1. Malinga ndi ngati ligament ya posterior cruciate yasungidwa
Malinga ndi ngati ligament ya posterior cruciate yasungidwa, prosthesis yoyamba yopangira bondo ikhoza kugawidwa m'magulu awiri: posterior cruciate ligament replacement (Posterior Stabilized, PS) ndi posterior cruciate ligament retention (Cruiate Retention, CR). M'zaka zaposachedwa, tibial plateau ya mitundu iwiriyi ya ma prostheses yapangidwa ndi madigiri osiyanasiyana a kufanana ndi m'lifupi mwa mzati wapakati malinga ndi kukhazikika kwa cholumikizira, ntchito ya ligament ndi lingaliro la dokotala wa opaleshoni, kuti apititse patsogolo kukhazikika kwa cholumikizira ndikuwonjezera magwiridwe antchito a kinematic.
(1) Makhalidwe a CR ndi PS prostheses:
Chigoba cha CR chimasunga ligament ya posterior cruciate yabondondipo amachepetsa kuchuluka kwa njira zochitira opaleshoni; amapewa kuchotsedwanso kwa femoral condyle ndikusunga mafupa; mwachiphunzitso, amatha kuwonjezera kukhazikika kwa kupindika, kuchepetsa kusuntha kwa anterior, ndikupangitsa kuti mafupa azigwedezeka kumbuyo. Amathandiza kusunga mawonekedwe a ziwalo.
Chigoba cha PS chimagwiritsa ntchito kapangidwe ka cam-column kuti chilowe m'malo mwa ntchito ya mtanda wa posterior pa kapangidwe kake, kotero kuti chigoba cha femoral chikhoza kubwezeretsedwanso panthawi yogwira ntchito yopindika. Pa opaleshoni,femoral intercondylarKuchotsa mafupa a mafupa kumafunika. Chifukwa cha kuchotsa kwa posterior cruciate ligament, mpata wopindika ndi waukulu, njira yolowera kumbuyo ndi yosavuta, ndipo mgwirizano wa ligament ndi wosavuta komanso wosavuta.
(2) Zizindikiro zokhudzana ndi ma prostheses a CR ndi PS:
Odwala ambiri omwe akuchitidwa opaleshoni ya primary total bondo arthroplasty amatha kugwiritsa ntchito CR prosthesis kapena PS prosthesis, ndipo kusankha prosthesis kumadalira kwambiri momwe wodwalayo alili komanso zomwe dokotala wakumana nazo. Komabe, CR prosthesis ndi yoyenera kwambiri kwa odwala omwe ali ndi posterior cruciate ligament function yabwinobwino, joint hyperplasia yofatsa, komanso joint deformity yochepa. PS prostheses ingagwiritsidwe ntchito kwambiri m'malo ambiri oyambira a bondo, kuphatikiza odwala omwe ali ndi hyperplasia yayikulu komanso deformity. Kwa odwala omwe ali ndi osteoporosis yayikulu kapena zolakwika zamafupa, ndodo zotalikitsa intramedullary zingafunike, ndipo collateral ligament dysfunction ingafunike. Gwiritsani ntchito zotchingira zoletsa.
2. Pulatifomu yokhazikika ndi yosunthika
Zopangachopangira cholumikizira bondoZingagawidwe m'magawo okhazikika ndi nsanja yosunthika malinga ndi njira yolumikizira ya polyethylene gasket ndi thireyi yachitsulo ya tibial. Chogwirira cha nsanja yosunthika ndi gawo la polyethylene lolumikizidwa ku tibial plateau pogwiritsa ntchito njira yotsekera. Gawo la polyethylene la chogwirira cha nsanja yosunthika limatha kuyenda pa tibial plateau. Kuphatikiza pa kupanga cholumikizira chosunthika ndi chogwirira cha femoral, chogwirira cha polyethylene chimalolanso kuyenda pang'ono pakati pa tibial plateau ndi tibial plateau.
Gasket yokhazikika ya prosthesis imatsekedwa pa bulaketi yachitsulo, yomwe ndi yolimba komanso yodalirika, ndipo imagwiritsidwa ntchito kwambiri. Ma geometries a fixation spacers amatha kusiyanasiyana kuchokera kwa wopanga wina kupita wina kuti agwirizane ndi prosthesis yawo yapadera ya femoral ndikukweza kinematics yomwe mukufuna. Itha kusinthidwanso mosavuta kukhala shim yoletsa ngati pakufunika.
Nthawi yotumizira: Sep-10-2022
