Ama-Hip Osteonecrosis Izimpawu Nezokwelapha

I-Necrosis ye-Avascular ye-Hip

I-osteonecrosis ye-Hip, ebizwa nangokuthi i-avascular necrosis, iyinkinga ngokunikezwa kwegazi ngethambo lomhlanganiso we- hip . Lesi simo senzeke uma kunokuphazamiseka kwegazi ukufika ekhanda le-femur (ibhola, ibhola ne-socket joint hip). Ukuntuleka kwegazi elijwayelekile emangqamuzaneni amathambo kubangela ukwehla kokulethwa kwe-oksijeni nezakhi ezitheni, futhi amangqamuzana amathambo abuye afe.

Lapho amangqamuzana amathambo ewonakele, amandla esithambo ayancipha kakhulu, futhi ithambo liyakwazi ukuwa.

Izimbangela

Akekho owazi kahle ukuthi yini ebangelwa i-hip osteonecrosis. Lapho i-hip osteonecrosis ivela, ithambo liwela futhi ubuso obunamathele, i-cartilage, balahlekelwe ukusekelwa kwalo. Ngenxa yokuthi i-cartilage ilahlekelwe ukusekelwa kwethambo ngaphansi, indawo ehlangene isheshe igugile, futhi i- arthritis iyaqhubeka ngokushesha.

Iziguli eziningi ezine-hip osteonecrosis zihlotshaniswa nokusetshenziswa kotshwala noma ukusetshenziswa kwe-steroid . Ezinye izici ezingozini zokuthuthukisa i-hip osteonecrosis zifaka isifo se-sickle cell, ukuhlukumezeka ku-hip (ukuchithwa noma ukuphuka), i-lupus, nezinye izifo zofuzo.

Izimpawu

I-osteonecrosis ye-Hip ngokuvamile inezibonakaliso ezimbalwa zokuxwayisa. Iziguli zivame ukukhalaza ngobuhlungu obusha bokuqala be-hip nobunzima bokuhamba. Izimpawu ezijwayelekile ze-hip osteonecrosis zihlanganisa:

• Ukuzwa ubuhlungu ku-groin
• Ubuhlungu ngokuhamba kwe-hip

• Kunzima ukuhamba noma ukuphoqa

Izivivinyo ezimbili eziwusizo kakhulu ekuhloleni nasekuphatheni i-hip osteonecrosis ziyi-x ray kanye neMIsis . I-x ray ingahle ibe yinto evamile, noma ingabonisa umonakalo omkhulu ekuhlanganyeleni kwe-hip. Uma i-ray-ray ingavamile, i-MRI ingenziwa ukuze ibheke izimpawu zokuqala ze-hip osteonecrosis.

I-osteonecrosis yokuqala ye-hip ingase ingabonakali kwi-x-ray yesimiso, kodwa kufanele ihlale iboniswa kuhlolo lwe-MRI. Izigaba kamuva ze-osteonecrosis zizobonakala kalula kwi-x-ray, futhi ama-MRIs awadingekile futhi awanakusizo. Ngeshwa, ngokuvamile isikhathi se-hip osteonecrosis sibonakala ku-x-ray, ukwelapha kuphela okuhlinzeka okungatholakala kuyindlela yokufaka esikhundleni.

Ezinye izimo ezingaba nezimpawu ezifanayo zihlanganisa i- osteoarthritis ye-hip , i- osteoporosis yangemva kwesikhathi ye-hip , nezinkinga zangemva .

Ukwelapha

Ukwelashwa kwe-hip osteonecrosis kunzima ngoba inkinga ijwayele ukuqhubeka ngokushesha naphezu kokungenelela. Ezikhathini zokuqala ze-hip osteonecrosis, imichilo nemithi elwa nokuvuvukala ingasiza.

Izinketho zokuhlinzwa ezinyathelweni zokuqala ze-hip osteonecrosis zihlanganisa ukuchithwa kwe-hip nokufakelwa kwamathambo. Ukunciphisa kwe-Hip kwenziwa ukunciphisa ingcindezi eyengeziwe ngaphakathi kwekhanda lesifazane elingase libe negalelo ekungeneni kwegazi elijwayelekile. Ukudonswa kwe-hip kwenziwa nesikhala esilele ekamelweni lokusebenza. Izimbobo ezincane ziboshwe endaweni ye-hip osteonecrosis ukuze kutholakale ukucindezelwa ngaphakathi kwekhanda lesifazane.

I- vascularized bone graft isusa amathambo enempilo kusukela emlenzeni ophansi (kanye nemithambo yegazi ehlanganiswe nasetheni), futhi ibeka lokhu endaweni ye-hip osteonecrosis.

Umgomo walokhu kuhlinzeka ukuletha ukugeleza kwegazi okujwayelekile ku-hip ethintekile. Odokotela abahlinzayo baye bazama nezinye izinhlobo zokufakelwa (kufaka phakathi i-cadaver bone ne-graft synthetic) ukukhuthaza ukuphulukiswa kwethambo ekhanda lesifazane. Lezi zinqubo zenziwa kuphela ngezigaba zakuqala ze-hip osteonecrosis; uma le-cartilage isilele, lezi zinqubo zokuhlinzwa cishe ngeke ziphumelele.

Ukwelapha okuvame kakhulu ukwelashwa kwe-hip osteonecrosis kungu- total hip esikhundleni . Uma kunomonakalo emzimbeni we-joint, khona-ke ukuphinda esikhundleni kunokwenzeka okungcono kakhulu. Ngenkathi ukufakwa esikhundleni se-hip kusebenza kahle, ukushintshwa kuzokwenzeka ngokuhamba kwesikhathi.

Lokhu kubonisa inkinga ebalulekile ezigulini ezincane ezixilongwe nge-hip osteonecrosis. Enye inketho yeziguli ezincane ibizwa ngokuthi ukuhlinzwa kokuhlinzwa kwe-hip . Le nqubo ifana nokushintshwa okujwayelekile kwe-hip , kodwa isusa ithambo elincane elingaphansi.

_Imithombo:

_{I-Zalavras CG noLieeberman JR. "I-Osteonecrosis ye-Femoral Head: Ukuhlolwa Nokuphathwa" J Am Acad Orthop Surg July 2014 vol. 22 cha. 7 455-464.}

_{CJ Lavernia, RJ Sierra, neFr Grieco "Osteonecrosis yekhanda lesifazane" J. Am. I-Acad. I-Ortho. Ukuhlinzwa., Jul 1999; 7: 250 - 261.}