1. Ngokwendlela yokuba i-posterior cruciate ligament igcinwe na
Ngokwendlela i-posterior cruciate ligament egciniweyo ngayo, i-prosthesis yokuqala yokufakelwa kwedolo enokwahlulwahlulwa ibe yi-posterior cruciate ligament replacement (Posterior Stabilized, PS) kunye ne-posterior cruciate ligament retention (Cruiate Retention, CR). Kwiminyaka yakutshanje, i-tibial plateau yezi ntlobo zimbini ze-prostheses iye yayilwa ngamanqanaba ahlukeneyo okuhambelana kunye nobubanzi bekholamu ephakathi ngokwendlela ezinzileyo yejoyinti, umsebenzi we-ligament kunye nengcamango yogqirha, ukuze kuphuculwe ukuzinza kwejoyinti kunye nokuphucula ukusebenza kwe-kinematic.
(1) Iimpawu ze-CR kunye ne-PS prostheses:
I-CR prosthesis igcina i-posterior cruciate ligament ye-idolokwaye inciphisa inani lamanyathelo otyando; ithintela ukususwa kwakhona kwe-femoral condyle kwaye igcina ubunzima bamathambo; ngokwethiyori, inokunyusa uzinzo lokujika, inciphise ukufuduka kwangaphambili okungaqhelekanga, kwaye ifikelele ekujikeni okungasemva. Inceda ukugcina ukuqonda okubonakalayo.
I-PS prosthesis isebenzisa isakhiwo se-cam-column ukuze ithathe indawo yomsebenzi womnqamlezo ongasemva kuyilo, ukuze i-femoral prosthesis ikwazi ukujikwa ngexesha lemisebenzi yokujikwa. Ngexesha lotyando, i-i-femoral intercondylari-osteotomy iyafuneka. Ngenxa yokususwa kwe-posterior cruciate ligament, i-flexion gap inkulu, i-posterior maneuver ilula, kwaye i-ligament balance ilula kwaye icacile.
(2) Iimpawu ezinxulumene ne-CR kunye ne-PS prostheses:
Uninzi lwezigulana ezisebenzisa i-primary total knee arthroplasty zinokusebenzisa i-CR prosthesis okanye i-PS prosthesis, kwaye ukhetho lwe-prosthesis luxhomekeke kakhulu kwimeko yesigulana kunye namava kagqirha. Nangona kunjalo, i-CR prosthesis ifanelekile ngakumbi kwizigulana ezinomsebenzi oqhelekileyo we-posterior cruciate ligament, i-hyperplasia encinci yamalungu, kunye ne-joint deformity engembi kangako. Ii-PS prostheses zingasetyenziswa kakhulu kwiindawo ezininzi zokutshintshwa kwamadolo apheleleyo, kuquka nezigulana ezine-hyperplasia enzima kunye ne-deformity. Kwizigulana ezine-osteoporosis enzima okanye iziphene zamathambo, iintonga zokwandisa i-intramedullary zinokufuneka, kwaye i-collateral ligament dysfunction inokufuneka. Sebenzisa ii-restrictive spacers.
2. Iqonga elizinzileyo kunye neqonga elinokushukuma
Okwenziwayoi-prosthesis yamadoloIngohlulwa ibe yiplatifomu esisigxina kunye neplatifomu eshukumayo ngokwendlela yokudibanisa i-gasket ye-polyethylene kunye netreyi ye-tibial yesinyithi. I-prosthesis yeplatifomu esisigxina yinxalenye ye-polyethylene enamathele kwi-tibial plateau ngendlela yokutshixa. Inxalenye ye-polyethylene ye-prosthesis yeplatifomu eshukumayo inokushukuma kwi-tibial plateau. Ukongeza ekwenzeni i-joint eshukumayo kunye ne-femoral prosthesis, i-polyethylene spacer ikwavumela inqanaba elithile lokuhamba phakathi kwe-tibial plateau kunye ne-tibial plateau.
I-gasket ye-prosthesis yeplatifomu esisigxina itshixiwe kwi-bracket yesinyithi, eqinileyo nethembekileyo, kwaye isetyenziswa kakhulu. I-geometries ye-fixation spacers inokwahluka kakhulu kumenzi ngamnye ukuze ihambelane ne-prosthesis yayo ekhethekileyo ye-femoral kwaye iphucule i-kinematics efunekayo. Ingatshintshwa ngokulula ibe yi-shim ethintelayo ukuba kuyimfuneko.
Ixesha lokuthumela: Septemba-10-2022
