Isihluthulelo Sokuhlinza Ukuhlinzwa Kweminyango Ephumelelayo Ingabe I-Rehab
Ukuvuselelwa emva kokuhlinzwa okuncane kwamadolo kuyisihluthulelo sokwelashwa okuphumelelayo. Ngenkathi inqubo yokuhlinza ingenziwa ngokugcwele, ngaphandle kokunakekelwa okufanele ngemuva kokuhlinzwa, imiphumela ayinakwenzeka ukuba iphumelele Ukulungiswa okuqondile okuvela ekuhlinzekeni okukhipha imishini kuxhomeke ebukhulu nasendaweni yendawo yokulimala kwe-cartilage.
Imigomo eyisisekelo yokuvuselelwa kusuka kumakhansela amancane:
Ukuphakama kwesisindo
Isilinganiso sesisindo esibekwa endaweni ye-microfracture kumele sinqunyelwe. Lokhu kuvumela amangqamuzana ukuba akhule ekuthuthukiseni endaweni eyathola ukwelashwa okuncane.
Indlela yokunciphisa isisindo endaweni ye-microfracture incike endaweni yokulimala. Uma i-microfracture ingaphezulu kwethambo le-shin (tibia) noma ekupheleni kwethambo lethanga (femur), isisindo sinqunyelwe ngokuba nesiguli sokusebenzisa izikhonkwane . Uma i-microfracture isendaweni ye-kneecap (i-patella) noma ngaphakathi kwe-groove ye-patella (trochlea), ukunyakaza kwamadolo kufanele kunqunyelwe ngoba ukuguqa ngamadolo kuzobangela ukucindezelwa kule ndawo.
Isisindo esithwalayo sivame ukulinganisa amasonto ayisithupha kuya kwangu-8, bese kancane kancane sathuthuka ngokuhamba kwesikhathi. Kungathatha izinyanga ezingu-4 kuya kwezingu-6 ngaphambi kokuthi umuntu abuyele emisebenzini yezemidlalo, futhi ngisho nangaphezulu ukuze abuyele emncintiswaneni. Abagijimi bezobuchwepheshe bangase bahlelwe kuze kube unyaka ngemva kokuhlinzwa okuncane.
Ukuhamba kwe-Motion
Ukuhamba okuhamba phambili kuvame ukuqaliswa ngokushesha ngemuva kokuhlinzwa. Kodwa-ke, uma indawo yokwelapha okuncane okuyi-microfracture isendaweni ye-kneecap noma ngaphakathi kwe-groove yayo, khona-ke ukunyakaza kuzokwenziwe amasonto amaningana.
Abanye odokotela abahlinzayo bayokhetha ukusebenzisa i-CPM, noma umshini wokunyakaza , ukusiza iziguli ukuba ziqhube ngamadolo ngokushesha ngemva kokuhlinzwa okuncane.
Ukusetshenziswa kwe-CPM akuzange kuboniswe ukuthi kungcono kunokuzivocavoca okuhamba phambili , kodwa abanye odokotela bazohlinzeka ukusebenzisa umshini.
Isizathu sokuqala ukuhamba ngokushesha ngangokunokwenzeka ukuthi ukunyakaza kusiza ukugqugquzela ukukhula kwe-cartilage enempilo.
Imiphumela Yokuhlinzwa
I-Microfracture iboniswe ukuthi iyindlela yokwelapha ephumelelayo kakhulu iziguli ezifanele ezine-knetilage ezilimazayo ezingenakho kulezi zinhlobo zokuhlinzwa. Imibiko kulezi zincwadi iyashintsha, kodwa cishe iziguli ezingu-80% zithola ukuthuthukiswa kwezibonakaliso zabo. Imiphumela evela ekuhlinzekeni ivame ukuba ngcono eminyakeni yokuqala emva kwenqubo, futhi kukhona ubufakazi bokuthi imiphumela inganciphisa ngokuhamba kwesikhathi.
Isizathu sicatshangwa ukuthi siwumphumela wohlobo lwe-cartilage olukhula lapho kwenziwa ukuhlinzwa okuncane. Ngokungafani ne-cartilage evamile yehlangothini lamadolo, okuthiwa i-hyaline cartilage, ukukhishwa kwe-microfracture kukhuthaza ukukhula kwe-fibrocartilage. Njengoba kufana nezicubu ezibomvu esikhumbeni, ukubonakala nokuqina kwalesi sikhumba se-scarti akufani nesikhumba esivamile. Ngakho-ke, eminyakeni embalwa ngemva kokuhlinzwa okuncane, ezinye izifundo zibonisa ukuwohloka kwemiphumela ngeziguli ezimbalwa ezibika imiphumela ephumelelayo.
Kuye kwenziwa ucwaningo oluningi lokuqhathanisa ukuhlinzekwa kwe-microfracture kwezinye izinketho zokwelashwa zomonakalo we-cartilage. Lezi ezinye izinketho zihlanganisa ukufakelwa kwe-chondrocyte autologous (ACI) nokufakelwa kwe-osteochondral autograft (OATS). Ngokuvamile, ayikho inqubo eye yaboniswa ukuba nemiphumela ephakeme komunye, futhi njengoba izingozi nezindleko ze-microfracture zingaphansi kakhulu, futhi ukulula okulula kakhulu, ukukhishwa kwamagciwane ngokuvamile kubhekwa ukwelashwa komugqa wokuqala. Ezinye izinketho ezifana ne-ACI ne-OATS zigcinelwe iziguli ezingaphumeleli emva kokuhlinzwa okuncane.
Imithombo:
I-Safran MR, i-Seiber K. "Ubufakazi bokulungiswa kokuhlinzwa kwe-articular cartilage emadolweni" J Am Acad Orthop Surg. 2010 Meyi; 18 (5): 259-66.
Umhlahlandlela we-Steadman-Hawkins Clinic we-Microfracture Rehabilitation