Le ngxenye ye-hip esikhundleni sakho ingaphelelwa yisikhathi
Ukuhlinzeka ukuhlinzwa kwe-Hip kuqhubeka ngokwengeziwe futhi kuyinye yezinqubo zokuhlinzwa eziphumelela kakhulu ngokuthuthukisa impilo nomsebenzi womuntu, kuyilapho futhi kunezinga eliphansi kakhulu lokucindezeleka. Uma indawo ejwayelekile ye-cartilage ye-joint hip igugile, ngisho nemisebenzi elula ingaba nzima. Ukushintshwa kwe-Hip kususa ukuhlanganiswa kwe-hip okugqamile futhi kuyishintsha ngokufakelwa okufakelwayo.
Kodwa-ke, lokho akusho ukuthi azikho izingozi zokuhlinzwa , kanti omunye wemigomo yakho yokuhlinza oyinhloko ukugwema izinkinga ezingenzeka. Enye ingcindezi engase ibe yinto yokuthambekela kwe-hip esikhundleni sokuphela kwesikhathi .
Imiklamo yokufaka esikhundleni se-hip, kanye nezinto ezisetshenziselwa ukwakhiwa kwe-hip esikhundleni sendawo, zishintshile, zahlanjululwa, zangena futhi zavela ngaphandle, futhi ziyaqhubeka ziphenywa ukuze zithole umklamo ophambili we-hip yokufakelwa. Izikhathi eziningi kule minyaka engamashumi embalwa edlule, izimpande ezintsha nezinto ezizofika emakethe ngenjabulo enkulu, kuphela ukuthola ukuthi ngokuhamba kwesikhathi ayisebenzi futhi kulindeleke.
Surface Bearing
Isixhumanisi esibucayi kakhulu se-hip esikhundleni, ngokuphathelene nokuphila isikhathi eside kwezinto ezifakiwe, yilokho okubizwa okuthiwa yi-bearing surface. Lokhu kungukuthi indawo yokuqhaqhazela ivumela ukuqhuma phakathi kwebhola kanye nesibekelo sokufakelwa.
Ukufakelwa kabusha kwe-hip esikhundleni sokuphinda kufakwe kabusha ibhola ne-socket ye-joint evamile ye-hip nebhola lokufakelwa kanye nesokhethini lokufakelwa. Lezi zingxenye ezifakiwe ziza ngobuningi nobukhulu, futhi yini efakwe emzimbeni wakho ingathembela ku:
- Ubukhulu besifazane nesifuba sakho
- Noma yikuphi ukukhubazeka noma okungavamile kokujoyina kwakho kwe-hip
- Ukuhlinzeka ngaphambi kokuhlinzwa okwenziwe ekhanda lakho
- Okuthandwa nguwe ohlinzayo
Ibhola kanye ne-socket ye-hip implant substlacement kuyoba yinto eshukumisa isikhathi ngasinye lapho iqhwa lakho lihamba phezu kwenkathi yokuphila kwakho. Lokhu kubonakala kuzokuveza izigidi zezikhathi futhi kulungele ukugqoka iminyaka engaphezu kweminye yemisebenzi. Ngokufana nokunyathela kwamathayi akho emoto kungaphelelwa amandla njengoba uhamba amakhulu namakhulu ezinkulungwane zamakhilomitha, ukuphakama kwe-hip kungaphelela iminyaka engaphezu kwamashumi eminyaka yomsebenzi.
Ngezinye izikhathi izimpande zokufaka esikhundleni se-hip zihlala isikhathi eside noma ezincane kakhulu. Umgomo ukuklama ukufakwa okuzohlala isikhathi eside ngangokunokwenzeka. Phakathi kwezici ezibalulekile ukucacisa isikhathi eside salokhu okubheke kuyo:
- Izinto ezisetshenziselwa ukubhekwa
- Ubukhulu bezindawo zokuthwala
Kukhona nezinye izici ezingabalulekile, kodwa lezi yizici ezimbili ongakhetha kuzo ohlinzayo ongasithinta kanjani ukuthi ukufakelwa kwakho kokufaka esikhundleni se-hip kuzohlala isikhathi eside kangakanani. Ngenxa yalesi sizathu, abantu abaningi abanomsebenzi we-hip bathola isithakazelo ezinhlobonhlobo zezinto ezibekwa ngaphakathi emzimbeni wabo.
Ukuguqulwa kwezimpande ze-Hip
Ukufakelwa kabusha kwendabuko ye-hip esikhundleni sisebenzisa insimbi ye-femal head (ibhola lokufakelwa) kanye ne-polyethylene ejwayelekile, noma ipulasitiki, njengengxenye ye-acetabular (i-socket of the implant).
Ngokomlando, ikhanda lezinsikazi laliyingcosana kakhulu, ikakhulukazi ngoba lokho kusho ukuthi indawo encane yokugubha phakathi kwebhola kanye nesokhethi, okuholela ekutheni izinga eliphansi lokugqoka lezimpande. Inkinga ngezimpande ezincane ze-femoral headings ukuthi zinezintambo eziphansi futhi izinga eliphakeme lokuhlukanisa . Ngenxa yalesi sizathu, ubukhulu bekhanda besifazane buye banda ukwenzela ukuthi ukufakelwa kwe-hip kuzinzile.
Kwakukhona injabulo enkulu eminyakeni engaba ngu-10 kuya kwengu-20 eyedlule lapho izimpande ezintsha zenzelwe ngokusebenzisa isixhumi se-acetabular metal. Lezi zimila, ezibizwa ngokuthi yi-metal-on-metal esikhundleni se-hip, zibonisa izinga eliphakeme kakhulu lokugqoka ezifundweni zelabhorethri, zazizinzile kakhulu ngenxa yezinhloko ezinkulu zezinsikazi ezingasetshenziswa, futhi zathandwa kakhulu.
Ngeshwa, ukugqoka kwezimpande kwakha izinhlayiya zensimbi ezincane eziye zadala izinkinga ngamathissi wendawo kanye nesistimu , okwenza izimpande zensimbi zensimbi zensimbi ezishintshayo zingacishe zizwakale namhlanje.
Enye yezinyathelo eziphawulekayo ekufakweni kwe-hip esikhundleni se-hip ibe yindlela yokuthuthukiswa kwe-polyethylene entsha (ipulasitiki) ehlala isikhathi eside kune-polyethylene evamile. Ukuthuthukiswa kwamuva kuye kwaba nokusetshenziswa kwe-polyethylene ehlanganisiwe kakhulu. I-polyethylene ehlanganisiwe yenziwa ngokukhipha nokushisa kabusha izimpande ze-polyethylene ezivumela iplastiki ukuba iqinise isakhiwo sayo se-molecular ngokusebenzisa inqubo yokuxhumanisa. I-polyethylene ekhonjiswe esiphambene nayo iboniswe ukuthi inezinga eliphansi lokugqoka kune-polyethylene evamile.
Izimplantshi ze-Ceramic nazo zaphenywa ngomzamo wokuthola isitshalo eside. I-Ceramic yinkimbinkimbi kakhulu, futhi izinto ezilukhuni azigqoki ngokushesha njengensimbi encane neplastiki. Inkinga nge-implants endala ye-ceramic yukuthi yenze imifucumfucu engabangela ukuthi ukufakelwa kushone ngokungazelelwe ngokuphula. I-ceramic emisha ibonise izinkinga ezimbalwa ngokuhluleka, nakuba kukhona nokucwaninga okuncane mayelana nemiphumela yesikhathi eside yemijondolo ye-ceramic, ikakhulukazi izinto ezintsha ze-ceramic.
Ukucabanga Kwamanje: Okulungile Kakhulu Manje
Ukucabanga kwamanje phakathi kwezinsizwa eziningi zokuhlinzeka ngamathambo ukuthi i-polyethylene engxenyeni ehlanganisiwe, ehlangene nekhanda le-ceramic noma yensimbi yesifazane, inomlando omuhle kakhulu wethrekhi. Kukhona futhi nedatha enhle yokusekela ukusebenzisa izimplantshi kokubili ikhanda le-ceramic femcket kanye nesokhethi se-ceramic, kodwa akukho ukulandelwa kwemitholampilo isikhathi eside kulezi zimila.
Umehluko phakathi kokusebenzisa ikhanda le-ceramic nensimbi yesifazane nge-cross-linked polyethylene insert ayizange iboniswe ukuthi ibalulekile. Kunezizathu ezithile zokuthi kungani odokotela abahlinzayo bangakhetha amakhanda ezinsikazi ze-ceramic, ikakhulukazi ezigulini ezincane, kodwa okuyiqiniso ukuthi kuze kube yimanje akuzange kuboniswe ukuthi kukhona umehluko omkhulu.
Uma Okusha Kungcono
Kuhlale kulingayo, kokubili iziguli kanye nodokotela ohlinzayo, ukukhangwa ekufakweni okusha emakethe. Ngokuvamile lezi zimila zikhuthazwa izinkampani zokukhiqiza zamathambo njengendlela engcono, futhi engase ibe yinde isikhathi eside, kunezimplanyithi ezitholakalayo okwamanje.
Ngasekuqaleni kwawo-2000, omunye wabakhiqizi abakhiqiza imithi ababizwa ngokuba yiDePuy Orthopedics, ukuhlukaniswa kukaJohnson & Johnson, beza emakethe ngenhloso yokufakelwa kabusha esikhundleni se-hip metal-on-metal eyakhelwe ngokuqondile ukuzinza nokuphila isikhathi eside. Lezi zimila zaziqedile ukuxazulula inkinga enzima yokufaka esikhundleni se-hip kubantu abancane, abakhuthele kakhulu. Ekugcineni, lezi zimila zazikhunjulwa futhi zithathwe emakethe, futhi eziningi zalezi ziguli zaphela zadinga ukuhlinzekwa okungeziwe ukuze zisuse futhi zithathele lesi sitshalo.
Enye yezinkinga ezinkulu ezifakiwe zokufaka esikhundleni sokujoyina ngokuhlanganyela ukuthi zivame ukuza emakethe ngokuphenywa okuncane noma okungekho emtholampilo. Ngenkathi iziguli zingakholelwa ukuthi noma yikuphi ukufakelwa okusha okuye kwahlolwa ukuhlolwa komtholampilo, iqiniso liwukuthi abakhiqizi abaningi abakhiqizayo basebenzisa indlela ebizwa ngokuthi i-501 (K) indlela yokudlula inqubo yokugunyazwa kwe-FDA yokugunyazwa. Uma nje umenzi angasho ukuthi idivayisi entsha "ilingana kakhulu" namadivayisi wamanje emakethe, akudingeki ukuthi abonise noma iyiphi idatha yemitholampilo ukuze bakwazi ukuthengisa ukufakwa okusha.
Ukwakhiwa okusha nokuthuthukiswa kwezimpande zokufaka esikhundleni se-hip kungcono inqubo eqhubekayo, kodwa ngeshwa, akuzona zonke izinyathelo ezintsha ezizuzisa iziguli. Ezimweni eziningi, abantu akufanele bafune ukwelashwa okusha kunayo yonke emakethe. Ukuba nerekhodi elihle kakhulu lomsindo kungase kusho ukuthi awutholi uhlobo olusha lokufakelwa olutholakalayo, kodwa lungase lisho ukuthi uthola isitshalo esihle kakhulu esitholakalayo.
Izwi elivela
Akuzona zonke iziguli ezifuna ukwazi ngezinsimbi zokufakelwa ezizofakwa ngesikhathi sokuhlinzwa, kodwa abanye banesithakazelo. Ngaphezu kwalokho, ngiyakunitshela ukuthi udokotela wakho ohlinzayo othakazelisayo unesithakazelo ezintweni ezisetshenzisiwe ngesikhathi senqubo yakho yokuhlinzwa, ngakho-ke unganqikazi ukuqala ingxoxo nokwaziswa.
Idatha engcono kunazo zonke etholakalayo kuleli phuzu ngesikhathi sithola ukuthi ukufakwa esikhundleni se-hip kuzohlala isikhathi eside kunazo zonke lapho ikhanda lesifazane lenziwe nge-ceramic noma lensimbi futhi isikhwama se-acetabular senziwe nge-polyethylene noma i-ceramic ehlanganisiwe. Izimpande zerekhodi elide kunazo zonke ezitholakalayo yilabo abenziwe ngensimbi yamakhanda e-femoral kanye namasokhethi e-polyethylene e-cross-linked axet acetabular.
Akungabazeki ukuthi eminyakeni ezayo kanye neminyaka engamashumi ayisishiyagalolunye ezayo izakhiwo zizoqhubeka ziguquke. Noma kunjalo, kufanele kuqashelwe ukuqapha lapho kunomthelela omusha emakethe.
> Imithombo:
> I-Lachiewicz PF, uKleeman LT, i-Seyler T. "Ukuphakama Kwendawo Yonke Ye-Hip Arthroplasty" J Am Acad Orthop Surg. 2018 Jan 15; 26 (2): 45-57.
> Atienza C Jr, Maloney WJ. "Izakhiwo ezinama-polyethylene ahlanganiswe kakhulu e-hip arthroplasty" J Surg Orthop Adv. 2008 Spring; 17 (1): 27-33.
> López-López JA, Humphriss RL, Beswick AD, Thom HHZ, Hunt LP, Burston A, Fawsitt CG, Hollingworth W, Higgins JPT, Welton NJ, Blom AW, Marques EMR "Ukukhethwa kokuhlanganiswa kokufakelwa ngokuphindaphindiwe kwe-hip: ukubuyekezwa okuhlelekile futhi inethiwekhi ye-meta-analysis "BMJ. 2017 Nov 2; 359: j4651.