Chii chinonzi kubvaruka kweACL?
ACL iri pakati pebvi. Inobatanidza pfupa rechidya (femur) netibia uye inodzivirira tibia kuti isatsvedzerere mberi uye ichitenderera zvakanyanya. Kana ukabvarura ACL yako, chero shanduko yakangoerekana yaitika, senge kufamba kwedivi kana kutenderera, panguva yemitambo yakaita senhabvu, basketball, tennis, rugby kana martial arts, inogona kukonzera kuti ibvi rako risashande zvakanaka.
Zviitiko zvakawanda zvekubvaruka kweACL zvinoitika mukukuvara kusingasanganisike kunokonzerwa nekukombama kwebvi panguva yekudzidzira kana makwikwi. Vatambi venhabvu vanogonawo kuva nedambudziko rimwe chete pavanoyambuka bhora padaro refu, vachiisa simba rakawanda pagumbo rakamira.
Mashoko asina kunaka kune vatambi vechikadzi vari kuverenga izvi: Vakadzi vari panjodzi huru yekubvaruka kweACL nekuti mabvi avo haana kurongeka zvakanaka, saizi uye chimiro.
Vatambi vanobvarura ACL yavo vanowanzonzwa "kuputika" uye ibvi rinozvimba kamwe kamwe (nekuda kwekubuda ropa kubva mutsinga yakabvaruka). Pamusoro pezvo, pane chiratidzo chikuru: murwere haakwanise kufamba kana kuramba achitamba mitambo nekukurumidza nekuda kwekurwadziwa kwebvi. Kana kuzvimba kwebvi kwapera, murwere anogona kunzwa kuti ibvi harina kugadzikana uye kutotadza kumira, zvichiita kuti murwere asakwanise kutamba mutambo waanoda zvikuru.
Vatambi vakakurumbira vakati wandei vakamborwadziwa neACL cricket. Izvi zvinosanganisira: Zlatan Ibrahimovich, Ruud Van Nistelrooy, Francesco Totti, Paul Gascoigne, Alan Shearer, Tom Brady, Tiger Woods, Jamal Crawford, naDerrick Rose. Kana wakambosangana nematambudziko akafanana, hausi wega. Mashoko akanaka ndeekuti vatambi ava vakakwanisa kuramba vachiita mabasa avo ehunyanzvi mushure mekuvandudzwa kweACL. Nekurapwa kwakakodzera, unogona kufanana navo zvakare!
Nzira yekuongorora ACL Tear
Unofanira kuenda kuna chiremba wako kana uchifungidzira kuti une ACL yakabvaruka. Vachakwanisa kusimbisa izvi nekuongororwa uye vanokurudzira matanho akanakisisa ekutevera. Chiremba wako achaita mimwe miedzo kuti aone kana uine ACL yakabvaruka, kusanganisira:
1. Kuongororwa kwemuviri uko chiremba wako achaongorora kuti gumbo rako rinofamba sei zvichienzaniswa nerimwe gumbo rako risina kukuvara. Vanogonawo kuita bvunzo yeLachman kana bvunzo yedhirowa repamberi kuti vaone mafambiro aro uye kuti gumbo racho rinoshanda sei, uye vokubvunza mibvunzo yekuti rinonzwa sei.
2. Kuongororwa kweX-ray uko chiremba wako anogona kuona kana pfupa rako rakatyoka kana kuti rakatyoka.
3.Kuongororwa kweMRI kunoratidza marunda ako nenyama dzakapfava uye kunoita kuti chiremba wako aone kuti kukuvara kwacho kwakura zvakadii.
4.Kuongororwa kweUltrasound kuti uongorore marunda, marunda, uye tsandanyama.
Kana kukuvara kwako kuri kudiki ungangove usina kubvarura ACL asi wakangoitambanudza chete. Makuvara eACL anoongororwa kuti aonekwe kuti akanyanya sei.
Ko ACL yakabvaruka inogona kupora yoga here?
ACL inowanzo pora zvakanaka yoga nekuti haina ropa rakanaka. Inenge tambo. Kana yakabvaruka zvachose pakati, zvinonetsa kuti mativi maviri aya abatane zviri nyore, kunyanya sezvo ibvi richigara richifamba. Zvisinei, vamwe vatambi vane ACL yakabvaruka vanogona kudzoka kuzotamba chero bedzi jointi yakagadzikana uye mitambo yavanotamba isingasanganisire mafambiro anongoerekana akombama (senge baseball).
Kuvhiyiwa kwekugadzirisa ACL ndiyo chete nzira yekurapa here?
Kugadziriswa kweACL ndiko kutsiva ACL yakabvaruka ne "tissue graft" (inowanzogadzirwa nematendo anobva muhudyu) kuti ibvi rigadzikane. Uku ndiko kurapwa kunokurudzirwa kune vatambi vane ibvi risina kugadzikana uye vasingakwanise kutora chikamu mumitambo mushure mekubvaruka kweACL.
Usati wafunga nezvekuvhiyiwa, unofanira kubvunza nyanzvi yekurapa muviri inokurudzirwa nachiremba wako wekurapa muviri uye wozorapwa nemuviri. Izvi zvichabatsira kudzorera ibvi rako kusimba uye kufamba zvakanaka, ukuwo zvichibvumirawo kurerukirwa kwekukuvara kwemapfupa. Vamwe vanachiremba vanotendawo kuti kugadziriswa kweACL kunobatanidzwa nenjodzi shoma yekuva nearthritis nekukurumidza (kuchinja kwemuviri) zvichibva pane zvakawanikwa pa x-ray.
Kugadzirisa ACL inzira itsva yekurapa mamwe marudzi emisodzi. Vanachiremba vanobatanidza magumo akatsemuka eACL pabhonzo rehudyu vachishandisa mudziyo unonzi medial brace. Zvisinei, misodzi mizhinji yeACL haina kukodzera nzira iyi yekugadzirisa zvakananga. Varwere vakagadziriswa vane mukana mukuru wekuvhiyiwa kwekudzokorora (mumwe chete pavanhu vasere, zvichienderana nemamwe mapepa). Pari zvino pane tsvakurudzo yakawanda pamusoro pekushandiswa kwemasero emuviri uye plasma yakapfuma muplatelet kubatsira ACL kupora. Zvisinei, nzira idzi dzichiri kuyedzwa, uye kurapwa kwe "gold standard" kuchiri kuvhiyiwa kweACL reconstruction.
Ndiani anogona kubatsirwa zvakanyanya nekuvhiyiwa kwekugadzirisa ACL?
1. Varwere vakuru vanoshanda vanotora chikamu mumitambo inosanganisira kutenderera kana kutenderera.
2. Varwere vakuru vanoshanda nesimba vanoshanda mumabasa anoda simba rakawanda remuviri uye anosanganisira kutenderera kana kutenderera.
3. Varwere vakwegura (vakadai sevanopfuura makore makumi mashanu) vanotamba mitambo yepamusoro uye vasina shanduko dzinokanganisa mabvi.
4. Vana kana vechidiki vane misodzi yeACL. Nzira dzakagadziriswa dzinogona kushandiswa kuderedza njodzi yekukuvara kwegrowth plate.
5. Vatambi vane mamwe maronda emabvi kunze kwekubvaruka kweACL, akadai sekukuvara kweposterior cruciate ligament (PCL), collateral ligament (LCL), meniscus, uye cartilage. Kunyanya kune vamwe varwere vane meniscus tears, kana akakwanisa kugadzirisa ACL panguva imwe chete, mhedzisiro yacho ichave iri nani.
Ndeapi marudzi akasiyana-siyana ekuvhiyiwa kwekugadzirisa ACL?
1. Hamstring tendon – Iyi inogona kubviswa zviri nyore kubva mukati mebvi kuburikidza nekucheka kudiki panguva yekuvhiyiwa (autograft). ACL yakabvaruka inogonawo kutsiviwa netendon yakapihwa nemumwe munhu (allograft). Vatambi vane hypermobility (hyperlaxity), very loose medial collateral ligaments (MCL), kana diki hamstring tendons vanogona kunge vari nani pakushandisa allograft kana patellar tendon graft (ona pazasi).
2. Patellar tendon – Chikamu chimwe muzvitatu che patellar tendon yemurwere, pamwe chete nemabhonzo emapfupa anobva ku tibia nekneecap, zvinogona kushandiswa pa patellar tendon autograft. Inoshanda zvakafanana ne tendon graft, asi ine njodzi yakakura yekurwadziwa kwebvi, kunyanya kana murwere akapfugama uye akatyoka ibvi. Murwere wacho achavawo nevanga guru pamberi pebvi.
3. Nzira yekubatanidza mabvi ne tibial alignment femoral tunnel - Pakutanga kwekuvhiyiwa kwe ACL reconstruction, chiremba anoboora pfupa rakatwasuka (tibial tunnel) kubva ku tibia kuenda ku femur. Izvi zvinoreva kuti pfupa riri mu femur harisi iro ACL yaive pakutanga. Kusiyana neizvi, vanachiremba vanoshandisa nzira ye medial approach vanoedza kuisa pfupa uye kuisa graft pedyo nenzvimbo yekutanga (anatomical) ye ACL sezvinobvira. Vamwe vanachiremba vanotenda kuti kushandisa nzira ye tibial-based femoral tunnel kunotungamira mukusagadzikana kwe rotational uye kuwedzera kwe revision rates mumabvi evarwere.
4. Nzira yekubatanidza mapfupa ese ari pakati nepakati/kusanganisa mapfupa - Nzira iyi inoshandisa kuboora mapfupa kumashure kuderedza huwandu hwemapfupa anoda kubviswa pabvi. Hamstring imwe chete ndiyo inodiwa kugadzira mapfupa pakuvaka ACL. Chikonzero ndechekuti nzira iyi inogona kunge isinganyanyi kukuvadza uye isingarwadzi kupfuura nzira yechinyakare.
5. Chibato chimwe chete kana chibato chimwe chete - Vamwe vanachiremba vanoedza kugadzirazve mabundle maviri eACL nekuchera maburi mana pachinzvimbo chemaburi maviri. Hapana musiyano wakakura mumhedzisiro yekuvandudzwa kweACL imwe chete kana kuti mabundle maviri - vanachiremba vakawana mhedzisiro inogutsa vachishandisa nzira dzese dziri mbiri.
6. Kuchengetedza Purati Yekukura - Mapari ekukura evana kana vechidiki vane kukuvara kweACL anoramba akavhurika kusvika pazera remakore gumi nemana kuvasikana uye gumi nematanhatu kuvakomana. Kushandisa nzira yakajairika yekuvakazve ACL (transvertebral) kunogona kukuvadza mapari ekukura uye kumisa kukura kwepfupa (growth arrest). Chiremba anofanira kuongorora mapari ekukura emurwere asati arapwa, kumirira kusvika murwere apedza kukura, kana kushandisa nzira yakakosha kudzivirira kubata mapari ekukura (periosteum kana adventitia).
Ndeipi nguva yakanakisisa yekuva neACL reconstruction mushure mekukuvara?
Zvakanaka kuti uvhiyiwe mukati memavhiki mashoma mushure mekukuvara kwako. Kunonoka kuvhiyiwa kwemwedzi mitanhatu kana kupfuura kunowedzera njodzi yekukuvadza tsinga dzemabvi nezvimwe zvimiro zvebvi, zvakaita semeniscus. Usati wavhiyiwa, zvakanaka kana wawana kurapwa kwemuviri kuderedza kuzvimba uye kudzokera padanho rakazara rekufamba, uye kusimbisa tsandanyama dzemakumbo ako (quadriceps) (tsandanyama dzepamberi dzehudyu).
Chii chinonzi kupora mushure mekuvhiyiwa kwekugadzirisa ACL?
1. Mushure mekuvhiyiwa, murwere achanzwa kurwadziwa kwebvi, asi chiremba achanyora mishonga ine simba inoderedza marwadzo.
2. Mushure mekuvhiyiwa, unogona kushandisa madondoro kuti umire uye ufambe ipapo ipapo.
3. Vamwe varwere vane hutano hwakanaka zvekuti vanogona kuburitswa muchipatara pazuva rimwe chete.
4. Zvakakosha kuti munhu awane kurapwa kwemuviri nekukurumidza mushure mekuvhiyiwa.
5. Ungangoda kushandisa madondoro kwemavhiki matanhatu
6. Unogona kudzokera kubasa remuhofisi mushure memavhiki maviri.
7. Asi kana basa rako richida kushanda nesimba, zvinotora nguva yakareba kuti udzokere kubasa.
8. Zvinogona kutora mwedzi 6 kusvika ku12 kuti utangezve mitambo, kazhinji mwedzi 9
Ungatarisira kuvandudzika kwakadini mushure mekuvhiyiwa kwekugadzirisa ACL?
Zvichienderana neongororo yakakura yakaitwa pavarwere 7,556 vakagadziriswazve ACL, vazhinji vevarwere vakakwanisa kudzokera kumitambo yavo (81%). Zvikamu zviviri muzvitatu zvevarwere vakakwanisa kudzokera kumitambo yavo vasati vakuvara, uye 55% vakakwanisa kudzokera kumitambo yepamusoro.
Nguva yekutumira: Ndira-16-2025
