Abahlinzayo bama-orthopedic baye baba ngcono ekuqondeni imithombo yobuhlungu, futhi ubuchwepheshe buye bwandisa ikhono lethu lokuxilonga izimo ezazingakafiki ngaphambili. Omunye umthombo wezinyosi ze-hip no-groin esitholwa ukuthi ngokuvamile zibizwa ngokuthi i- hip labral izinyembezi .
I-labrum ye-hip iyinxantathu ye-cartilage ezungeza isikhwama se-ball-and-socket joint joint.
Ngokuvamile kufaniswa nokuqhekeka kwamadolo, i-hip labrum izinyembezi zingase zibe umthombo wobuhlungu futhi ungahambi kahle ekuhlanganyeleni kwe-hip.
Izinkinga ezihlangene ze-hi zisetshenziselwa ukuba zibe yimfihlakalo. Abantu abaningi abavela esikoleni samabanga aphezulu kanye nabagijimi bekolishi kuya emavikini asezingeni eliphakathi abanamandla bangakhononda ubuhlungu obujulile esifubeni sabo, ngokuvamile e-groin yabo. Laba bantu banikwe ukuxilongwa kwesifo sokugula noma isisindo esidonsa umzimba , kodwa ngokuvamile ukuphulukiswa kwabo kwakungenakulinganiswa futhi ngezinye izikhathi izimpawu zaphela.
Njengoba sesithole ukuqonda kangcono ukuhlanganiswa kokuhlanganiswa kwe-hip, futhi ezobuchwepheshe ezifana ne-MRIs zithuthukise ikhono lethu lokubona okungavamile kule-anatomy, sithole imithombo ekhethekile yemilenze ehambisana ne-hip. Isakhiwo esisodwa esivame ukubonwa njengomthombo wezinyosi ze-hip yisigqila se-hip.
I-Lab Labrum
Ukuhlanganiswa kwe-hip ibhola kanye nehlangothini ehlangothini ehlangothini lwethambo lesenzeni kanye ne-pelvis.
Ngokungafani nezinye ibhola nezinhlanganisela ezingezansi ezifana nehlombe, umlenze unomsila ojulile futhi oqinile. I-labrum yi-cuff ye-cartilage eyenza indandatho ijikeleze emaphethelweni ensikeni ye-hip. Lokhu kusiza ukujulisa isikhwama, kanti futhi kuguquguquka (ngokungafani nethambo lesokhethi) ukuvumela ukunyakaza okuthile.
I-labrum ye-hip, njengezinye izinhlobo ze-cartilage, ivame ukuba nezinkinga zokuphulukisa ekulimazeni. I-tisti ye-cartilage ayinakho ukuhlinzeka ngegazi okuhle ngakho-ke ayinayo ikhono lokuphulukisa ngemuva kokulimala. Ngenxa yalesi sizathu, uma i-labrum ibonakalisiwe, ijwayele ukukhombisa izimpawu zomonakalo ezingase zingalungisi ngokuhamba kwesikhathi.
Izinyembezi ze-Hip Labrum
Lapho i-labrum yehlangothini ye-hip ibonakalisiwe, abantu ngokuvamile babhekisela kulo monakalo njenge "izinyembezi zebramu." Naphezu kokusebenzisa lolu limi ukuchaza cishe noma yiliphi ukulimala embhedeni we-hip, izinyembezi ze-labral izinyembezi zivela ngezindlela ezihlukahlukene, ubukhulu, nezinhlobo. Akuzona zonke izinyembezi zezinyosi ezifanayo, futhi ukwelashwa kwezinyembezi ze-labral kungahluka kakhulu. Ngaphezu kwalokho, iziguli ziza ezinhlobonhlobo ezinemibono ehlukene yokulondoloza kanye namazinga ahlukene ezithakazelisayo ezinhlobonhlobo zokwelapha. Okubaluleke nakakhulu, izinyembezi ze-labral zivame ukubonakala lapho kukhonjiswa omunye umonakalo ohlanganyelwe ku-hip kubandakanya i-arthritis ne- bone spurs . Izinyembezi ezinamahlombe lapho kutholakala isifo samathambo akufani neze nezinyembezi ezinjengokulimala okude.
Lapho ukuhlinzwa kubhekwa njengenhlanzi ye-hip labral, indlela ejwayelekile kakhulu yokubhekana nalokhu ngukulashwa kwe-arthroscopic. Ukuhlinzeka ngokuhlinzwa kwe-hip arcroscopic kwakungakabonakali eminyakeni engama-20 edlule, kungavamile kakhulu eminyakeni eyishumi edlule, kodwa sekuyiyona ndlela eyenziwa ngokuhlinzwa njalo namuhla.
Eqinisweni, eminyakeni eyishumi edlule, ukuhlinzwa kwe-arthroscopic ye-joint hip kuye kwanda ngo-18. Naphezu kwalokhu kwanda okukhulu, kuye kwaba nokuhlaziywa okuncane kwezesayensi mayelana nokuthi le nqubo izuzisa kanjani izinyembezi ze-hip labral. Ngokuqondile, kuncane okwenziwe ukuqhathanisa uma ukuhlinzeka kwe-hip arcroscopic kungcono kunezinye izindlela zokwelapha izinyembezi ezifana nokwelapha ngokomzimba, ukuphumula, nemithi elwa nokuvuvukala.
I-Hip Arthroscopy
Ukuhlinzeka nge-hip arthroscopic yindlela yokuhlinza yokwelashwa eyenziwa ngaphansi kwe-anesthesia jikelele. Udokotela wakho ohlinzayo ubeka ikhamera encane yethelevishini enomthombo wokukhanya onamathele ohlangene ohlangothini lwe-hip, futhi nge-incision encane encane ingafaka izinsimbi zokubhekana nezinyembezi ze-labral izinyembezi.
Imithi ejwayelekile yokubhekana nezinyembezi ze-hip i-labral izinyembezi ukulungisa umonakalo nge-sutures noma ukuqothula ingxenye ebhidliziwe ye-labrum. Isinqumo sendlela yokulungisa izinyembezi ngokuvamile kuxhomeke ezintweni ezihlanganisa uhlobo lwezinyembezi nendawo.
Ukuhlinzwa kwe-hip arthroscopic akuyona ingozi engenzeka . Lezi zingozi zihlanganisa nezinkinga ezifana nokutheleleka, ubuhlungu obuphikelela, nokulimala komkhumbi noma igazi. Njengoba kunikezwa izingozi eziyaziwayo zokwelashwa, kubalulekile ukukala ukuthi ngezinzuzo zokuhlinzwa. Ngakho-ke lo mbuzo uba, ingabe ukwelashwa okuhlinzekwa kangcono noma okubi kunokwelashwa okungenasidingo? Ngenxa yokuthi siyazi ukuthi izinyembezi ze-labral azifaki ukuphulukisa, abantu abaningi bangaphansi kokucabangela ukuthi uma befuna ukuthi ubuhlungu buqondiswe, inqubo yokuhlinzwa yindlela yabo yokukhetha kuphela. Kodwa ingabe kunjalo ngempela?
Imiphumela Yokwelashwa Okuhlinzekwayo
Ucwaningo oluthile lwamuva lubike imiphumela emihle yesikhashana ngemuva kokuhlinzwa kwe-hip arcroscopic. Iningi lalezi zifundo zithola ukuthi abantu abahamba nge-hip arthroscopy banemiphumela emihle yokuphulukisa ubuhlungu ezinyangeni naseminyaka ukulandela ukwelashwa okuhlinzekwayo. Ikakhulukazi ezigulini ezingenayo izibonakaliso ze-arthritis, le miphumela ivame ukubamba isikhathi eside, futhi abantu banelisekile ngemithi yabo. Lobu bufakazi ngokuqinisekile busekela ukucutshungulwa kokwelapha okuhlinzekwa, kodwa izifundo ezimbalwa kuphela empeleni ziqhathanise uma ukwelashwa okuphambene kungcono kunokwelashwa okungenasidingo.
Ucwaningo oluthile oluthile lwamabutho angaba ngu-100 abaqoqiwe bezempi abaye bekhala izinyembezi zezinyembezi ngezikhathi ezithile babanikeza ukuba bahlinzekwe noma baphathwe kabi. Ngemuva kweminyaka emibili ukwelashwa kuqediwe, kwakungekho umehluko ophawulekayo phakathi kwamaqembu abantu abaphathwa ngokweqile nalabo abaphathwa ngokweqile. Lokhu akusho ukuthi wonke umuntu ube ngcono, kusho nje ukuthi inani elingana elilinganayo leziguli liye laphuthuka ngokuphathwa okungenasidingo njengokwelashwa okuhlinzekwayo. Ngombono omuhle, iningi leziguli kuzo zombili amaqembu, ukuhlinzwa nokungahambi kahle, zithole ngcono.
Kubuye kube nokuphikisana ngokuphathelene nokuphathwa kweziguli ezingaphezu kweminyaka engama-40 ubudala abanamabhulebhisi. Lezi ziguli kufanele zenziwe ngokucophelela lapho zibhekwa ukwelashwa kokuhlinzwa. Ngenkathi kunezimo ezithile lapho abantu abaneminyaka emaphakathi bangathola ukuphumula okuhle ngokuhlinzeka kwe-hip arcroscopic, abaningi balaba bantu abakhethi abahlinzeka kahle. Ucwaningo luye lwabonisa ngokuphindaphindiwe ukuthi abantu abaneminyaka engaphezu kwengu-40 banesisindo esiphakeme se-arthritis eqhubekayo yehlangothini lwe-hip, futhi izinyembezi ezingamabhodlela cishe ziyisibonakaliso sokuqala samathambo e-hip. Eziningi zalezi ziguli zizogcina sezihlinzwa ngokuhlinzwa, ngisho nangemva kokuhlinzwa kokuhlinzwa kwe-hiproscopic.
Njengoba kunjalo ngezinqubo eziningi zokuhlinzwa, i-hip arthroscopy ifakiwe, abahlinzayo bama-orthopedic bafunda kancane kancane ukuthi iziphi iziguli ezingase zizuze, futhi okungezona, kusukela ekungeneni kokuhlinzwa. Kusobala ukuthi akuwona wonke umuntu onenhlanzi yamahlombe e-hip odinga ukuhlinzeka nge-hip arthroscopic. Eqinisweni, ukwelashwa okungekho emthethweni ezimweni eziningi kungase kuphumelele, futhi ngezinye izikhathi kuphumelele nakakhulu, kunokungenelela okuhlinzekwayo. Ukusebenza ukuchaza ukuthi yiziphi iziguli ezingase zizuze inqubo eqhubekayo. Kuyacaca ukuthi cishe kuzo zonke izimo ukwelashwa okungadingekile kufanele kwenziwe kuqala futhi iziguli ezingaphezu kweminyaka engu-40 kufanele zibhekwe ngokucophelela ukuze zithole ukwelashwa.
Izwi elivela
Ukuhlinzwa ngokuhlinzwa kwe-hip arcroscopic ngokungathandabuzeki kudlala indima ebalulekile ekwelapheni ukulimala kwama-labral. Lokho kusho ukuthi iziguli eziningi zingathola ukwelashwa okulinganayo ngendlela yokwelashwa okungenasidingo. Cishe zonke izimo, ukwelashwa okungenasidingo kumele kusetshenzwe ngaphambi kokucubungula ukuhlinzwa kwe-arthroscopic. Ucwaningo lubonise ukuthi uma kuqhathaniswa ukwelashwa okungenasidakamizwa nokuhlinzwa, imiphumela ayiyona ehluke kakhulu phakathi kwala maqembu; kokubili ukwelashwa kuvame ukuholela ekuthuthukiseni izimpawu. Kunezimo lapho izidakamizwa ezingasebenzi zingasebenzi, futhi ukuhlinzwa kungacatshangelwa. Okhethwe kahle ukwelashwa ukwelashwa ungaphansi kweminyaka engama-40 ubudala futhi akanalo izibonakaliso ze-arthritis ekuhlanganyeleni kwazo kwe-hip.
> Imithombo:
> Mansell NS, Rhon I-DI, Meyer J, i-Slevin JM, i-Marchant BG. "Ukuhlinzwa Kwe-Arthroscopic noma Ukwelashwa Kwemvelo Kwalaba Abagulayo Nge-Femoroacetabular Impingement Syndrome: Isivivinyo Esilawulwe Ngokungahleliwe Ngokulandelwa Kwaminyaka emibili" Am J Sports Med. 2018 Feb 1: 363546517751912.
> Horner NS, Ekhtiari S, Simunovic N, Safran MR, Philippon MJ, Ayeni OR. "I-Hip Arthroscopy Ezigulini Ezigulayo Iminyaka engu-40 noma Edala: Ukubuyekezwa Okuhlelekile" I-Arthroscopy. 2017 Feb; 33 (2): 464-475.e3.