Kusintha Knee Kwa Cementless Kumatanthauza Kuchepa KAPENA Nthawi

Kusintha kwa mawondo opanda simenti, njira ina yopangira opaleshoni ya mawondo a simenti, ikubweretsa chidwi pazachipatala cha mafupa. Ofufuza pa Chipatala cha Opaleshoni Yapadera (HSS) adayambitsa kafukufuku kuti afanizire zotsatira za mawondo amakono opanda simenti ndi mawondo okhazikika omwe amafunikira simenti ya fupa kuti akonze.              

Dokotala wa opaleshoni ya chiuno ndi mawondo a HSS Geoffrey H. Westrich, MD, ndi anzake sanapeze kusiyana pakati pa chipatala nthawi yayitali, zovuta, kubwezeredwa m'chipatala mkati mwa masiku a 90 a opaleshoni, kapena mitengo ya opaleshoni yokonzanso pambuyo pa zaka ziwiri zotsatila odwala. Zomwe zapezazi zidaperekedwa lero ku Msonkhano Wapachaka wa American Academy of Orthopedic Surgeons 2022 ku Chicago.

Pankhani ya nthawi yogwiritsidwa ntchito m'chipinda chopangira opaleshoni (OR), ofufuza adapeza kuti kugwiritsa ntchito implant yopanda simenti kunachepetsa KAPENA nthawi ndi 25%, kupulumutsa pafupifupi mphindi 27. "M'malo mwa mawondo opanda simenti, simuyenera kudikirira kuti simenti ikhale yolimba komanso yowuma monga momwe mumachitira pochotsa bondo," adalongosola Brian P. Chalmers, MD, dokotala wa opaleshoni ya chiuno ndi mawondo ku HSS ndi wolemba mabuku. .

"Nthawi yochepetsedwa mu OR pansi pa anesthesia ndi yopindulitsa kwa odwala, koma izi sizokhazo zomwe zingapindule ndi prosthesis yopanda simenti," anawonjezera Dr. Westrich, yemwenso ndi wotsogolera kafukufuku wotuluka pa Adult Reconstruction and Joint Replacement Service ku HSS. “Posintha mawondo opanda simenti, mawondowo amakanikizidwa kuti agwirizane ndi 'biologic fixation,' zomwe zikutanthauza kuti fupa limakula kukhala choyikapo. Ngati pali kukhazikika koyambirira kwa biologic, implant kumasulidwa pakapita nthawi kuyenera kukhala kocheperako ndipo kusintha mawondo athunthu kumatha kukhala nthawi yayitali. ”

M'malo mwa mawondo achikhalidwe, zida zoyikapo zimatetezedwa molumikizana ndi simenti ya mafupa. Ndi njira yoyesera-yowona yomwe yagwira ntchito bwino kwa zaka zambiri. Koma m'kupita kwa nthawi, simenti imayamba kumasuka ku fupa ndi / kapena implant. Ikatha kapena kumasuka, odwala nthawi zambiri amafunikira mawondo achiwiri, omwe amatchedwa opaleshoni yokonzanso.

Dr. Westrich amakhulupirira kuti choyikapo chopanda simenti chopangidwa bwino chimapangitsa kuti mawondo azitha kumasuka nthawi yayitali, zomwe zimapangitsa kuti mawondo onse azikhala nthawi yayitali. Kukhala ndi moyo wautali ndikofunikira, makamaka kwa odwala achichepere omwe ali ndi nyamakazi omwe amasankha kuphatikizana kuti akhalebe ndi moyo wokangalika. Nthawi zambiri amaika zofuna zambiri pamagulu awo, zomwe zimapangitsa kuti ziwonongeke komanso kusungunuka. Kuyika kwa bondo komangidwa komwe kumagwiritsidwa ntchito polowa m'malo mwachikhalidwe nthawi zambiri kumakhala zaka 15 mpaka 20.

"Ma implants opanda simenti akhala akugwiritsidwa ntchito bwino pochita maopaleshoni obwezeretsa m'chiuno kwa zaka zambiri. Zakhala zovuta kwambiri kupanga prosthesis yopanda simenti yomwe ingagwire ntchito bwino pabondo chifukwa cha thupi la bondo,” adatero Dr. Westrich.

"M'mbuyomu, ma implants angapo opanda simenti a mawondo adawonetsedwa kuti ali ndi zolakwika zamapangidwe, ndikumasula ku tibia," adawonjezera. "Prosthesis yatsopano yopanda simenti yomwe idagwiritsidwa ntchito mu kafukufuku wathu sinawonetse kumasulidwa kwamtunduwu monga momwe zidasindikizidwa m'mbuyomu. Tinanyamuka kuti tiwone momwe implant imayendera odwala a HSS. "

Ochita kafukufuku adawunikiranso mawondo okwana 598 amtundu umodzi wokhazikika pa HSS (170 cementless ndi 428 cemented) a mapangidwe omwewo kuyambira 2016 mpaka 2018. Zambiri za kuchuluka kwa anthu, zambiri zantchito ndi zovuta zilizonse zidapezedwa kuchokera ku zolemba zachipatala za odwala. Odwala omwe amachitidwa popanda simenti anali aang'ono, omwe ali ndi zaka 63, poyerekeza ndi 68 kwa omwe anali ndi mawondo achikhalidwe. Mafupa abwino ndi ofunika kwambiri pakuchita bwino kwa mawondo opanda simenti. Choncho, madokotala ochita opaleshoni amasankha odwala ang'onoang'ono kuti agwiritse ntchito cementless, Dr. Chalmers adanena.

Panalibe kusiyana kwakukulu kwa chiwerengero cha kutalika kwa chipatala, zovuta, kapena kubwezeredwa kuchipatala chifukwa cha vuto m'masiku oyambirira a 90 pambuyo pa opaleshoni. Makumi asanu ndi anayi mphambu asanu ndi limodzi mwa magawo asanu ndi anayi mphambu asanu ndi limodzi mwa odwala olowa m'malo opanda simenti motsutsana ndi 95% mwa omwe ali ndi mawondo opangidwa ndi simenti adasungabe implant yawo popanda kufunikira kwa opaleshoni yokonzanso pakatsatira zaka ziwiri.

"Funso lalikulu tsopano ndiloti ngati mawondo opanda simenti amatha kukhala olimba komanso osasunthika kwa nthawi yaitali kuposa mawondo a simenti," adatero Dr. Chalmers. "Kutsatira odwalawa kuti awone zotsatira za nthawi yayitali ndi sitepe yotsatira."