I- anterior cruciate ligament , noma i-ACL, ingenye yemigqa emine emikhulu emadolweni enikeza ukuzinza kokujoyina. Uma isiguli sigcina izinyembezi ku-ACL, ukuzwa kokungazinzile , noma ukuphawula, kungase kuthuthuke emadolweni alalomele. Lezi zimpawu zokungazinzi zivame ukukhathazeka ikakhulukazi kubadlali abafuna ukuhlala besebenza emidlalweni.
Ezinye zezemidlalo kunzima kakhulu ukuqhubeka nokuhlanganyela kwabagijimi abalimele i-ACL yabo. Le midlalo ephezulu engozini , njengobhola bebhola, basketball, kanye ne-lacrosse, ihlanganisa ukunyakaza okuzumayo kanye nokunyakaza okuzenzekelayo okudinga i-ACL ephelele.
Lapho umgijimi ephule i-ACL, idolo lizothambekela ekuthunjeni lapho kuqhutshwa noma ukushintsha ngokungazelelwe. Ukuze ubuyisele ukuzinza emadolweni, udokotela wakho angancoma ukwakhiwa kwe-ACL ukuze afake umugqa omusha esikhundleni se-ACL ewonakele. Inqubo entsha, ebizwa ngokuthi ukwakha kabusha kabusha kwe-ACL, isetshenziselwe ukuphindaphinda kangcono umsebenzi we-ACL evamile.
Izinkampani ze-ACL
I-anterior cruciate ligament yenziwe ngamathishu aqinile, anesibindi ahlanganisa ihlangothini lamadolo, ahlanganiswe ne-femur (ithambo lesithambo) phezulu, ne-tibia (ithambo lesifuba) ngezansi. I-ligament ngokwayo yenziwa ngezinkulungwane zezinhlamvu zomuntu ngamunye, ukuthi ndawonye zakha i-ACL.
Eminye yalezi zicucu zihlelwe zibe yizicucu ezihlukene. I-ACL evamile inezinqwaba ezimbili zezintambo.
Lezi zinqwaba zimi ndawonye, kwezinye iziguli ezine-ACL evamile kungase kube nzima ukuhlukanisa izibopho ezihlukile. Kodwa siyazi ukuthi kunezibopho ezimbili eziyinhloko, futhi isivuno ngasinye sibizwa ngokuthi indawo yaso.
Isixuku esiphezulu se-anteromedial sisimisiwe phambi kwesikhwama esincane esifushane esilandelayo.
Ukwelashwa kwe-ACL engashadile
Amaphayona amaningi okuvuselelwa kwe-ACL asetshenzisiwe esebenzisa ukuvuselelwa kwe-single-bundle. Ukwakhiwa kwe-ACL eyodwa-kwesikhwama kusebentisa i- tendon graft ukuze ithathe indawo ye-ACL ekhishwe. Ngeshwa, izinyembezi ze-ACL azikwazi ukulungiswa, noma zihlanganiswe ndawonye, futhi ukufakelwa kufanele kusetshenziselwe ukuvuselela i-ligament. Uma i-ACL isakhiwe kabusha, ukufakelwa kwe-graft kufakwe endaweni yesigungu esiphezulu.
Ama-graft aqhutshwa endaweni ngokuwenza imbobo ethanjeni elibizwa ngokuthi umhubhe. Omunye umhubhe wenziwa ku-femur kanti omunye ku-tibia. I-graft ibanjwe esitokisini ngedivaysi yokulungisa, ngokuvamile i-screw.
Ukuhlinza kabili kwe-ACL
Esikhundleni sokubeka i-graft eyodwa eyodwa enkulu, inqubo yokuvuselela i-ACL ye-double-bundle isebenzisa ama-graft amabili amancane. Ngakho-ke, kunemibandela emibili ye-ligament, eyodwa yesigxobo ngasinye. Inqubo ye-double-bundle idinga ama-tunnels amabili okwanele engeziwe ukuze afake ukuhlanganiswa kwesibili kanye nokuhlanganiswa okunye okunye. Inqubo yokuhlinzeka ingathatha isikhathi esincane, nakuba odokotela abahlinzayo benza le nqubo ngokujwayelekile bangayenza ngendlela efanako nokwakhiwa kabusha kwe-ACL esisodwa.
Ingabe I-Double Bundle Better?
Ucwaningo luye lwabonisa izinzuzo ezithile ze-double-bundle reconstruction. Lezi zifundo zibonisa umsebenzi ojwayelekile 'ojwayelekile' wendandatho eyakhiwe ngemuva kwalokhu kuhlinzekwa kabusha kokuvuselelwa kwe-ACL yesibili. Okungaziwa ukuthi lokhu kusho ukuthi iziguli ziyoba nempumelelo engcono ngezingqalasizinda ezimbili ze-ACL. Ngokuqondile, ikhono lokubuyela ezemidlalo ezingeni elifanayo njengoba ngaphambi kokulimala kungakabonakali kube ngcono nganoma iyiphi indlela yokuvuselela i-ACL.
Ukwakhiwa kabusha kwe-ACL yesibili kuyindlela entsha, futhi njengoba kunjalo nanoma iyiphi inqubo entsha, imiphumela yesikhathi eside ayiqondakali kahle.
Kungenzeka ukuthi le nqubo izoba ngcono kwizingqalasizinda ezijwayelekile ze-ACL-bundle, kodwa kungenzeka ukuthi lezi ziguli zingaba okufanayo, noma kubi nakakhulu, imiphumela yesikhathi eside. Akekho owazi ngempela okwamanje.
I-double-fundle ihlose ngokwengeziwe inqubo, futhi kukhona abahlinzayo abambalwa abanolwazi kulolu hlelo lokuhlinza.
Ngaphansi
Akucaci ukuthi ukwakhiwa kabusha kwe-ACL yesibili kwindlela enhle, kodwa ezinye iziguli zizimisele ukuzama inqubo entsha ngomzamo wokuthuthukisa imiphumela yabo yesikhathi eside. Ukulungiswa okujwayelekile kwe-single-bundle ye-ACL kunemiphumela emihle kakhulu, kanti iziguli ezingaba ngu-90% zikwazi ukubuyela emisebenzini ezingeni labo lokulimala. Noma kunjalo, imiphumela ayi-100%, kanti ezinye iziguli zinezinkinga eziqhubekayo emva kokuvuselelwa kwe-ACL futhi zingase zenze izinkinga kamuva ekuphileni.
Ukwakhiwa kabusha kwe-ACL isisindo sesibili kuwumzamo wokuthuthukisa imiphumela yenqubo ehle kakade. Uma unesithakazelo, khuluma nodokotela wakho ngale nqubo. Njengoba kukhonjisiwe, abambalwa abahlinzayo benza ukwakhiwa kabusha kwe-ACL yesibili. Kodwa ngokuqinisekile ungaxoxisana nale nqubo nodokotela wakho futhi uthole imibono yakhe ekwakhiweni kabusha kwe-ACL yesibili.
Imithombo:
> Li YL, Ning GZ, Wu Q, Wu QL, Li Y, Hao Y, Feng SQ. "Isibopho esisodwa noma i-double-fundle ye-anterior cruciate ligament reconstruction: i-meta-analysis" Knee. 2014 Jan; 21 (1): 28-37.
> Ahn JH, Kang HW, Choi KJ. "Imiphumela Ngemuva Kwesibili I-Bundle Anterior Cruciate Ligament Ukwakhiwa kabusha" I-Arthroscopy. 2017 Septhemba 8. pii: S0749-8063 (17) 30799-5.
> Dhawan A, Gallo RA, Lynch SA. "Umhubhe We-Anatomic Ukubekwa Emgodleni WaseLigament U-Reconstruction" I-Am Acad Orthop Surg. 2016 Jul; 24 (7): 443-54.