1. Dangane da ko an kiyaye jijiyar giciye ta baya
Dangane da ko an kiyaye jijiyar bayan giciye, za a iya raba babban aikin gyaran gwiwa na wucin gadi zuwa maye gurbin jijiyar bayan giciye (Posterior Stabilized, PS) da kuma riƙe jijiyar bayan giciye (Cruiate Retention, CR). A cikin 'yan shekarun nan, an tsara tudun tibial na waɗannan nau'ikan kayan aikin guda biyu tare da matakai daban-daban na daidaito da faɗin ginshiƙin tsakiya bisa ga kwanciyar hankalin haɗin gwiwa, aikin jijiyar da kuma ra'ayin likitan tiyata, don inganta kwanciyar hankalin haɗin gwiwa da inganta aikin kinematic.
(1) Siffofin robar CR da PS:
Ƙwaƙwalwar CR tana kiyaye jijiyar giciye ta bayahaɗin gwiwakuma yana rage yawan matakan tiyata; yana guje wa ƙarin yankewar femoral condyle kuma yana kiyaye ƙashi; a ka'ida, yana iya ƙara kwanciyar hankali na lanƙwasawa, rage ƙaura ta gaba mai ban mamaki, da kuma cimma juyawar baya. Yana taimakawa wajen kiyaye daidaiton dabi'a.
Na'urar PS prosthesis tana amfani da tsarin cam-column don maye gurbin aikin giciye na baya a cikin ƙirar, ta yadda za a iya mirgina na'urar femoral a lokacin ayyukan lanƙwasa. A lokacin aikin,tsakiyar cinyar maceAna buƙatar tiyatar osteotomy. Saboda cire jijiyar giciye ta baya, gibin lanƙwasa ya fi girma, motsa jiki na baya yana da sauƙi, kuma daidaiton jijiyar ya fi sauƙi kuma ya fi sauƙi.
(2) Alamomin alaƙa na ƙwayoyin halittar CR da PS:
Yawancin marasa lafiya da aka yi wa tiyatar gyaran gwiwa ta farko za su iya amfani da ko dai robar CR ko robar PS, kuma zaɓin robar ya dogara ne kawai da yanayin majiyyaci da ƙwarewar likita. Duk da haka, robar CR ta fi dacewa da marasa lafiya da ke da aikin ligament na baya na yau da kullun, ƙarancin hyperplasia na haɗin gwiwa, da kuma ƙarancin nakasar haɗin gwiwa. Ana iya amfani da robar PS sosai a yawancin maye gurbin gwiwa na farko, gami da marasa lafiya da ke da matsanancin hyperplasia da nakasar ƙashi. A cikin marasa lafiya da ke da matsanancin osteoporosis ko lahani na ƙashi, ana iya buƙatar sandunan tsawaita intramedullary, kuma ana iya buƙatar rashin aikin haɗin gwiwa na haɗin gwiwa. Yi amfani da masu rarrabawa masu ƙuntatawa.
2. Tsarin da aka gyara da kuma na'urar da aka yi amfani da ita wajen yin aiki
Na'urar wucin gadina'urar gyaran haɗin gwiwa ta gwiwaza a iya raba shi zuwa dandamali mai tsayayye da dandamali mai motsi bisa ga hanyar haɗin gasket ɗin polyethylene da tire na tibial na ƙarfe. Tsarin da aka gyara na dandamali wani abu ne na polyethylene wanda aka gyara a kan tibial plateau ta hanyar hanyar kullewa. Tsarin da aka yi da polyethylene na tsarin da aka yi da dandamali mai motsi zai iya motsawa akan tibial plateau. Baya ga ƙirƙirar haɗin gwiwa mai motsi tare da tsarin da aka yi da femoral, mai spacer polyethylene kuma yana ba da damar wani mataki na motsi tsakanin tibial plateau da tibial plateau.
Gasket ɗin prosthesis ɗin da aka gyara yana kulle a kan maƙallin ƙarfe, wanda yake da ƙarfi kuma abin dogaro, kuma ana amfani da shi sosai. Geometrics na spacers na gyara na iya bambanta sosai daga masana'anta zuwa masana'anta don dacewa da takamaiman prosthesis ɗin femoral ɗinsu da kuma inganta kinematics da ake so. Hakanan ana iya canza shi cikin sauƙi zuwa shim mai takura idan an buƙata.
Lokacin Saƙo: Satumba-10-2022
