I -stress cruciate ligament , okanye i-ACL, yenye yezona zinto eziphambili ezinegama ezisegodini ezinika ukuzinza kwi-joint. Xa isiguli sigcina iinyembezi kwi-ACL, uvakalelo lokungazinzi , okanye ukunikezela, lunokuphuhliswa kwidolo elimazileyo. Ezi zimpawu zokungazinzi ziba nzima kakhulu kubadlali abafuna ukuhlala besebenza kwimidlalo.
Ezinye iimidlalo zinzima kakhulu ukuqhubeka nokuthatha inxaxheba kumatlali abalimele i-ACL yabo. Le midlalo ephezulu yengozi , efana nebhola, ibhola yebhoksi, kunye ne-lacrosse, kuquka ukunyakaza ngokukhawuleza kunye nokunyuka okuphazamisayo okufuna i-ACL echanekileyo.
Xa umgijimi ephula i-ACL yabo, idolo liyakuthi likhuphe xa lijikeleza okanye lijikeleze ngokukhawuleza. Ukuze ubuyisele ukuzinza emadolweni, ugqirha wakho unokuncoma ukuvuselelwa kwe-ACL ukufaka i-ligament entsha kwindawo ye-ACL eyonakalisiweyo. Inkqubo entsha, ebizwa ngokuba yindawo yokuvuselela i-ACL yesibini, iphuhlisiwe ukuba iphinde iphinde iphinde iphinde iphendule umsebenzi we-ACL eqhelekileyo.
I-ACL Bundles
Ingqungquthela yangaphambili yomhlaba yenziwe ngumbumba onzima, onobunqabileyo obunqamle idolo, uxhomeke kwi-femur (ithambo lesithambo) phezulu, kunye ne-tibia (bone bone) ngezantsi. I-ligament ngokwayo iyenziwe ngamawaka eemfayili nganye, edibanisa ifom ye-ACL.
Ezinye zee fiber zihlelwe kwiimfumba ezihlukeneyo. I-ACL eqhelekileyo inezimbombo ezimbini zokubambisa.
Ezi zikhwelo zimi kunye ngokubambisana, kwezinye izigulane ezine-ACL eziqhelekileyo kunokuba nzima ukuqonda izixhobo ezihlukeneyo. Kodwa siyazi ukuba kukho iimbumba ezimbini eziphambili, kwaye isithandwa ngasinye sithiwa indawo yaso.
Isithandwa esiphezulu se-anteromedial isimiswe phambi kwe-shorterolateral chain.
Isilwanyana esisodwa esisodwa se-ACL
Uninzi lwe-ACL yokwakha uphenyo lwenziwe lusetyenziswa ngokutsha kwakhona. Ukwakhiwa kwe-ACL eyodwa-kwintsimbi kusetyenziswa ukufakelwa kwetampon ukutshintsha i-ACL echithwe. Ngelishwa, iinyembezi ze-ACL azikwazi ukulungiswa, okanye zityinwe kunye, kunye ne-graft kufuneka isetyenziswe ukuhlaziya i-ligament. Xa i-ACL ivuselelwa kwakhona, ulwahlulo lubekwe kwindawo yesigxina esiphezulu.
Iingqungquthela ziqhutywe endaweni ngokwenza umgodi kwithambo elibizwa ngokuba ngumbane. Omnye umjelo wenziwa kwintombi kunye nomnye kwi-tibia. Ulwahlulo lubanjwe esitheni ngesisombululo sokuqhayisa, ngokuqhelekileyo isiqendu.
I-Double Bundle I-ACL Surgery
Esikhundleni sokubeka i-graft eyodwa enkulu, inqubo yokuvuselela i-ACL ye-double-bundle isebenzisa iireferensi ezimbini ezincinci. Ngoko ke, kukho izinto ezimbini zokubuyiswa kwegilithi, enye yesondlo ngasinye. Inkqubo ephindwe kabini ifuna iitoni ezimbini ezongezelelweyo zethambo ukuze zenze i-graft yesibini kunye nesinye isixhobo esongezelelweyo. Inkqubo yokugqirha ingathatha ixesha elide, nangona oogqirha abenza le nkqubo bahlala benza ngendlela efana neyokwakha enye i-ACL.
Ingcono Isisombululo Esibini?
Izifundo ziye zabonisa ezinye iingenelo zokuvuselelwa kwe-ACL ye-double-bundle. Ezi zifundo zibonisa umsebenzi oqhelekileyo 'oqhelekileyo' wegolitry reconstructed emva kwesi sixhobo sokuvuselela ukulungiswa kwe-ACL. Into engaziwayo kukuba ngaba oku kuthetha ukuba izigulane ziza kuba nempumelelo engcono kunye nezixhobo zokuvuselela ii-ACL zombini. Ngokukodwa, ukukwazi ukubuyela kwimidlalo kwinqanaba elifanayo phambi kokuba ukulimala kungakhange kuboniswe ngcono ngeendlela zokuvuselela i-ACL.
Ukwakhiwa kwe-ACL ye-Double-bundle yinkqubo entsha, kwaye njengokuba kunjalo nayiphi na inkqubo emitsha, iziphumo zexesha elide aziqondi kakuhle.
Kunokwenzeka ukuba le nkqubo iya kuba yinkqubela kwi-reconstitutional-single-bundle ACL, kodwa kunokwenzeka ukuba ezi gulane zinokufanayo, okanye zibi nakakhulu, iziphumo zesikhathi eside. Akukho mntu uyayazi okwangoku.
I-bundle ephindwe kabini imfuneko kakhulu kwinkqubo, kwaye baninzi abagqirha abanamava kule ndlela yokuhlinzwa.
Okukwintsusa
Akucaci ukuba ukwakhiwa kwe-ACL yesibini kwimiqathango yinkqubo engcono, kodwa ezinye izigulane zizimisele ukuzama inkqubo entsha kumzamo wokuphucula umphumo wabo wexesha elide. Iziphumo zokulungiswa komgangatho we-ACL olulodwa kunye neziphumo ezihle kakhulu, malunga ne-90% yezigulane zikwazi ukubuyela kwimisebenzi kwinqanaba labo langaphambi kokulimala. Nangona kunjalo, iziphumo azikho i-100%, kwaye ezinye izigulane zinokungazinzi ngokuqhubekayo emva kokuvuselelwa kwe-ACL kwaye zi novelisa iingxaki kamva ebomini.
Ukwakhiwa kwe-ACL ye-double-bundle ngumzamo wokuphucula iziphumo zenkqubo evelele kakhulu. Ukuba unomdla, xela ugqirha wakho malunga nale nkqubo. Njengoko kubonisiwe, abambalwa abagqirha benza i-ACL-bundle reconstruction. Kodwa unokwenjenjalo uxoxe ngale nkqubo kunye nogqirha uze ufumane iingcamango zakhe kwi-ACL-bundle reconstruction.
Imithombo:
> Li YL, Ning GZ, Wu Q, Wu QL, Li Y, Hao Y, Feng SQ. "I-bundle-bundle okanye i-double-bundle ye-anterior cruciate reconstruction: i-meta-analysis" Knee. 2014 Jan; 21 (1): 28-37.
> Ahn JH, Kang HW, Choi KJ. "Iziphumo emva kwe-Double-Bundle Anterior Isiqhamo seLigament Ukuvuselelwa" iArthroscopy. 2017 Septemba 8. pii: S0749-8063 (17) 30799-5.
> Dhawan A, Gallo RA, Lynch SA. "I-Anatomic Tunnel Ukubekwa kwi-Anterior Cruciate Ligament Ukwakhiwa kabusha" J Am Acad Orthop Surgery. 2016 Jul; 24 (7): 443-54.