mbendera

Ma prostheses ophatikiza mawondo onse amagawidwa m'njira zosiyanasiyana malinga ndi mawonekedwe osiyanasiyana.

1. Malingana ndi ngati posterior cruciate ligament imasungidwa

Malingana ndi ngati mitsempha yam'mbuyo imasungidwa, mawondo opangira mawondo amatha kugawidwa m'malo mwa posterior cruciate ligament (Posterior Stabilized, PS) ndi posterior cruciate ligament retention (Cruiate Retention, CR).M'zaka zaposachedwa, mapiri a tibial a mitundu iwiriyi ya prostheses adapangidwa ndi magawo osiyanasiyana a conformity ndi m'lifupi mwa chigawo chapakati malinga ndi kukhazikika kwa mgwirizano, ntchito ya ligament ndi lingaliro la dokotala wa opaleshoni, kotero kuti kusintha kukhazikika kwa olowa ndikuwongolera magwiridwe antchito a kinematic.

1
2

(1) Mawonekedwe a CR ndi PS prostheses:

CR prosthesis imateteza kumbuyo kwa cruciate ligamentbondo limodzindi kuchepetsa chiwerengero cha masitepe opaleshoni;imapewa kuwonjezereka kwina kwa condyle yachikazi ndikusunga fupa;mwamalingaliro, imatha kukulitsa kukhazikika kwa ma flexion, kuchepetsa kusamuka kwapambuyo kwapambuyo, ndikukwaniritsa kugubuduzika chakumbuyo.Imathandiza kusunga makonda.

Prosthesis ya PS imagwiritsa ntchito mawonekedwe a cam-column kuti alowe m'malo mwa mtanda wam'mbuyo pamapangidwewo, kotero kuti prosthesis yachikazi ikhoza kubwezeredwa m'mbuyo pazochitika za flexion.Pa opareshoni, ndichikazi intercondylarosteotomy amafunika.Chifukwa cha kuchotsedwa kwa mitsempha ya posterior cruciate ligament, kusiyana kwa flexion ndi kwakukulu, kusuntha kwapambuyo kumakhala kosavuta, ndipo kugwirizana kwa ligament kumakhala kosavuta komanso kosavuta.

3

(2) Zizindikiro zofananira za CR ndi PS prostheses:

Odwala ambiri omwe ali ndi vuto lalikulu la mawondo amatha kugwiritsa ntchito CR prosthesis kapena PS prosthesis, ndipo kusankha kwa prosthesis kumadalira makamaka momwe wodwalayo alili komanso zomwe dokotala wakumana nazo.Komabe, CR prosthesis ndi yoyenera kwambiri kwa odwala omwe ali ndi vuto la posterior cruciate ligament ligament, hyperplasia yofatsa kwambiri, komanso kupunduka kwakukulu kwa mgwirizano.Ma prostheses a PS amatha kugwiritsidwa ntchito kwambiri m'malo ambiri oyambira mawondo, kuphatikiza odwala omwe ali ndi hyperplasia yayikulu komanso kupunduka.Odwala omwe ali ndi matenda osteoporosis aakulu kapena zofooka za mafupa, ndodo zotalikitsa za intramedullary zingafunike, ndipo kusokonezeka kwa ligament kungafunike.Gwiritsani ntchito ma spacers oletsa.

2. Pulatifomu yokhazikika ndi prosthesis yosunthika ya nsanja

Zochita kupangaprosthesis ya bondoakhoza kugawidwa mu nsanja yokhazikika ndi nsanja yosunthika molingana ndi njira yolumikizira ya polyethylene gasket ndi thireyi yachitsulo ya tibial.Prosthesis yokhazikika ya nsanja ndi chigawo cha polyethylene chokhazikika kumtunda wa tibial ndi makina otseka.Chigawo cha polyethylene cha prosthesis yosunthika ya nsanja imatha kusuntha pamtunda wa tibial.Kuphatikiza pa kupanga cholumikizira chosunthika ndi chiwopsezo cha chikazi, polyethylene spacer imalolanso kuyenda pang'ono pakati pa tibial plateau ndi tibial.

Gasket ya prosthesis yokhazikika imatsekedwa pazitsulo zachitsulo, zomwe zimakhala zolimba komanso zodalirika, ndipo zimagwiritsidwa ntchito kwambiri.Ma geometries a fixation spacers amatha kusiyanasiyana kuchokera kwa wopanga kupita kwa wopanga kuti agwirizane ndi mawonekedwe awo apadera achikazi ndikuwongolera ma kinematics omwe akufuna.Itha kusinthidwanso mosavuta kukhala shim yoletsa ngati ikufunika.

4
5

Nthawi yotumiza: Sep-10-2022