I-Osteochondritis dissecans, evame ukubizwa nge-OCD okwesikhashana, yisimo esibangela ukukhululeka kwe-cartilage nethambo layo elisekelayo. U-OCD uvamise ukwenzeka emadolweni, nakuba kungenzeka nakwamanye amajoyina kufaka ne-ankle kanye ne-elbow.
Isizathu se-OCD asiqondakali kahle. Kwenzekani ezigulini ezine-OCD, ukugeleza kwegazi emthanjeni ozungeza ubuso obumbene kuyaba okungavamile.
Abacwaningi abaningi baye bacacisa ukuthi kungani lokhu kuphazanyiswa kwegazi kuhamba, futhi kucatshangwa ukuthi kuhlobene nokucindezeleka okuphindaphindiwe noma ukulimala okhathazekile emathanjeni. Njengoba ukugeleza kwegazi kuya emthanjeni kunciphisa, i-cartilage enamathiselwe ingahlukanisa kude nethambo.
I-Joint Cartilage
I-cartilage ehlangene evamile ibalulekile ukuba ne-joint egoqa kahle futhi ingenabuhlungu. Uma uqwanga lonakalisiwe, izinkinga eziningana zingenzeka. Ehlangeni elivamile elidolweni, ungqimba lwe-cartilage onamamitha amaningana ubukhulu obunzima obugqoka ama-bone. I-cartilage evamile iyabushelela futhi iyashesha futhi ifakwe ngokuqinile emathanjeni asisekelo.
Iziguli ezine-OCD zithuthukisa ukugeleza kwegazi okungavamile okwethambo elizungezile ngokuhlanganyela. Ukuntuleka kokugeleza kwegazi okuvamile kulimaza ithambo elisekela uhlaka lwe-cartilage. Lokhu kungenza ithambo libe yingxenyana ne-cartilage ukuze ihlukaniswe nokunamathiselwe kwayo okujwayelekile.
Isilonda se-OCD ('i-lesion' yi-cartilage nanoma yisiphi isifuba esihlanganiswe nengxenyana ye-cartilage) singakhulula futhi siphume emkhathini ohlangene. Izimpawu ezingaphezu kakhudlwana zingenzeka uma kunesigcawu se-cartilage esondela nxazonke.
Izimpawu ze-OCD ye-Knee
Izimpawu ze-OCD zifaka:
Ukwelashwa kwe-OCD ye-Knee
Kunezinto eziningi okufanele zicatshangelwe uma kunquma ukwelashwa okungcono kakhulu kwe-OCD.
Umgogodla Umdala: Isici esibaluleke kakhulu sokubikezela yisikhathi sesiguli. Iziguli ezinezicabha zokukhula ezivulekile (izingane kanye nentsha) zine-prognosis engcono kakhulu yokuphulukisa i-OCD kokubili ukwelashwa okungahlinzekiwe nokungahlinzeki.
Ubukhulu Nendawo: Izingcezu ezinkulu nezicucu ezingxenyeni ezibucayi kakhulu ezihlangene ngokuvamile ziphathwa kabi ngokukhetha okukhethwa kukho.
I-Degree Yokuhlukaniswa / I-Detachment: Izingcezu ze-OCD zihlukaniswa njengokuthi zizinzile noma zizinzile, kuye ngokuthi kungenzeka yini le fragment ehlukanisa namathambo. Izingcezu ezingazinzile ezingase zikwazi ukuhlukaniswa ngokuvamile zilungiswa ngokuhlinzwa. Izingcezu eziqinile zingase ziphuluke ngezokwelapha okungenasisindo.
Kuye ngokuhlanganiswa kwezici, udokotela ohlinzayo wamazinyo angenza izincomo zokwelashwa. Uma i-OCD ingxenyeni ingase iphuluke, ukwelashwa okungewona ukwelashwa kungasebenza. Ngenkathi udokotela wakho engase ancoma ice , imithi elwa nokuvuvukala , nezinye izifo zokwelashwa, ingxenye ebalulekile yokwelapha okungelashwa ukuphumula ukujoyina ukuvumela ukuphulukiswa.
Lokhu kusho umsebenzi okhawulayo futhi kungase kusho ukusebenzisa imikhonto ukuze unciphise isisindo ekuhlanganyeleni.
Umgomo wokwelapha ukwelashwa ukuphela ngendawo ebusisiwe ye-cartilage ye-joint. Uma kucatshangwa ukuthi i-fragment ingaphulukisa, udokotela wakho cishe uzozama ukulungisa i-lesion ye-OCD, ngokuvamile ngokusebenzisa izikrini noma izikhonkwane zokubamba isiqephu endaweni. Izikrini zanamuhla nezikhonkwane zenziwe ngezinto ezibonakalayo (kunokuba zenziwe zensimbi) ukuze zingabangeli izinkinga zesikhathi esizayo.
Uma amathuba okuphulukisa aphansi, i-cartilage evulekile iyosuswa emadolweni, kanti ukwelashwa kuzogxila ekugqugquzeni ukukhula kwe-cartilage entsha ngaphandle kwezinto ezihlangene.
Kunezindlela eziningi zokuzama ukugqugquzela ukukhula kwe-cartilage entsha, futhi ngayinye inezinzuzo nezingozi:
Ukukhipha imfucuza : Ukuhlinzekwa kwe-microfracture kwenziwa ukugqugquzela ukugeleza kwegazi endaweni yomonakalo, okungavumela ukuqothulwa kwe-cartilage. Le ndlela yokwelashwa ayivame ukusetshenziselwa i-OCD yezingane ngoba ayihlali isikhathi.
I-OATS / I-Cartilage Transfer : Izinqubo zokudluliswa kwe-cartilage zihambisa uqwanga kanye namathambo ezindaweni ezihlangene ezingadingi i-cartilage endaweni yomonakalo.
Ukwakhiwa kwe-Chondrocyte Autologous (ACI) : I-ACI yinkqubo ekhula amangqamuzana e-cartilage ebhodini, bese ifaka uqwanga olusha olusha olumonakalo.
> Imithombo:
> Chambers HG, et al. "Ukuxilongwa Nokuphathwa Kwe-Osteochondritis Dissecans" J Am Acad Orthop Surg Meyi 2011 vol. 19 cha. 5 297-306.
> Crawford DC no-Safran MR. "Osteochondritis Dissecans of the Knee" J Am Acad Orthop Surg NgoFebruwari 2006 vol. 14 cha. 2 90-100