Ukuzihlanganisa Okuhlangene Akukude Phakathi Kokuphathwa Okunconywayo Knee Osteoarthritis
Emuva ngawo-1970, kwakungavamile ukuzwa ngesiguli se-arthritis esasibhekene nesigxobo se- arthroscopic ngokuhlanzwa okuhlangene. Emashumini eminyaka kamuva, ukugcoba ngokuhlanganyela akuyona into evamile. Eqinisweni, ukuhlunga okuhlangene akufakiwe ohlwini lwezokwelapha eziphakanyisiwe ze-knee osteoarthritis .
Kuyini Ukuhlukana Okuhlangene?
Esikhathini se-osteoarthritis, njengoba uqhekeko luyehla, izibhamu zezincubu, i-cartilage debris kanye nama-enzyme ahlambalazayo angase ashiywe ngaphakathi kokujoyina.
Kungase kube khona amakristali kuhlangene noma endaweni ehlangene . Ukuhlunga okuhlangene kuyinkqubo ehlanza izicubu ezingcolile noma izidumbu ezivela endaweni ehlangene.
Le nqubo ihilela ukungena kwamatayipi amancane abe yingxenye eyodwa noma ngaphezulu amaphuzu wokungena. Kunezinhlobo ezintathu zokuhlanzwa okuhlangene:
- Ukugcoba okuhlangeneko kokunisela i-Tidal - isebenzisa iphuzu elilodwa lokungena ekuhlanganyeleni ukujova uketshezi bese udweba amanzi.
- Ukuhlanjululwa okuhlangene okungenayo i-arthroscopic - isebenzisa amaphuzu amabili okungena kuhlangene, eyodwa ukujova uketshezi kanti enye ukudweba ngaphandle. Akukho ukuhlola okubukwayo kokuhlanganiswa kwenzeka.
- Ukuhlunga okuhlangene kwe-arthroscopic - ukuhlanganiswa okuhlangene nokuhlolwa okubonwayo kwe-joint (arthroscopy) .
Ngesikhathi sokugcoba okuhlangene, ukujoyina kujojowe ngosawoti kanye nokugeza amanzi (isib. Saline), kanye nohlobo oluhlangene lukhishwa ngaphandle kokuhlanganyela. Umjikelezo wokujova nokukhipha ungaphindwa izikhathi eziningana. Ngokwemfundiso, ukuqeda ukuhlanganiswa kwamanqamu kunciphisa ukuvuvukala nobuhlungu obuhlangene.
Kodwa ukuphumelela kokuhlanzwa okuhlangene kuye kwabuzwa futhi kwafundwa.
Izifundo Eziphikisana Ngokusebenza Kokuhlanza Okuhlangene
Ngokwe-Cochrane ukubuyekezwa kwezilingo eziyisikhombisa ezitholakala emitholampilo ezibandakanya iziguli ezingu-567, abacwaningi banqume ukuthi ukugaya okuhlangene akukhiqizi inzuzo enkulu yeziguli ezine-knee ostoarthritis mayelana nokuphumula ubuhlungu noma ukuthuthukiswa komsebenzi ohlangene.
Izilingo ezintathu kulezi ziyisikhombisa zazibandakanya ukugcoba okuhlangene kwe-arthroscopic. Izifundo ezimbili zazibandakanya ukugcoba okuhlangene okungeyona i-arthroscopic, kanti ezimbili ezisele zazingela.
Ukutholakala kokubuyekezwa kweChcomrane kuphikisana neziphetho zocwaningo olwanyatheliswa ku- Arthritis & Rheumatism ngo-1999. Kulesi sifundo, iziguli ezingu-98 ezine-tisteofroral knee osteoarthritis zabhalwa isifundo sezinyanga ezingu-6 futhi ngezikhathi ezithile zanikeza enye yezokwelapha ezine: indawo ye- intraarticular placebo, i- corticosteroids yangaphakathi, i-placebo ehlanganiswayo kanye ne-intraarticular placebo, kanye ne-corticosteroids yokulahla kanye ne-joint. Imiphumela yabonisa ukuthi, uma kuqhathaniswa ne-placebo, kokubili i-corticosteroids yangaphakathi ne-intanarticular kanye nokulahla okuhlanganyelwe ubuhlungu obukhululekile - kepha akukho msebenzi othuthukisiwe. I-corticosteroid ye-intraarticular yanikeza usizo lokuphumula lwesikhashana, kuyilapho izinzuzo zokugqoka okuhlanganyelwe zaze zaba amasonto angu-24.
Ngo-2008, i-American Academy of Orthopedic Surgeons (AAOS) yashicilela izincomo ezingu-22 zokwelashwa kwe- knee osteoarthritis . I-arthroscopy ene-debridement noma ukuhlanganiswa kokuhlanganiswa akuzange kunconywe ukuphatha i-kneearthritis ye-knem ephawulekayo. Ngokusho kwe-AAOS, kwakungekho ubufakazi bokuhlomula okukhulu.
Kodwa esinye isifundo, eshicilelwe ku- Annals of Rheumatic Diseases ngo-2004, sabonisa ukuthi kungabi khona kuphela ukuntuleka kwenzuzo okuhlobene nokuhlanzwa okuhlangene, izinkinga ezihlobene nenqubo kungenzeka.
I-pseudogout iyinkimbinkimbi ekhona yokugcoba i-arthroscopic kwiziguli ezine- chondrocalcinosis . Ingozi yokubambelela ezindabeni ezihambisana ne-chondrocalcinosis, kanye / noma amakristalu, ngaphambi kokuhlanza kwaba izikhathi ezinhlanu kulabo abangenazo izinkinga.
Njenganoma imuphi umjovo, kukhona futhi amathuba okutheleleka okulandela ukuhlanganiswa okuhlangene. Xoxa ngakho konke okukhethwa kukho ukwelashwa nodokotela wakho. Ngokubambisana, thola izinzuzo nezingozi, futhi wenze isinqumo esinolwazi.
Imithombo:
Ukuhlanza okuhlangene kwe-osteoarthritis emadolweni. Reichenbach S. et al. Ukubuyekezwa kwesistimu yeCchrane Database. 2010 Meyi 12; (5): CD007320.
Imiphumela yomjovo wokugcoba kanye ne-steroid ezigulini ezine-osteoarthritis yamadolo: imiphumela yesilingo esiningi, esingahleliwe, esilawulwayo. Ravaud P. Arthritis & Rheumatism 42 (3): 475-82. 03/01/1999.
Ukwelashwa kwe-Osteoarthritis ye-Knee (Nonarthroplasty). Richmond, John MD. Journal of the American Academy of Orthopedic Surgeons 17 (9): 591-600. September 2009.
Ukuhlunga okuhlangene kanye nokusekela. Pasquetti P. et al. Ama-Annal of the Rheumatic Diseases. 2004; 63: 1529-1530