Iisetyhula ezitshalisiweyo zithatha i-Cartilage Damage
Ukufakelwa kwe-Autologous chondrocyte, okanye i-ACI, yinkqubo eyenziwe ngasekupheleni kweminyaka yee-1980 ukuphatha indawo yokulimala kwidala. I-ACI nayo isetyenziswe ngokungaqhelekanga kwamanye amajoyina, njenge-ankle, kodwa yenziwa ngokubanzi emadolweni.
Incamango yenqubo ye-ACI kukuba ithathe iiselflethi ezincinci ukusuka emadolweni, zikhulele ebhodini, kwaye xa izigidi zeeseli zikhulile zifakwa endaweni yomonakalo we-cartilage.
Sibanzi
I-ACI yinkqubo ehambelana neendlela ezimbini, efuna ukuba ezimbini iiveki zingabikho. Iiseli zokuqala zivuna, ngoko zifakwe.
Inyathelo lokuqala: iArthroscopy
Isinyathelo sokuqala se-ACI kukuba wenze utyando lwe - arthroscopic ukuchonga indawo yomonakalo we-cartilage, kwaye unqume ukuba kulungile yini inkqubo ye-ACI.
Ngexesha le-arthroscopic inkqubo, iiseltilage zeeseli ziqokelelwa. Ezi iiseli zithunyelwa kwi-laboratory yolwandiso lweeseli apho zanda ngokukhula kwenkcubeko. Ukukhula okwaneleyo amaseli kuthatha malunga neeveki ezine ukuya ezintandathu. Xa sele sele ikhulile iiseli, zithunyelwa kumgqirha, kwaye uphando lwesibini luhlelelwe.
Inyathelo lesibini: Utyando lwe-Implantation
Xa sele sele ikhulile iseltilage iiselitile, ukuhlinzwa okwesibini kuhleliwe. Ngethuba lokuhlinzwa, ukuchithwa okukhulu kusetshenziselwa ukujonga ngokuthe ngqo ummandla we-cartilage umonakalo (kungekhona i-arthroscopy). Isicatshulwa sesibini senziwe phezu kwethambo lesifuba kunye nommandla weetyhulwa ezibizwa ngokuba yi-periosteum.
I-periosteum yinyama eninzi efihla isifuba shin. I "patch periosteal", ngokubanzi ubukhulu bendawo yomonakalo we-cartilage, ivunwa.
I-puncosteal patch igxininiswa phezu kwendawo yokulimala. Emva kokuba isitywina esomeleleyo senziwa phakathi kwepatch kunye ne-cartilage ejikelezile, iiselti ze-cartilage ezikhulayo zijojowe phantsi kwepatch.
Isiqwenga se-periosteal sisetyenziselwa ukubamba iiseli ezintsha ze-cartilage endaweni yomonakalo we-cartilage.
Abaviwa
I-ACI yinkqubo ebalulekileyo. Ukubuyiswa kude, kwaye izigulane kufuneka zilungele ukuthatha inxaxheba kwiyeza elinyango . I-ACI ifanelekile kuphela kwizigulane ezinemizila emincinci yomonakalo we-cartilage, kungekhona isambatho esisasazekayo sesigqabi se- arthritis . Izigulane eziqwalasela i-ACI kufuneka zifanelane nale projekthi elandelayo:
- Indawo ephambili ye-cartilage umonakalo, kungekhona isifo se-arthritis
- Ngaba ubuhlungu okanye ukuvuvukala okunqanda umsebenzi wabo
- Idolo elizinzile elingenalo umonakalo wegament
- Ukulinganisela okufanelekileyo ukuphakama (kungekudala)
Ukongezelela, izigulane kufuneka zizame ezinye izigulane zonyango ngaphambi kokuqwalasela le nkqubo ebalulekileyo. Ukongezelela, izigulane kufuneka zibe nokuqonda ngokucacileyo ukulungiswa kwe-post-operative ukusuka ku-ACI. Le nyathelo ibaluleke kakhulu kwimpumelelo ye-ACI inkqubo. Ngaphandle kokulungiswa okufanelekileyo kweziphumo zihlala zingaphantsi kwezinto ezifanelekileyo.
Iingxaki
Impumelelo ye-ACI iguquke kakhulu, kunye nabagqirha abahlukahlukeneyo bakha amanqanaba aphumelelayo. Inkxalabo eqhelekileyo ibangelwa ukubunjwa kwamathambo ajikeleze ngaphaya komda wepatch periosteal, ebizwa ngokuba yi-periosteal hypertrophy.
Le ngxaki idinga ukuba utyando lwe-arthroscopic olongezelelweyo lususe isisitye esingaphezulu kwesibalo.
Ezinye iingxaki zibandakanya ukungaphumeleli kweeseli ezifakiwe ukudibanisa ngokufanelekileyo, ukusuleleka kwamadolo, kunye nokuqina kogulo .
Ku hlaziywa
Ukubuyiselwa kwe-ACI kuyafana kakhulu nokuvuselelwa emva kwe-microfracture kwaye kuxhomekeke kubukhulu kunye nendawo yomonakalo we-cartilage. Imigaqo-siseko yokuvuselela i-ACI yile:
- Isisindo-Ukukhupha: Ubunzima bumele bubekwe kummandla we-cartilage implant. Isizathu sokunciphisa ubunzima kukuba iiseli mazivunyelwe ukuba zihambelane nommandla owenziwe kwinkqubo ye-ACI.
Indlela yokunciphisa ubunzima kwindawo ye-ACI incike kwindawo. Xa i-ACI ikwi-tibia (phezulu kwethambo lesifuba) okanye i-femur (ekupheleni kwethambo lesithambo), ubunzima bunqunywe ngokuba nesigulane sisebenzisa iinqumle . Xa i-ACI ihamba nge-kneecap (i-patella) okanye ngaphakathi kwiproove ye patella (i-trochlea), isinyanzelo kufuneka siphelelwe ukuba oku kuya kubangela ukunyanzeliswa kwiiseli ezifakiwe.
- I-Mo-----Motion: Inkqubo yesininzi iqala ukuqala emva kokuhlinzwa. Nangona kunjalo, njengoko kuchaziwe ngasentla, ukuba indawo yonyango lwe-ACI i-kneecap okanye ngaphakathi kwendawo yayo, isondlo siya kuphelelwa kwiiveki ezintandathu ukuya kweebhozo.
Isizathu sokuqalisa isantya ngokukhawuleza kukuba ukunyakaza kunceda ekukhuthazeni ukukhula kwe-cartilage. Nangona kunjalo, esi sikhuthazo kufuneka silinganiswe noxinzelelo obangelwa ukunyakaza. Kumele uhambelane ngokungqongqo kwiingcebiso zogqirha bakho njengoko ziza kubakho ukulimala okanye unyango lwakho.
Ukunyuka kwesisindo kudla ngokukhawulelana ubuncinane kwiiveki ezintandathu ukuya kweebhozo, kwaye ngokuthe ngcembe kuqhubela phambili ngokuhamba kwesikhathi. Emva kweenyanga ezintathu ukuya kweyesithandathu, uqeqesho lunokunyuka kumthwalo kunye nokuqina. Imisebenzi ethile yemidlalo ingaqala malunga neenyanga ezili-12 emva kokuhlinzwa. Uninzi lwabagijimi ababuyiselanga kwimidlalo epheleleyo kude kube malunga neenyanga ezili-16 emva kokuhlinzwa.
Imithombo:
UJohn DG, uPetererson L. "Ukufakelwa kwe-Autologous chondrocyte" i-Instr Course Lect. 2007; 56: 429-45.