Iyintoni iNkqubo yokuSungula ukuKhusela i-Hip?
Ukuvuthwa kwe-Hip kungenye indlela yokuhlinzwa okutshintshileyo yokutshintshwa kwe-hip esetyenziselwa unyango lwe- hip arthritis . Ukuvuthwa kwe-Hip akuyiyo into entsha yokuhlinzwa. Utyando lokuvusa i-Hip lwenziwa ukususela ekuqaleni kwee-1970. Nangona kunjalo, utshintsho olutshanje olusenyakalweni ukuvelisa ukuyila ukuveliswa kwezinto lukhokelela kumdla omtsha kule nkqubo.
Ngubani Ongenayo I-Hip Resurfacing Surgery?
Ukugqithwa kwe-Hip ukuhlinzwa ngokugqithisileyo kunokuqwalasela izigulane ezinezifo ezinzima zonyango.
Ukuvuswa kwe-Hip kukucetyiswa kwizigulane ezincinci kwaye zinokujamelana nokuhlinzwa ezininzi ngexesha lokuphila kwabo. Akukho zifundo eziye zabonisa ukuba ukuvuthwa kwe-hip kubungcono kwizigulane eziselula, kodwa kukho iingenelelo eziye zabangela abanye oogqirha ukuba baphumelele.
Kutheni i-Hip Resurfacing yawa phantsi kweNtando kuma-1970?
Ukuvuthwa kwe-Hip kwaba yinkqubo ethandwayo kwiminyaka emininzi edlulileyo. Izimpembelelo ezisetyenzisiweyo ngelo xesha zenziwe zetsimbi kunye neeplastiki. Ngelishwa, ezi ziimpembelelo zineengxaki ezibalulekileyo kwaye zivame ukungaphumeleli kwiminyaka emibini yokuqala emva kokuhlinzwa. Ezi gulane zisoloko zifuna utyando olongezelelweyo, nangona kwithuba elifutshane emva kokuvuthwa kwabo kokuqala.
Yintoni ekhokelela ekunyuseni kwangoko kwi-Hip Resurfacing Surgery?
Ngama-1990, ukuveliswa kwe-hip entsha kwenzelwe. Ukufakelwa kwe-hip resurfacing implants ngoku kwenziwe ngentsimbi ngokupheleleyo, kunye neziqendu ezimbini.
Enye yezimpembelelo zetsimbi yi "cap" ebekwe kwibhola yomxube we-ball kunye ne-socket, kunye nenye icala kwicala lokufakelwa yimbobe yensimbi eyenza isakhelo sobambiswano. Ezi zimpembelo azibonisanga izinga eliphezulu lokungaphumeleli kwangaphambili kubonwe kwintsimbi kunye neeplastiki eziphambili kwi-1970 kunye ne-80.
Abanye oogqirha baye baxhasa ukuvuthwa kokuvelisa izimpembelelo ngenxa yeenzuzo ezininzi.
Ezi nzuzo ziquka:
- Ukugcinwa kwethambo eliqhelekileyo: Ukuhlinzwa kwe-Hip ukuvuthwa kususa ithambo elincinci kunomlinganiselo wokutshintshwa kwe-hip. Kwimiqathango yokutshintsha i-hip , ibhola lonke lomxhasi we-ball-and-socket isalathisi isuswa. Ngophakamiso lokuqhaqhafaza kwenyonga, esikhundleni sokususa ibhola, isitya sensimbi sisetyenziswe apho i-cartilage igugile khona. Ngenxa yokuba ithambo elijikeleze ukufakelwa lixhasa isithwathwa sensimbi, le thambo lihlala liphilile kwaye lomelele. Ithambo elijikeleze ukutshintshwa kwe-hip eliqhelekileyo lingaba lincinci kwaye linyanzele ukuba ukufakelwa kwe-hip esikhundleni sisekela yonke imithwalo. Le ngxaki ibizwa ngokuba "ukuphepha kwengcinezelo," kwaye ibonakala ingaphantsi ngokuqhelekileyo ekugqibeleni.
- Umngcipheko omncinci wokutshintshwa: I- Hip resurfacing implants ziphinda ziphindaphindiwe ngendlela eqhelekileyo ye-hip kunye kunye, ngoko ke, inomngcipheko omncinci wokutshatyalaliswa emva kokuhlinzwa. Ingakumbi kwizigulana ezincinci, ezikhuselekileyo, ukuchithwa kwamanzi kungabungozi obukhulu bokuhlinzwa ngokutsha .
- Ukuhlaziywa ngokukhawuleza : Ukuba utyando lokuvuthwa kwe-hip alupheli ubomi bogulane, ukuhlaziywa kwakhona (ukuphindaphinda) ukutshintshwa akulona nzima. Njalo ngexesha inkqubo yokuhlaziya iqhutyelwa, utyando oluninzi kunye nokukhutshwa okukhulu kufuneka kusetyenziswe. Ngokunciphisa ithambo lisuswe, kwaye kusetyenziswe isincinci esincinci, ukulungiswa kokubuyiselwa okulandelayo emva kokuvuthwa komzimba kunokufana nokwenza ukutshintshwa kwe-hip ejwayelekile.
Ngubani Owona Monde oMhle kakhulu we-Hip Resurfacing Procedure?
Isigulane esifanelekileyo kwinkqubo yokuvuthwa kwe-hip yinkwenkwana (engaphantsi kweminyaka engama-60 ubudala) isigulane esinethambo elinamandla malunga nomxube we-hip. Izigulane ezincinci zixhalabisa ngokukhethekileyo kubagqirha abathintekayo ngokubambisana ngenxa yeli thuba baya kufuna ukutshintshwa okongeziweyo ( ukuhlaziywa kwe-hip replacement ) ngexesha elithile ebomini. Inkqubo yokuvuselela i-hip kucingelwa ukuba igcine ithambo elongezelelweyo kwaye likhusele iingxaki ezinokuthi zihlolwe ngokuphandululwa ngokutsha.
Ngubani Ongenalo Monde Mhle ngokuba ne-Hip Resurfacing Surgery?
Izigulane ezinengxaki kwithambo ejikeleziweyo kunye ne-hip zibandakanyeka zingabikho ukuhlinzwa ngokutsha.
Ezi ziquka izigulane ezinokulahleka kwethambo ngenxa yesifo se-arthritis, izigulane ezine-osteoporosis, kunye nezigulane ezinama-cyst ngaphakathi kwithambo. Naliphi na le miqathango inokuthi buthathaka ithambo elungelelene ne-joint hip, kwaye likhokelela kwiinkcenkceshelo zokuvuthwa kwe-hip ekuvuzeni ukuhlinzwa.
Ezinye izinto ezinokubangela ukuba izigulane zingabikho kwiinkqubo zokuvuthwa kwe-hip. Ezi zinto ziquka:
- Ubudala: Izigulane ezingaphezu kweminyaka engama-60 kufuneka ziqwalasele ngenyameko ukutyunjwa okutshintshwayo kwe-hip. Nangona i-hip resurfacing inikezela ngeenzuzo ezithile, sisazi ukuba ezininzi izigulane ezingaphezu kweminyaka engama-60 ziya kwenza ngokugqithiseleyo ngokutshintshwa kwe-hip ejwayelekile. Ukuhlaziywa ngokutsha (ukuphindaphinda ukutshintshwa kwe-hip) kuya kuba nzima kakhulu kwizigulane ezingaphezu kweminyaka engama-60 ubudala, ngoko ke, ukutshintshwa kwe-hip ejwayelekile kudla ngokuthandwa
- Abasetyhini : Abasetyhini baye baboniswa ukuba banomlinganiselo ophezulu weenkcenkceshe ukusuka ekugqibeleni ukuvuthwa. Isizathu esona salo asiyaziwa, kodwa kucatshangelwa ukuba ngenxa yecandelo lethambo elixhasa ukuveliswa kwe-hip resurfacing. Abasetyhini baye baboniswa ukuba baphinde bahlawule umngcipheko wokuqhaqhaza ukujikeleza ukufakelwa okulandelayo emva kokuhlinzwa.
- Ukunyaniseka: Izigulane ezigqithiseleyo ziye zafumana inqanaba eliphezulu leengxaki ezilandelayo emva kokuvuthwa kokuhlinzwa. Ezinye zeengxaki zicingelwa ukuba zibangelwa ngamandla okwandisa ithambo elisekela ukufakelwa, kunye nobunzima bezobugcisa ekutyunjweni kwesigulane esikhulu.
- I-Arthritis enobuhlungu kunye ne-Osteonecrosis: Izigulane ezine-arthritis ezivuthayo, ezinjenge- rheumatoid arthritis , okanye i- osteonecrosis ezibangela iingxaki zabo, zifanele ziqwalasele ukutshintshwa kwe-hip standard. Ezi zi gulane zihlala zinezifuba ezingaqhelekanga ezingakhokelela kwiingxaki ezixhasa ukuveliswa kwe-hip resurfacing. Ugqirha wakho unokuyalela iimvavanyo ezizodwa ukufumanisa ukuba kukho ithambo elaneleyo lokuxhasa ukuveliswa kwe-hip resurfacing.
Utyando lokuvuthwa kwe-Hip luyenziwa ngokuchaneka okufana nokutshintshwa kwe-hip standard. I-arthritic joint is exposed, kwaye i- cartilage esele isusiwe, kodwa ininzi yethambo ihlala kwindawo. Ikhuni yentsimbi iya kufakwa kwibhola, kwaye isiseko sensimbi sifakwe kwi-pelvis.
Ziziphi iingxaki ezenzekayo ze-Hip Resurfacing Surgery?
Kukho iinkxalabo ezimbalwa ezixhalabisayo zokuvuthwa kwe-hip, kwaye ngelishwa, akukho namnye owaziyo iziphumo ezide zeemveliso ezisetyenziswayo ngoku. Ngako oko, akukho mntu unokutsho ngokuqinisekileyo ukuba lo msebenzi uphezulu okanye ulunge ngakumbi kunokutshintshwa kwe-hip standard. Izimpembelelo ezikhoyo ezisetyenziselwa ukuvuthwa kwe-hip zisetyenzisiwe kuphela malunga neminyaka elishumi, kwaye idatha kuphela ekhoyo ikwabizwa ngokuba yi-short-term (engaphantsi konyaka omnye) kunye phakathi kwekota (1 ukuya kwe-10) ukulandelelana. Akukho datha yexesha elide efumanekayo yokuvuthwa kwe-hip ekuveleni.
Iingxaki ezinokuthi ziquka:
- Ukuqhekeka: Umngcipheko wokwaphulwa kwethambo exhasa ukuveliswa kwe-hip ekufakeni ukutsalwa kwamanye amazwe kuye kwaholela oogqirha ukuba babuze ukuba ngaba utyando kufuneka lwenziwe naziphi na izigulane. Nangona uphando luye lwahluka, umngcipheko wokuphulwa kwethambo kubonakala uphakathi kwe-1% kunye ne-20% yezigulane. Iifractures ziqhelekileyo kwizigulane ezinobungakanani bemfuyo embi, izigulane ezigqithisileyo kunye nabasetyhini. Kwakhona, iziqheko ziqhelekileyo kubagqirha abaye benza lo msebenzi ngokuthe rhoqo.
- Ukukhululeka: kufana nokutshintshwa kwe-hip replacements, ukuphinda ukuvelisa izimpembelelo kunokugqithisa ngokuhamba kwesikhathi. Ukuba ukufakela kutyhutyhile, ukutshintshwa kwe-hip ejwayelekile kufuneka kuqhutywe kwenziwe.
- I-Metal Ions: Zonke izimpembelelo ezifakwe emzimbeni zigqithise ngokukhawuleza emva kwexesha. Izifakelo zetsimbi ezisetyenziselwa ukuvuthwa ukuvulwa komzimba ziye zaboniswa ukuba zinxibe ngaphantsi kweeplastiki, kodwa izifake zensimbi zikhulula ioni zensimbi emzimbeni njengoko zigqoka. Ezi ioni zensimbi zingabonwa kuwo wonke umzimba kwizigulane eziye zatshintshwa izitopu zensimbi zensimbi zetsimbi okanye zonyango.
Umphumo wale ioni zensimbi emzimbeni awuyazi. Kukho iingxakini ngokubangela ukuphendula kwe-hypersensitivity kunye neemeko ezinobungozi be-carcinogenic (i-cancer-causing). Ngethamsanqa, kukho idatha encinane yokubonisa le ngxaki, kodwa kukuxhalabisa.
Yintoni ukubuyisela kwi-Hip Resurfacing Surgery?
Ukubuyiselwa okulandelayo emva kokuvuthwa kokuvulwa komzimba kufana nokulandela utyando lokutshintshwa kwe-hip. Izigulane zinomngcipheko ophantsi wokutshintshwa kwezimpembelelo, ngoko izilingo ezibekwe kwisigulane zingabalulekanga.
Ngonyaka wokuqala emva kokuhlinzwa, yonke imisebenzi yempembelelo kunye nokuphakamisa okunzima kufuneka kugwenywe. Eli lixesha elifanelekileyo xa ithambo elithintelayo litshatyalaliswa kakhulu. Ngoko ke, iingcebiso zangoku ziyakuphepha ukuhamba, ukuxumla, nokuphakamisa kwiinyanga ezili-12 zokuqala emva kokuhlinzwa.
Ngaba Ndiya Kufuna Unyango Olugqithisileyo Ngomhla Olandelayo?
Ayaziwa ukuba ixesha elide lokuvelisa ukufakelwa kwe-hip izakhi ziza kuhlala. Ngezimpembelelo ezenziwe ngcono, zibonakala zisebenza kakuhle kwiminyaka eyi-10. Nangona kunjalo, loo nto ayifanelekanga njengento eyaziwayo ngokutshintshwa kwe-hip esikhundleni.
Ukuba ukuveliswa kwe-hip kuvelisa iingxaki, okanye ukuba kuphelelwa yinto, utyando olongezelelweyo lunokucetyiswa. Ngenxa yokuba ukuhlinzwa kokuqala kokuqhaqha isicatshulwa kususwe ngaphantsi kwe-hip substitution, ukuhlaziywa (ukuphindaphinda) ukuhlinzwa ngokuqhelekileyo kunzima kakhulu emva kwenkqubo yokwakhiwa kwe-hip. Inqubo eqhelekileyo kukuguqula ukuvuthwa kwe-hip ekugqibeleni ukufakelwa kwisithuba esifanelekileyo sokutshintsha.
Ndingayifumana phi iNgakumbi malunga ne-Hip Resurfacing Surgery?
Ukufakelwa kwesiqhelo esasetyenziswa ngokuqhelekileyo ukuvuthwa kwe-hip e-United States kuthiwa yi-Birmingham Hip Resurfacing implant okanye iBHR Hip evela kuSmith & Nephew. Ezinye iiprogram zivunyiwe yiStryker Corporation kunye ne-Conserv-Plus yokuphinda i-hip resurfacing system yi-Wright Medical Technology. Unokufumana ulwazi malunga nale nkunkuma, kunye nabagqirha abenza le nkqubo ngokuya kwiwebhusayithi yabo.
Ezinye iikhampani ziyila kunye nokuvavanya i-hip ukuvelisa izimpembelelo, ngoko ke ezinye iinketho ziya kufumaneka kwiminyaka ezayo.
> Imithombo:
> Mont, MA, et al. "I-Hip Resurfacing Arthroplasty" J. Am. Acad. IOrn. Ugqirha, Agasti 2006; 14: 454 - 463.
> Birmingham Hip Resurfacing System; Smith & Nephew