Le nxalenye yokutshintshwa kwe-hip ingakwazi ukuguga
Utyando olutshintsho lwe-Hip luye lwaba luqhelekileyo kwaye lunye lweenkqubo zokucwangcisa eziphumelele ngokubhekiselele ekuphuculeni ubomi bomntu kunye nomsebenzi, ngelixa kunye nokuba nezinga elincinci le-complication rate. Xa iindawo eziqhelekileyo ze-cartilage ebusweni be-hip idityanisiwe, kwanemisebenzi elula ingaba nzima. Ukutshintshwa kwe-Hip kususa iqhagamshelo eligqityiweyo le-hip kwaye liyifake endaweni yokufakelwa kokufakelwa.
Nangona kunjalo, oko akuthethi ukuba akukho mingcipheko yokuhlinzwa , kwaye enye yeenjongo eziphambili zonyango kukugwema iingxaki. Enye inkxalabo enokwenzeka yinto yokuthabatha indawo yokugqithisa ukunxiba ngaphandle kwexesha .
Iimpawu zokutshintshwa kwe-hip, kunye nezixhobo ezisetyenziselwa ukwenza i-hip replacement substlacement implant, zitshintshile, zihlanjululwe, zingene kwaye zingabikho, kwaye ziqhubeke ziphandwa ukuze zichongiwe i-hip. Amaxesha amaninzi kwiminyaka eminci edlulileyo, iziphumo ezintsha kunye nezinto eziye zafika kwiimarike zivuya kakhulu, zifumanisa ukuba emva kwexesha azisebenzi kunye nokulindeleke.
Surface Bearing
Isibambiso esibalulekileyo kakhulu sokutshintshwa kwe-hip, ngokubhekisele kwexesha elide lezinto ezifakelwayo, libizwa ngokuba ngumthwalo wendawo. Lo ngumhlaba wendawo yokutshintshwa kwe-hip evumela ukunyakaza phakathi kwebhola kunye nesiseko se-implant.
Ukufakela okutshintshwayo kwendawo yokubuyisela i-hip ibuyisela ibhola kunye ne-socket yesiqhelo esiqhelekileyo se-hip kunye nebhola yokufakelwa kunye nesakhelo sokufakelwa. Ezi ndawo zifakwe kwiindawo ezininzi kunye nobukhulu, kwaye into eyenziwe emzimbeni wakho inokuxhomekeka kwi:
- Ubungakanani bentombi yakho kunye neentsimbi
- Naziphi na iziphoso okanye ukungaqhelekanga kwendibano yakho ye-hip
- Ngaphambi kokuhlinzwa okwenziwe kwi-hip yakho
- Ukhetho lwakho lotyando
Ibhola kunye ne-socket ye-hip implant substlacement kuyoba ngumhlaba ohamba rhoqo ngexesha lakho lokuhamba lihamba phezu kwekhosi yakho yokuphila. Olu phawu luza kubonisa izigidi ngezihlandlo kwaye lilungele ukugqitha ngaphezu kweeminyaka emininzi yemisebenzi. Okufana nokunyathela kwinqwelo yakho yamatye kunokugqithisa njengoko uqhuba amakhulu kunye namawaka eekhilomitha, ukuphakama kwendawo yokutshintshwa kwe-hip kunokugqithisa ngaphezu kweminyaka kunye neminyaka eminyaka yomsebenzi.
Ngamanye amaxesha ukufakelwa kweempembelelo zokutshintshwa kwimihla yokugqibela kufaka ixesha elide okanye elifutshane. Injongo kukuyila i-implant eyokuhlala ixesha elide kunokwenzeka. Phakathi kwezinto ezibalulekileyo ukucacisa ukuba ixesha elide lobu bunzima buyilo:
- Izinto ezisetyenziswe kwiindawo eziphathekayo
- Ubungakanani bendawo yokuthwala
Kukho nezinye izinto ezinokubaluleka, kodwa ezi zimbini izinto ogqirha wakho angakhetha ngazo ezinokuchaphazela ukuba ixesha lokutshintshwa kwendawo yokufakelwa kwe-hip liza kuthatha ixesha elingakanani. Ngenxa yesi sizathu, abantu abaninzi abanomsebenzi wokutshintsha i-hip bafake inomdla kwiintlobo zezinto ezifakwe ngaphakathi emzimbeni wabo.
Ukuguqulwa kwee-Hip Implants
Ukufakelwa okutshintshwayo kwendawo yokusebenzisa indawo kusetyenziswa intloko yentsimbi yesibini (ibhola yokufakelwa) kunye ne-polyethylene eqhelekileyo, okanye iplastiki, njengecandelo le-acetabular (iscket of the implant).
Ngokomlando, intloko yesifazane yayincinci, inxalenye enkulu kuba loo nto ithetha indawo engaphantsi komhlaba ukuba igubhe phakathi kwebhola kunye nesiseko, ekhokelela kwizinga elincinci lokuguga kwiimplants. Ingxaki ngeentsholongwane ezincinci zeentloko ze-femoral kukuba zinozinzo eziphantsi kunye nezinga eliphezulu lokukhupha . Ngenxa yeso sizathu, ubukhulu beentloko zebhinqa zandile ukwenzela ukuba ukunyuswa kwe-hip kuzinzile.
Kwakukho uvuyo olukhulu malunga neminyaka eyi-10 ukuya kuma-20 edlulileyo xa izilwanyana ezintsha zenziwe ngokusetyenziswa kwesiseko sensimbi ye-acetabular. Ezi zifakelo, ezibizwa ngokuba yi-substitute-metal-substituted hip replacements, zibonise ixabiso elincinci lokugqoka kwii-laboratory izifundo, zazizinzile kakhulu ngenxa yeentloko ezinkulu ze-femor ezingasetyenziselwa, kwaye zathandwa kakhulu.
Ngelishwa, inxiba yeziplani zenze iinqununu zetsimbi ezincinci ezinokubangela iingxaki zamathambo zendawo kunye neenkqubo , ukwenza izifakelo zokutshintshwa kwe-hip zensimbi ezitshintshileyo zingabonakaliyo namhlanje.
Enye yentuthuko ebalulekileyo kwiimpembelelo zokutshintshwa kwe-hip kuye kwaba kukuphuhliswa kwe-polyethylene entsha (iplastiki) ehlala ixesha elide kune-polyethylene eqhelekileyo. Ukuqhubela phambili kwangoko kuye kwaba nokusetyenziswa kwe-polyethylene ehlanganiswe kakhulu. I-polyethylene edibeneyo yomnqamlezo idalwe ngokutshabalalisa nokuvuselela iipolithylene izimpembelelo ezivumela iplastiki ukuba iqinise isakhiwo sayo se-molecular ngokusebenzisa inkqubo yokuqhagamshela. I-polyethylene edibanisene nomnqamlezo iboniswe ukuba inexabiso elincinane yokuguga kune-polyethylene eqhelekileyo.
Iziplantshi zeCeram ziye zaphandwa ngomgudu wokufumana i-implant. I-Ceramic yinto enzima kakhulu, kwaye izixhobo ezinzima azigqali ngokukhawuleza njengezityalo zensimbi kunye neplastiki. Ingxaki kunye nezimpembelelo ze-ceramic ezindala kukuba zivelise iziqhekeza ezingakhokelela ekufakweni kokungaphumeleli ngokuphazamiseka. I-ceramic entsha ibonise iingxaki ezimbalwa zokungaphumeleli, nangona kukho uphando oluncinane malunga neziphumo zangexesha elide zokufakelwa kweekheramic, ngokukodwa iincwadi ezintsha zeeramic.
Ukucinga kwangoku: Ilungelo elilungileyo ngakumbi ngoku
Iingcamango ezikhoyo phakathi kwamagqirha azinthambo amaninzi kukuba isiseko se-polyethylene esithintekayo esiphambeneyo, esidibaniswe kunye nentloko ye-ceramic okanye yentsimbi ye-femoral, inomxholo ophezulu. Kukho nedatha efanelekileyo yokuxhasa ukusetyenziswa kwezimpembelelo kunye nentloko ye-ceramic yentsimbi kunye nesiseko se-ceramic, kodwa ayikho ilandelelwano olude lwexesha elide kulezi ziphumo.
Ukwahlukana phakathi kokusebenzisa intsimbi ye-ceramic kunye nentsimbi yentsimbi yesibini kunye nefayile ye-polyethylene efakwe kwi-cross ayixhomekekanga. Kukho izizathu zokuthi kungani oogqirha banokukhetha iintloko zentombi ze-ceramic, ngokukodwa kwizigulane ezincinci, kodwa into eyinyani kukuba ukuya kutsho akuzange kuboniswe ukuba kuninzihluko.
Xa iNewer ingcono
Ihlala ikulinga, kokubini kwizigulane kunye noogqirha, ukukhangwa kwi-intengiso entsha. Ngokuqhelekileyo ezi zifakelo zikhuthazwa ngamashishini okuvelisa amazinyo njengendlela engcono, kwaye inokuhlala ihlala ixesha elide, kunezipholo ezikhoyo ngoku.
Kwiminyaka yokuqala ye-2000, omnye wabaphambili abafake umlomo wama-orthopedic obizwa ngokuba yiDePuy Orthopedics, ulwahlulo lukaJohnson & Johnson, weza kwiimarike kunye nokufakelwa okutshintshiselwa ukutshintshwa kwe-metal-on-metal eyenzelwe ukuzinza nokuphila ixesha elide. Ezi zifakeko zenzelwe ukuxazulula ingxaki enzima yokufaka indawo yokunyusa kwiindawo ezincinci, abantu ababenomsebenzi. Ekugqibeleni, ezi zimilo ziyakhunjulwa kwaye zithathwa kwiimarike, kwaye ezininzi zezi gulane zaphela zifuna ukuhlinzwa okongeziweyo ukuze zisuse kwaye zitshintshe le nto.
Enye yeengxaki eziphambili zokufakelwa kokutshintshwa ngokuhlanganyela kukuba zivame ukuza kwiimarike ezincinane okanye kungekho uphando lwekliniki. Ngexa izigulana zikholelwa ukuba nayiphi na into eyenza ukutshalwa kwintsholongwane iye yafumana uvavanyo olunzulu lwezonyango, inyaniso kukuba abakhiqizi abaninzi abafake izicelo basebenzise indlela ebizwa ngokuba yi-501 (K) indlela yokugqithisa inkqubo yokugunyazwa kwe-FDA. Ngethuba nje ukuba umenzi angatsho ukuba isixhobo esitsha "sinokulinganayo" kumaziko angoku kwiimarike, akufuneki ukuba zibonise nayiphi na idatha yekliniki ukuze ikwazi ukuthengisa okutsha.
Ukutsha kunye nokuphuhliswa kwezimpembelelo ezingcono zokutshintshwa kwe-hip yinkqubo eqhubekayo, kodwa ngelanga, akusiyo yonke inyathelo yezinto ezintsha eziza kubanceda izigulane. Kwiimeko ezininzi, abantu akufanele bafune unyango olutsha olutholakalayo kwimarike. Ukufumana irekhodi elihle kakhulu lithetha ukuba awufumani uhlobo olusandul 'ukutshalwa kwezinto ezikhoyo, kodwa kusenokuba lithetha ukuba ufumana ukulungiswa okulungileyo.
ILizwi
Akunjalo sonke isigulana sifuna ukwazi malunga nezinto zokutshintsha izinto eziza kutshalwa ngexesha lokuhlinzwa, kodwa abanye banomdla kakhulu. Ukongezelela, ndinokuqinisekisa ukuba ugqirha wakho osebenzayo othabathayo unomdla kwizixhobo ezisetyenziswe ngexesha locwangco lwakho, ngoko unganqikazi ukuqala incoko uze ufumane ulwazi.
Idatha efanelekileyo kakhulu ekhoyo kweli nqanaba ngexesha lifumanisa ukuba ukutshintshwa kwe-hip izakuhlala ixesha elide xa intloko yesifazane iyenziwe nge-ceramic okanye isinyithi kunye ne-acetabular socket yenziwe nge-polyethylene okanye i-ceramic. Izimpembelelo kunye nerekhodi elide kunabo bonke zikhoyo zizo zenziwe ngeentsimbi zeentloko ze-femor kunye neenqwelo zepetethylene eziphambeneyo.
Akungabazeki ukuba kwiminyaka ezayo kunye namashumi eminyaka ukuhlaziywa kwezixhobo ziya kutshintsha. Nangona kunjalo, kufuneka kuqaphele ukuba kusetyenziswe ukutshalwa kwezinto ezintsha kwiimarike.
> Imithombo:
> Lachiewicz PF, uKleeman LT, u-Seyler T. "Ukukhusela iindawo ezipheleleyo ze-Hip Arthroplasty" J Am Acad Orthop Surgery. 2018 Jan 15; 26 (2): 45-57.
> Atienza C Jr, Maloney WJ. "Iipolithylene eziphezulu eziqhagamshelwe kwi-polyethylene ezipheleleyo kwi-hip arthroplasty" J Surg Orthop Adv. 2008 Spring; 17 (1): 27-33.
> López-López JA, Humphriss RL, Beswick AD, Thom HHZ, Hunt LP, Burston A, Fawsitt CG, Hollingworth W, Higgins JPT, Welton NJ, Blom AW, Marques EMR "Ukukhethwa kokuhlanganiswa kokufakelwa kwi-hip substitution: kunye nenethiwekhi ye-meta-analysis "BMJ. 2017 Novemba 2; 359: j4651.