Chii chinonzi ACL misodzi?
Iyo ACL iri pakati pemabvi. Inobatanidza bhonzo rehudyu (femur) kune tibia uye inodzivirira kuti tibia irege kutsvedza mberi uye kutenderera zvakanyanya. Kana iwe ukabvarura yako ACL, chero kamwe kamwe shanduko yekutungamira, senge lateral kufamba kana kutenderera, panguva yemitambo yakaita senhabvu, basketball, tenesi, rugby kana martial arts, inogona kuita kuti ibvi rako rikundike.
Zviitiko zvakawanda zve ACL misodzi inoitika mukukuvadzwa kusingabatanidzi kunokonzerwa nekuputika kamwe kamwe kwemabvi panguva yekudzidzira kana kukwikwidzana. Vatambi venhabvu vanogonawo kuva nedambudziko rimwe chetero kana vakayambuka bhora nzendo refu, vachiisa pressure yakawandisa pagumbo rakamira.
Nhau dzakaipa dzevatambi vechikadzi vanoverenga izvi: Vakadzi vari panjodzi huru yeACL misodzi nekuti mabvi avo haawirirane mukurongeka, ukuru uye chimiro.
Vatambi vanobvarura ACL yavo vanowanzonzwa "pop" uye ipapo kuputika kamwe kamwe kwebvi (nekuda kwekubuda ropa kubva pamucheka wakabvaruka). Mukuwedzera, pane chiratidzo chinokosha: murwere haakwanisi kufamba kana kuramba achitamba mitambo pakarepo nekuda kwemarwadzo emabvi. Apo kuzvimba kwebvi kunozopera, murwere anganzwa kuti ibvi harina kugadzikana uye kunyange kutadza kusimudza, zvichiita kuti zvisabvire kuti murwere atambe mutambo waanonyanya kuda.
Vatambi vanoverengeka vane mukurumbira vakawana ACL misodzi. Izvi zvinosanganisira: Zlatan Ibrahimovich, Ruud Van Nistelrooy, Francesco Totti, Paul Gascoigne, Alan Shearer, Tom Brady, Tiger Woods, Jamal Crawford, naDerrick Rose. Kana wakambosangana nezvinetso zvakadaro, hausi woga. Nhau dzakanaka ndedzekuti vatambi ava vakakwanisa kubudirira kuenderera mberi nemabasa avo ehunyanzvi mushure mekuvakazve ACL. Nekurapwa kwakakodzera, unogona kufanana navo zvakare!
Nzira yekuongorora ACL Tear
Munofanira kushanyira Chiremba wenyu kana muchifungidzira kuti mune ACL yakabvaruka. Vachakwanisa kusimbisa izvi nekuongororwa uye kurumbidza matanho akanakisa ekumberi. Chiremba wako achaita mimwe miedzo kuti aone kana une ACL misodzi, kusanganisira:
1.Kuongorora kwepanyama apo chiremba wako achatarisa kuti mabvi ako anofamba sei mukuenzanisa kune imwe yako, ibvi risina kukuvara. Vanogona zvakare kuita bvunzo yeLachman kana anterior dhirowa bvunzo kuti vatarise huwandu hwekufamba uye kuti iyo joint inoshanda sei, uye nekukubvunza iwe mibvunzo nezvekuti inonzwa sei.
2.X-ray kuongorora apo chiremba wako anogona kutonga kunze kwekuputsika kana kuputsika pfupa.
3.MRI scan iyo icharatidza maitiro ako uye zvinyoro zvinyoro uye kubvumira chiremba wako kuti aone kuwanda kwekukuvadza.
4.Ultrasound scan kuti iongorore mitsipa, tendon, uye mhasuru.
Kana kukuvara kwako kuri munyoro ungangodaro usina kubvarura ACL uye wakaitambanudza chete. Kukuvara kwe ACL kunotaridzirwa kuti zvione kuoma kwavo sezvinotevera.
ACL yakabvaruka inogona kuporesa yega here?
Iyo ACL kazhinji haipore zvakanaka pachayo nekuti haina ropa rakanaka. Zvakafanana netambo. Kana yakanyatsobvaruka nepakati, zvakaoma kuti migumo miviri ibatane zvakasikwa, kunyanya sezvo ibvi rinogara richifamba. Zvisinei, vamwe vatambi vane chikamu che ACL kubvarura vanogona kudzoka kuzotamba chero bedzi mubatanidzwa wacho wakagadzikana uye mitambo yavanotamba haisanganisi kumonyoroka kamwe kamwe (sebaseball).
Ko ACL yekuvakazve kuvhiyiwa ndiyo yega nzira yekurapa?
ACL reconstruction ndiyo inotsiva yakakwana yeACL yakabvaruka ne "tissue graft" (kazhinji yakagadzirwa nematoni kubva mukati mehudyu) kupa kugadzikana kumabvi. Iyi ndiyo mishonga inokurudzirwa yevatambi vane mabvi asina kugadzikana uye vasingakwanisi kutora chikamu mumitambo yemitambo mushure mekubvarura kweAACL.
Usati wafunga kuvhiyiwa, unofanirwa kuonana nenyanzvi yekurapa yemuviri inokurudzirwa nachiremba wako uye kurapwa kwemuviri. Izvi zvichabatsira kudzoreredza ibvi rako kune rakazara rekufamba uye simba, ukuwo uchibvumira kusunungurwa kwekukuvara kwepfupa. Vamwe vanachiremba vanotendawo kuti kuvakwa kwe ACL kunobatanidzwa nehuwandu hwehutachiwana hweArthritis (kuchinja kwekuchinja) kunobva pane x-ray inowanikwa.
ACL kugadzirisa inzira itsva yekurapa kune mamwe marudzi emisodzi. Vanachiremba vanoisazve migumo yakabvaruka ye ACL pabhonzo rehudyu vachishandisa mudziyo unonzi medial brace. Zvisinei, misodzi yakawanda ye ACL haina kukodzera iyi nzira yekugadzirisa yakananga. Varwere vakave nekugadzirisa vane huwandu hwepamusoro hwekuvhiyiwa kwekudzokorora (1 mumatambudziko e8, maererano nemamwe mapepa). Parizvino pane tsvakiridzo yakawanda pamusoro pekushandiswa kwemasero e stem uye platelet-rich plasma kubatsira ACL kupora. Zvisinei, maitiro aya achiri kuedza, uye kurapwa kwe "gold standard" kuchiri kuvhiyiwa kweAACL.
Ndiani anogona kubatsirwa zvakanyanya kubva kuACL yekuvhiya patsva?
1. Varwere vakura vanoshingaira vanotora chikamu mumitambo inosanganisira kutenderera kana kutenderera.
2. Varwere vakuru vanoshanda vanoshanda mumabasa anoda simba rakawanda remuviri uye anosanganisira kutenderera kana kutenderera.
3. Varwere vakwegura (zvakadai semakore anopfuura 50) vanobatanidzwa mumitambo yepamusoro uye vasina kuchinja kwekuchinja mumabvi.
4. Vana kana vechidiki vane ACL misodzi. Nzira dzakagadziriswa dzinogona kushandiswa kuderedza njodzi yekukuvara kweplateti yekukura.
5. Vatambi vane mamwe maronda emabvi kunze kwe ACL misodzi, yakadai se posterior cruciate ligament (PCL), collateral ligament (LCL), meniscus, uye kukuvara kwekatekete. Kunyanya kune vamwe varwere vane meniscus misodzi, kana akakwanisa kugadzirisa ACL panguva imwe chete, mhedzisiro ichava nani.
Ndeapi marudzi akasiyana ekuvhiyazve ACL?
1. Hamstring tendon - Izvi zvinogona kukohwa nyore nyore kubva mukati memabvi kuburikidza nekucheka kuduku panguva yekuvhiyiwa (autograft). ACL yakabvaruka inogonawo kutsiviwa netendon inopiwa nemumwe munhu (allograft). Vamhanyi vane hypermobility (hyperlaxity), yakasununguka kwazvo medial collateral ligaments (MCL), kana diki hamstring tendon inogona kunge iri nani vanyori veallograft kana patellar tendon graft (ona pazasi).
2. Patellar tendon - Chikamu chimwe chete muzvitatu chemurwere patellar tendon, pamwe chete nemapfupa emapfupa kubva kune tibia uye kneecap, inogona kushandiswa patellar tendon autograft. Inoshanda senge tendon graft, asi inotakura njodzi yakakura yekurwadziwa kwemabvi, kunyanya apo murwere anopfugama uye ane kuputika kwebvi. Murwere achavawo nevanga rakakura pamberi pemabvi.
3. Medical knee approach uye tibial alignment femoral tunnel technique - Pakutanga kwekuvhiyiwa kwekugadzirisa kweAACL, chiremba anovhiya anochera pfupa rakananga (tibial tunnel) kubva kune tibia kusvika kune femur. Izvi zvinoreva kuti bhonzo mugero ari femur haisi apo ACL akanga pakutanga. Kusiyana neizvi, vanovhiya vanoshandisa nzira yepakati vanoedza kuisa pfupa tunnel uye graft pedyo nenzvimbo yepakutanga (anatomical) yeAACL sezvinobvira. Vamwe vanovhiya vanotenda kuti kushandisa tibial-based femoral tunnel process inokonzera kusagadzikana kutenderera uye kuwedzera kwekudzokorora mazinga mumabvi evarwere.
4. All-medial/graft attachment technique - Nzira yose-yepakati inoshandisa reverse drilling kuderedza kuwanda kwefupa rinoda kubviswa kubva pamabvi. Imwe chete hamstring inodiwa kugadzira iyo graft paunenge uchivakazve iyo ACL. Icho chikonzero ndechekuti nzira iyi inogona kunge isinganyanyi kupindira uye isingarwadzise kupfuura nzira yechinyakare.
5. Single-bundle vs. double-bundle - Vamwe vanachiremba vanoedza kugadzira patsva masumbu maviri e ACL nekuboora maburi mana mu kneecap pane maviri. Hapana mutsauko unokosha mumigumisiro ye-single-bundle kana kaviri-bundle ACL reconstructions - vanachiremba vakawana migumisiro inogutsa vachishandisa nzira mbiri.
6. Kuchengetedza Plate Yekukura - Mahwendefa ekukura evana kana vechidiki vane kukuvara kwe ACL anoramba akavhurika kusvika makore angangoita gumi nemana kuvasikana uye gumi nematanhatu kuvakomana. Kushandisa nzira yekuvakazve ACL (transvertebral) inogona kukuvadza mahwendefa ekukura uye kumisa pfupa kukura (kukura kusungwa). Chiremba anovhiya anofanira kuongorora mahwendefa ekukura kwemurwere asati arapwa, kumirira kusvikira murwere apedza kukura, kana kushandisa nzira yakakosha yekudzivisa kubata mahwendefa ekukura (periosteum kana adventitia).
Ndeipi nguva yakanakisisa yekuva neAACL yekuvakazve mushure mekukuvara?
Zvakanakisa, unofanira kuvhiyiwa mukati memavhiki mashoma ekukuvara kwako. Kunonoka kuvhiyiwa kwemwedzi mitanhatu kana kupfuura kunowedzera njodzi yekukuvadza shwashwa uye zvimwe zvimiro zvemabvi, senge meniscus. Usati wavhiyiwa, zvakanakisa kana iwe wakagamuchira kurapwa kwepanyama kuderedza kuzvimba uye kuwanazve huwandu hwakazara hwekufamba, uye kusimbisa quadriceps yako (mberi kwechidya tsandanyama).
Ndeipi nzira yekudzoreredza mushure mekuvhiyiwa kwekuvakazve ACL?
1. Mushure mekuvhiyiwa, murwere achanzwa kurwadziwa kwemabvi, asi chiremba acharayira marwadzo ane simba.
2. Mushure mekuvhiyiwa, unogona kushandisa madondoro kuti umire uye ufambe pakarepo.
3. Vamwe varwere vari muhutano hwakanaka zvakakwana kuti vasunungurwe pazuva rimwe chete.
4. Zvakakosha kugamuchira kurapwa kwepanyama nokukurumidza sezvinobvira mushure mekushanda.
5. Ungada kushandisa madondoro kusvika kumavhiki matanhatu
6. Unogona kudzokera kubasa rehofisi mushure memavhiki maviri.
7. Asi kana basa rako richibatanidza kushanda nesimba kwakawanda, zvinotora nguva yakareba kuti udzokere kubasa.
8. Zvinogona kutora 6 kusvika 12 mwedzi kuti utangezve mitambo yemitambo, kazhinji 9 mwedzi
Yakawanda sei yekuvandudza iwe yaungatarisira mushure mekuvhiyiwa kwe ACL kuvakazve?
Maererano nekuongorora kukuru kwevarwere ve7,556 vakange vane ACL kuvakazve, vazhinji vevarwere vakakwanisa kudzokera kumutambo wavo (81%). Zvikamu zviviri kubva muzvitatu zvevarwere vakakwanisa kudzokera kumutambo wavo wepamberi wekukuvara, uye 55% vakakwanisa kudzokera kune imwe nzvimbo yepamusoro.
Nguva yekutumira: Jan-16-2025
