeki ngokupheleleyo kuxinzelelo lwe-cuff qub.
Olu luyilo kunye ne-biomechanics ye-rTSA, kwaye kunokuba yinto ebonakalayo kwaye kunzima ukuyiqonda. Ngaba ikhona indlela elula yokuqonda? Impendulo ngu-ewe.
Owokuqala uyilo lwe-rTSA. Qwalasela ngononophelo iimpawu zomzimba ngamnye womzimba womntu, sinokufumana imigaqo ethile. Amalungu oluntu anokwenziwa phantse lahlulwe kabini. Inye ingamalungu e-trunk enjengamagxa kunye nezinqe, kunye nesiphelo se-proximal ukuba "sendebe" kunye nokuphela kwe "Ibhola".
Olunye uhlobo luhlanganisene kakhuluamadoloKwaye imifula, nesiphelo se-proximal ukuba yi "Ibhola" kunye nesiphelo "sendebe".
Esi sicwangciso samkelwe ngoovulindlela bonyango xa beyila i-Prostheses edibeneyo yegxalaba kwiintsuku zokuqala yayikukubuyisela isakhiwo se-Aalotomical sabakho kangako, zonke iiplani "njenge" ibhola ". Abanye babaphandi bayile ngabom i "Indebe" ibe nkulu kwaye inzulu ukuze kwandise uzinzo lwehlangelwano, olufana nomntuI-Hip JointKodwa kamva kwangqina ukuba ukunyusa uzinzo kwalonyusa umgangatho wokungaphumeleli, ngenxa yoko kuyilo lwamkeleka ngokukhawuleza. ncama. RTSA, kwelinye icala, ibuyisela umva iimpawu ze-anatomical zegxalaba lendalo, lingayiguquli "ibhola" kunye "nendebe", yeza "i-hip" edibeneyo "okanye" idolo ". Olu tshintsho lwezinto ezibonakalayo ekugqibeleni lusombulule ubunzima kunye namathandabuzo obutshintsho olwenziweyo, kwaye kwiimeko ezininzi, ixesha elide kunye nexabiso elifutshane lokuphuculwa.
Ngokukwanjalo, uyilo lwe-RTSA lutshintsha iziko lokujikeleza ukuze kuvumeleke ukwanda kwendlela yokuthintela i-Demoid, nto leyo inokuvakala. Kwaye ukuba sithelekisa igxalaba lethu lokudibana kwi-Speeaw, kulula ukuyiqonda. Njengoko kubonisiwe kumzobo ongezantsi, ukusebenzisa i-torque efanayo kwicandelo (amandla oxambulisane), ukuba isikhundla esipheleleyo kunye nesikhundla sokuqala sitshintshiwe, kuyacaca ukuba i-torqued enkulu (i-Apper Apped Ark) inokuveliswa kwicala le-B.
Utshintsho kwiZiko le-RTSA lokujikeleza linephuli-phumela, ivumela igxalaba elichithiweyo lokuqalisa ngaphandle koxinzelelo lwe-rotf. Njengoko i-ofvimedede ithe: ndinike ingqumbo kwaye ndinokuhambisa umhlaba uphela!
Isalathiso se-RTSA kunye nolwaphulo-mthetho
Isalathiso seklasikhi yeRTSA i-rTSA ye-Cuff I-Arthropathy (CTA), i-giator quartor ye-cufstid yentloko, ekhokelela kwi-Glenoid yeNtloko, ekhokelela kwi-Glenoid, i-Acromion kunye ne-fitural iqhubekile. Ukufuduswa okungaphezulu kwentloko ye-humeral kubangelwa sisibini esingalinganiyo phantsi kwesenzo se-Demoid emva kokungasebenzi kakuhle. I-CTA ixhaphake kakhulu kubafazi abadala, apho "i-pseudoparalysis yesifo" inokwenzeka.
Ukusetyenziswa kwe-arthroplasty, ngakumbi i-RTSA, ikhule kakhulu kule minyaka ingamashumi amabini idlulileyo. Ngokusekwe kwiziphumo zokuqala eziphumeleleyo zesicelo se-RTSA, ukuphuculwa okuqhubekayo kwendlela yokuhlinqwa, kunye nokusetyenziswa okusebenzayo kwale ndlela, kwaye ke iimpawu zokuqala ezincinci zeRTSA zandisiwe, kwaye ke, uninzi lweenkqubo ze-arthroplasty zisenziwa ngoku i-RTSA.
Umzekelo, i-anatomical iyonke i-arthroplasty (i-ATSA) yayilukhetho olukhethwayo kwi-osteoarthritis i-rotor kwi-rotor ye-rotor kwixesha elidlulileyo, kodwa kwiminyaka yakutshanje, inani labantu ababambelele ngokuthe ngcembe. Kukho le miba ilandelayo. Izizathu zikhokelele kule meko. Okokuqala, ukuya kwi-10% yezigulana ezifumana i-ATSA sele ine-rototor cuff. Okwesibini, kwezinye iimeko, "ukulungelelwa" ukuthembeka "komsebenzi" we-rotator Cuff ayiphelelanga, ngakumbi kwezinye izigulana ezikhulileyo. Okokugqibela, nokuba i-rotator cuff icocekile ngexesha lotyando, i-qubitor cufferete yenzeka ngobudala, ngakumbi emva kweenkqubo ze-ATSA, kwaye ngokwenene kukho ukungaqiniseki ngomsebenzi we-rostator cuff. Le phenomenon ihlala yenzeka kwizigulana ezikhulileyo ezindala kuneminyaka engama-70. Ke ngoko, oogqirha abaninzi baqala ukukhetha i-rTSA xa bejamelene negxalaba elicocekileyo. Le meko ikhokelele ekucingeni okutsha ukuba i-RTSA inokuba lukhetho lokuqala kwizigulana ezine-osteoarthritis ene-rourator ye-rottator cuff isekwe kubudala.
Ngokufanayo, kwixa elidlulileyo, kwilitye elingalunganga le-cuff qubuf irufyithi (Mnu) ngaphandle kwe-osteoarthritis, iindlela ezinokubandakanya ukubekwa kwe-fectial, indlela ye-RURFAtor ye-Cuff i-Cuff, kunye ne-Chinese Speent Afriet. , Ireyithi yempumelelo iyahluka. Ngokusekwe kubuchule kunye nokusetyenziswa okuphumelelayo kwe-RTSA kwiimeko ezahlukeneyo, uninzi lwabo bazame ngakumbi i-RTSA ebusweni be-MRTT, kwaye iphumelele kakhulu, kunye nenqanaba lokufumana iminyaka eli-10 elingaphezulu kwe-90%.
Kwisishwankathelo, ukongeza kwi-CTA, iimpawu ezikhoyo ezikhoyo ze-RTSA zibandakanya i-rotor enkulu engalunganga ye-cuff quiormarthroarthmarthmarthroarthmarthroarthmarthroarthmarthmarthmarthmarthroarthmarthroarthmarthroarmarthroarthmarthmarthy, amathumbu abuhlungu, amathambo abuhlungu. ukuvuvukala, kunye nokuchitheka okuphindaphindiweyo.
Zimbalwa iindlela zokuphambuka kwiRTSA. Ngaphandle kolwaphulo-mthetho ngokubanzi lwezinto ezidibeneyo zokudityaniswa kokufakelwa, ezingenamsebenzi wesihlunu seDemoid sisikhundla esiphezulu kwi-rTSA. Ukongeza, kwi-proximal humerus ye-humerus, vula i-quations kunye nokwenzakala kwe-brachial plexual kufuneka kuthathwe ukuba kuthathwe njengamatye, ngelixa ukulimala kwe-nexillary ye-nexillary ye-Axillary kufuneka kuthathwe ukuba kubekho ukulimala okungathandekiyo.
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