Kodi misozi ya ACL ndi chiyani?
ACL ili pakati pa bondo. Imalumikiza fupa la ntchafu (femur) ndi tibia ndipo imaletsa tibia kuti isayende patsogolo ndikuzungulira kwambiri. Ngati mutang'amba ACL yanu, kusintha kulikonse kwadzidzidzi kwa njira, monga kuyenda kapena kuzungulira mbali, pamasewera monga mpira, basketball, tenisi, rugby kapena masewera ankhondo, kungayambitse bondo lanu kulephera.
Nthawi zambiri kuvulala kwa ACL kumachitika chifukwa cha kuvulala kosakhudzana ndi bondo komwe kumachitika chifukwa cha kupindika mwadzidzidzi kwa bondo panthawi yophunzitsa kapena mpikisano. Osewera mpira amathanso kukhala ndi vuto lomweli akamadutsa mpira patali, zomwe zimapangitsa kuti mwendo woyimirira ukhale wopanikizika kwambiri.
Nkhani yoipa kwa othamanga achikazi omwe akuwerenga izi: Akazi ali pachiwopsezo chachikulu cha kung'ambika kwa ACL chifukwa mawondo awo sali bwino, kukula ndi mawonekedwe awo.
Ochita masewera omwe amadula ACL yawo nthawi zambiri amamva "kutupa" kenako bondo limatupa mwadzidzidzi (chifukwa cha kutuluka magazi kuchokera ku ligament yosweka). Kuphatikiza apo, pali chizindikiro chofunikira: wodwalayo sangathe kuyenda kapena kupitiriza kusewera masewera nthawi yomweyo chifukwa cha kupweteka kwa bondo. Pamene kutupa kwa bondo kumatha, wodwalayo angamve kuti bondo silikukhazikika komanso sangathe kuimirira, zomwe zimapangitsa kuti wodwalayo asamachite masewera omwe amawakonda kwambiri.
Osewera otchuka angapo adakumana ndi misozi ya ACL. Izi zikuphatikizapo: Zlatan Ibrahimovich, Ruud Van Nistelrooy, Francesco Totti, Paul Gascoigne, Alan Shearer, Tom Brady, Tiger Woods, Jamal Crawford, ndi Derrick Rose. Ngati mwakumanapo ndi mavuto ofanana, simuli nokha. Nkhani yabwino ndi yakuti othamanga awa adapitiliza ntchito zawo zaukadaulo atangomanganso ACL. Ndi chithandizo choyenera, mutha kukhala ngati iwonso!
Momwe Mungadziwire Kung'ambika kwa ACL
Muyenera kupita kwa dokotala wanu ngati mukuganiza kuti muli ndi ACL yong'ambika. Adzatha kutsimikizira izi ndikupeza matenda ndikukupatsani njira zabwino zopitira patsogolo. Dokotala wanu adzachita mayeso ena kuti adziwe ngati muli ndi ACL yong'ambika, kuphatikizapo:
1. Kuyezetsa thupi komwe dokotala wanu adzayang'ana momwe bondo lanu limayendera poyerekeza ndi bondo lanu lina losavulala. Angayesenso kuyesa kwa Lachman kapena kuyesa kwa kabati ka kutsogolo kuti awone momwe bondolo limayendera komanso momwe limagwirira ntchito bwino, ndikukufunsani mafunso okhudza momwe limamvera.
2. Kuyezetsa X-ray komwe dokotala wanu angatsimikizire ngati pali kusweka kapena kusweka kwa fupa.
3. Kujambula kwa MRI komwe kudzawonetsa minofu yanu ndi minofu yofewa ndikulola dokotala wanu kuwona kukula kwa kuwonongeka.
4. Kujambula kwa Ultrasound kuti muwone mitsempha, minyewa, ndi minofu.
Ngati kuvulala kwanu kuli kocheperako mwina simunang'ambe ACL koma munangoyitambasula. Kuvulala kwa ACL kumayesedwa kuti mudziwe kuopsa kwake motere.
Kodi ACL yong'ambika ingachiritse yokha?
Kawirikawiri ACL sichira bwino yokha chifukwa siili ndi magazi okwanira. Ili ngati chingwe. Ngati yang'ambika pakati, zimakhala zovuta kuti mbali ziwirizi zilumikizane mwachibadwa, makamaka chifukwa bondo limayenda nthawi zonse. Komabe, othamanga ena omwe ali ndi kung'ambika pang'ono kwa ACL amatha kubwerera kusewera bola ngati cholumikiziracho chili chokhazikika ndipo masewera omwe amasewera sakuphatikizapo kupotoza mwadzidzidzi (monga baseball).
Kodi opaleshoni yokonzanso ACL ndiyo njira yokhayo yothandizira?
Kukonzanso ACL ndiko kusintha kwathunthu ACL yong'ambika ndi "tishu graft" (yomwe nthawi zambiri imapangidwa ndi tendon kuchokera mu ntchafu yamkati) kuti bondo likhale lolimba. Iyi ndi njira yovomerezeka kwa othamanga omwe ali ndi bondo losakhazikika ndipo sangathe kutenga nawo mbali pamasewera atatha kung'ambika kwa ACL.
Musanaganize zochitidwa opaleshoni, muyenera kufunsa katswiri wodziwa bwino za thupi amene dokotala wanu wakupatsani ndipo muyenera kupatsidwa chithandizo cha thupi. Izi zidzakuthandizani kubwezeretsa bondo lanu kuti lizitha kuyenda bwino komanso kukhala ndi mphamvu, komanso kukuthandizani kuchepetsa kuwonongeka kwa mafupa. Madokotala ena amakhulupiriranso kuti kukonzanso kwa ACL kumagwirizanitsidwa ndi chiopsezo chochepa cha nyamakazi yoyambirira (kusintha kwa mafupa) kutengera zomwe zapezeka pa x-ray.
Kukonza ACL ndi njira yatsopano yochiritsira mitundu ina ya misozi. Madokotala amalumikizanso malekezero osweka a ACL ku fupa la ntchafu pogwiritsa ntchito chipangizo chotchedwa medial brace. Komabe, misozi yambiri ya ACL si yoyenera njira yochiritsira mwachindunji iyi. Odwala omwe adakonzedwanso amakhala ndi opaleshoni yokonzanso mwachangu (mmodzi mwa milandu 8, malinga ndi mapepala ena). Pakadali pano pali kafukufuku wambiri wokhudza kugwiritsa ntchito maselo oyambira ndi plasma yolemera m'ma platelet kuti athandize ACL kuchira. Komabe, njira izi zikadali zoyeserera, ndipo chithandizo cha "golide" chikadali opaleshoni yokonzanso ACL.
Ndani angapindule kwambiri ndi opaleshoni yokonzanso ACL?
1. Odwala akuluakulu omwe amachita masewera olimbitsa thupi omwe amakhudza kuzungulira kapena kusinthasintha.
2. Odwala akuluakulu omwe amagwira ntchito mwakhama omwe amagwira ntchito zomwe zimafuna mphamvu zambiri zakuthupi komanso zomwe zimafuna kuzungulira kapena kuzungulira.
3. Odwala okalamba (monga azaka zopitilira 50) omwe amachita nawo masewera apamwamba komanso omwe alibe kusintha kosasintha kwa bondo.
4. Ana kapena achinyamata omwe ali ndi misozi ya ACL. Njira zosinthidwa zingagwiritsidwe ntchito kuchepetsa chiopsezo cha kuvulala kwa mbale yokulirapo.
5. Ochita masewera omwe ali ndi kuvulala kwina kwa bondo kupatula misozi ya ACL, monga posterior cruciate ligament (PCL), collateral ligament (LCL), meniscus, ndi cartilage. Makamaka kwa odwala ena omwe ali ndi misozi ya meniscus, ngati angathe kukonza ACL nthawi yomweyo, zotsatira zake zidzakhala zabwino.
Kodi mitundu yosiyanasiyana ya opaleshoni yokonzanso ACL ndi iti?
1. Mnofu wa Hamstring - Izi zitha kuchotsedwa mosavuta kuchokera mkati mwa bondo kudzera mu kudula pang'ono panthawi ya opaleshoni (autograft). ACL yong'ambika ikhozanso kusinthidwa ndi mnofu woperekedwa ndi munthu wina (allograft). Othamanga omwe ali ndi hypermobility (hyperlaxity), very loose medial collateral ligaments (MCL), kapena minofu yaying'ono ya hamstring angakhale abwino kwambiri pa allograft kapena patellar tendon graft (onani pansipa).
2. Patellar tendon – Gawo limodzi mwa magawo atatu a patellar tendon ya wodwalayo, pamodzi ndi mafupa opangidwa kuchokera ku tibia ndi kneecap, angagwiritsidwe ntchito poika patellar tendon autograft. Ndi yothandiza ngati graft ya tendon, koma imakhala ndi chiopsezo chachikulu cha kupweteka kwa bondo, makamaka pamene wodwalayo wagwada ndipo wasweka bondo. Wodwalayo adzakhalanso ndi chilonda chachikulu kutsogolo kwa bondo.
3. Njira yolumikizira bondo lapakati komanso njira yolumikizira tibial femoral tunnel - Poyamba opaleshoni yokonzanso ACL, dokotalayo amabowola ngalande yolunjika ya fupa (tibial tunnel) kuchokera ku tibia kupita ku femur. Izi zikutanthauza kuti ngalande ya fupa mu femur si komwe ACL inali poyamba. Mosiyana ndi zimenezi, madokotala ochita opaleshoni omwe amagwiritsa ntchito njira yolumikizira mafupa amayesa kuyika ngalande ya fupa ndi graft pafupi ndi malo oyamba (anatomical) a ACL momwe angathere. Madokotala ena amakhulupirira kuti kugwiritsa ntchito njira yolumikizira tibial femoral tunnel kumabweretsa kusakhazikika kwa kuzungulira komanso kuchuluka kwa mawondo a odwala.
4. Njira yolumikizira mafupa onse/grafting - Njira yolumikizira mafupa onse imagwiritsa ntchito kuboola kumbuyo kuti muchepetse kuchuluka kwa mafupa omwe amafunika kuchotsedwa pa bondo. Pamafunika chigoba chimodzi chokha kuti mupange grafting pomanganso ACL. Chifukwa chake ndi chakuti njira iyi ingakhale yosavulaza komanso yosapweteka kwambiri kuposa njira yachikhalidwe.
5. Chikwama chimodzi poyerekeza ndi chikwama chachiwiri - Madokotala ena a opaleshoni amayesa kumanganso mitolo iwiri ya ACL mwa kuboola mabowo anayi pa bondo m'malo mwa awiri. Palibe kusiyana kwakukulu pa zotsatira za kukonzanso kwa ACL ya chikwama chimodzi kapena ziwiri - madokotala a opaleshoni apeza zotsatira zabwino pogwiritsa ntchito njira zonse ziwiri.
6. Kusunga Mbale Yokulira - Mapepala okulira a ana kapena achinyamata omwe ali ndi vuto la ACL amakhala otseguka mpaka zaka pafupifupi 14 kwa atsikana ndi 16 kwa anyamata. Kugwiritsa ntchito njira yodziwika bwino yokonzanso ACL (transvertebral) kungawononge mapepala okulira ndikuletsa fupa kukula (growth mistle). Dokotala wa opaleshoni ayenera kuyang'ana mapepala okulira a wodwalayo asanalandire chithandizo, kudikira mpaka wodwalayo atamaliza kukula, kapena kugwiritsa ntchito njira yapadera kuti asakhudze mapepala okulira (periosteum kapena adventitia).
Kodi nthawi yabwino yokonzanso ACL pambuyo pa kuvulala ndi iti?
Ndibwino kuti muchitidwe opaleshoni mkati mwa milungu ingapo mutavulala. Kuchedwetsa opaleshoni kwa miyezi 6 kapena kuposerapo kumawonjezera chiopsezo chowononga khosi ndi ziwalo zina za bondo, monga meniscus. Musanachite opaleshoni, ndi bwino ngati mwalandira chithandizo chamankhwala kuti muchepetse kutupa ndikubwezeretsanso mphamvu zonse zoyenda, ndikulimbitsa minofu yanu yakutsogolo ya ntchafu.
Kodi njira yochiritsira pambuyo pa opaleshoni yokonzanso ACL ndi yotani?
1. Pambuyo pa opaleshoni, wodwalayo adzamva kupweteka kwa bondo, koma dokotala adzamulembera mankhwala amphamvu ochepetsa ululu.
2. Pambuyo pa opaleshoni, mutha kugwiritsa ntchito ndodo kuti muyime ndikuyenda nthawi yomweyo.
3. Odwala ena ali ndi thanzi labwino moti angathe kutulutsidwa tsiku lomwelo.
4. Ndikofunikira kulandira chithandizo cha thupi mwamsanga mukatha opaleshoni.
5. Mungafunike kugwiritsa ntchito ndodo kwa milungu isanu ndi umodzi
6. Mutha kubwerera kuntchito ya muofesi patatha milungu iwiri.
7. Koma ngati ntchito yanu imafuna ntchito zambiri zakuthupi, zimatenga nthawi yayitali kuti mubwerere kuntchito.
8. Zingatenge miyezi 6 mpaka 12 kuti muyambirenso kuchita masewera olimbitsa thupi, nthawi zambiri miyezi 9
Kodi mungayembekezere kusintha kotani pambuyo pa opaleshoni yokonzanso ACL?
Malinga ndi kafukufuku wamkulu wa odwala 7,556 omwe adachira matenda a ACL, ambiri mwa odwalawo adabwerera ku masewera awo (81%). Awiri mwa atatu mwa odwalawo adabwerera ku masewera awo asanavulale, ndipo 55% adabwerera ku masewera apamwamba.
Nthawi yotumizira: Januwale-16-2025
