Amaseli atshintshiwe athatha ukulimala kwe-cartilage
Ukwakhiwa kwe-chondrocyte e-Autologous, noma i-ACI, inqubo eyenziwe ngasekupheleni kweminyaka yama-1980 ukuphatha izindawo zokulimala kwe-cartilage emadolweni. I-ACI nayo isetshenziswe ngokungajwayelekile kwamanye amajoyina, njenge-ankle, kodwa ngokuvamile iqhutshwa emadolweni.
Umqondo wenqubo ye-ACI ukuthatha amangqamuzana ambalwa we-cartilage emadolweni, akhulise ebhodini, futhi uma izigidi zamaseli sezikhulile zifakwa endaweni yokulimala kwe-cartilage.
Sibutsetelo
I-ACI yinkambiso yezinyathelo ezimbili, edinga ukuhlinza kabili ngamasonto ambalwa. Amaseli okuqala avunwa, bese afakwa.
Isinyathelo Sokuqala: I-Arthroscopy
Isinyathelo sokuqala se-ACI ukwenza ukwenziwa kwe-arthroscopic ukukhomba indawo yokulimala kwe-cartilage, futhi unqume ukuthi kufanelekile yini inqubo ye-ACI.
Phakathi nenqubo ye-arthroscopic, amaseli we-cartilage aqoqwe. Lawa maseli athunyelwa ebhokisini labanwetshiwe beselula lapho banda khona ngokukhula ngesiko. Ukukhulisa amangqamuzana anele kuthatha amasonto amane kuya ayisithupha. Uma selivele litshalwe amangqamuzana, athunyelwa kudokotela ohlinzayo, futhi ukuhlinzwa kwesibili kuhlelwe.
Isinyathelo Sokubili: Ukuhlinzekwa Ukutshala
Kanye nama cell cartilage okwanele asekhulile, ukuhlinzekwa kwesibili kuhlelwe. Phakathi nalokhu kuhlinzeka, ukugxila okukhudlwana kusetshenziselwa ukubuka ngokuqondile indawo yomonakalo we-cartilage (hhayi i-arthroscopy). Ukukhishwa kwesibili kwenziwa phezu kwethambo le-shin nendawo yesikhumba esibizwa nge-periosteum ivunwa.
I-periosteum yizicubu ezinzima ezihlanganisa isifuba shin. I "patch periosteal," cishe ubukhulu bendawo yokulimala kwe-cartilage, ivunwa.
Isiqephu se-periosteal sithungelwa phezu kwendawo ye-cartilage ewonakele. Uma kusungulwa uphawu oluqinile phakathi kwe-patch kanye ne-cartilage ezungezile, amangqamuzana ase-cultivated cultured ajowe ngaphansi kwesigatshana.
I-patch periosteal isetshenziselwa ukubamba amangqamuzana amasha okuqothulwa endaweni engumonakalo we-cartilage.
Abafundi
I-ACI yinkambiso ebalulekile. Ukuphumula kuyinde, futhi iziguli kufanele zilungele ukuhlanganyela ekwelapheni okujulile ngokomzimba . I-ACI ifanele kuphela iziguli ezinezindawo ezincane zokulimala kwe-cartilage, hhayi ukugqoka okwejwayelekile kwe-carticlage ye- arthritis yamadolo . Iziguli ezicubungula i-ACI kufanele zivumelane nale phrofayela elandelayo:
- Indawo ebalulekile yokulimala kwe-cartilage, hhayi i- arthritis evamile
- Ukuzwa ubuhlungu noma ukuvuvukala okuvimbela umsebenzi wabo
- Idolo elizinzile elingenalo umonakalo wegament
- Isisindo esifanele ukuphakama (hhayi okwedlula)
Ngaphezu kwalokho, iziguli kufanele zizame ezinye izifo ezingekho emthethweni ngaphambi kokucubungula le nqubo ebalulekile. Ngaphezu kwalokho, iziguli kumele zibe nokuqonda okuqinile ukuvuselelwa kokuthunyelwa komsebenzi kusuka ku-ACI. Lesi sinyathelo sibalulekile ekuphumeleleni kwenqubo ye-ACI. Ngaphandle kokubuyiselwa okufanele kwemiphumela kaningi kungaphansi kokuhle.
Izinkinga
Impumelelo ye-ACI iyashintsha kakhulu, kanye nabahlinzayo abahlukahlukene ababika amazinga ahlukene ephumelelayo. Ukuhlukumeza okuvame kakhulu kubangelwa ukubunjwa kwamathambo okuzungeze emaphethelweni e-periosteal patch, ebizwa nge-periosteal hypertrophy.
Le nkinga idinga ukuthi ukuhlinzekwa kwe-arthroscopic eyengeziwe kususe izicubu ezinzima kakhulu.
Ezinye izinkinga zihlanganisa ukuhluleka kwamaseli asetshenziselwe ukuhlanganisa ngokufanele, ukutheleleka kwamadolo nokuqina kogulo .
Ukuvuselelwa
Ukuvuselelwa okuvela ku-ACI kufana kakhulu nokuvuselelwa okulandela ukukhishwa kwamagciwane futhi kuxhomeke kubukhulu nendawo yendawo yokulimala kwe-cartilage. Izimiso eziyisisekelo zokuvuselelwa kwe-ACI yizi:
- Ukuphakama kwesisindo: Isisindo kumele sinqunywe endaweni yokufakelwa kwe-cartilage. Isizathu sokwehlisa isisindo ukuthi amaseli kumele avunyelwe ukunamathela endaweni eyenze inqubo ye-ACI.
Indlela yokulinganisela isisindo endaweni ye-ACI incike endaweni. Uma i-ACI i-tibia (phezulu kwesifuba shin) noma i-femur (ekupheleni kwethanga lesthanga), isisindo sinqunyelwe ngokuba nesiguli sokusebenzisa izikhonkwane . Lapho i-ACI ivulekile (i-patella) noma ngaphakathi kwendawo yokudla i-patella (i-trochlea), ukunyakaza kufanele kunqunyelwe ngoba lokhu kuzokwenza ukucindezelwa kumaseli asetshenziswe.
- Ukuhamba kwe-Motion: Ukuhamba kwesimo kuvame ukuqaliswa ngokushesha ngemuva kokuhlinzwa. Kodwa-ke, njengoba kuchaziwe ngenhla, uma indawo ye-ACI yokwelapha ivulekile noma ingaphakathi kwendawo yayo, ukuhamba kuyobe kunqunyelwe amasonto ayisithupha kuya kwangu-8.
Isizathu sokuqala ukuhamba ngokushesha ngangokunokwenzeka ukuthi ukunyakaza kusiza ekuvuseleleni ukukhula kwe-cartilage enempilo. Noma kunjalo, lokhu kuqhutshwa kufanele kufanelane nokucindezelwa okubangelwa ukunyakaza. Kumelwe uhambelane ngokuqinile nezincomo zodokotela wakho njengoba zizocaca ngokulimala kwakho nokwelashwa kwakho.
Ukuphakama kwesisindo kuvame ukulinganiselwa okungenani amasonto ayisithupha kuya kwangu-8, bese kancane kancane kuqhubeka ngokuhamba kwesikhathi. Ngemuva kwezinyanga ezintathu kuya kweziyisithupha, ukuqeqeshwa kungakhuphuka ekuziphatheni nasekuqiniseni. Imisebenzi ethize yezemidlalo ingaqala cishe izinyanga ezingu-12 emva kokuhlinzwa. Abagijimi abaningi ababuyeli emidlalweni egcwele kuze kube yizinyanga ezingu-16 emva kokuhlinzwa.
Imithombo:
UJona DG, uPetererson L. "Ukufakelwa kwe-Autologous chondrocyte" i-Instr Course Lect. 2007; 56: 429-45.