Iyo Patella, inowanzozivikanwa se ibenecap, ipfupa reSesamoid rakaumbwa mu quadriceps tendon uye zvakare iri pfupa rakakura kwazvo reSesamoid mumuviri. Iyo yakatetepa uye yemabai-yakaumbwa, iri pasi peganda uye nyore kunzwa. Pfupa rakakura kumusoro uye rakanongedzerwa pasi, paine yakaoma kumberi uye yakatsauka kumashure. Inogona kukwira kumusoro uye pasi, kuruboshwe uye kurudyi, uye inodzivirira ibvi rakabatana. Iyo kumashure kwePatella inotsvedza uye yakafukidzwa ne cartilage, kubatanidza kune iyo patelar pamusoro pe femur. Kumberi kwakashata, uye iyo quadriceps tendoni inopfuura kuburikidza nayo.
Patellar Chondromalaca chirwere chakabatana chebvi. Munguva yakapfuura, chirwere ichi chaizivikanwa pakati pevakwegura uye vakwegura. Zvino, nekwavanhu vezvemitambo uye kusimba, chirwere ichi chine huwandu hwakanyanya huwandu pakati pevechidiki.
I. Chii chinonzi chirevo chechokwadi uye chinokonzeresa chondromalacia patella?
ChondRaalacia Patellae (CMP) iri PatelloFemOral Inosimbisa Kukuvadzwa Kwekukuvara kwePatellar, inokonzera kupwanyika cartello, kupaza, kuputsa, kupaza, uye kudeura. Chekupedzisira, iyo inopesana nekadzi cintilage inoisawo shanduko dzakafanana dzipi. Zvinoreva chokwadi cheCSM
Sezvo articular cartilage haina nerve yemukati, maitiro ekurwadziwa anokonzerwa naChondromalacia achiri pachena. CMP ndiyo mhedzisiro yemhedzisiro yemhedzisiro yezvakawanda zvinhu. Zvinhu zvakasiyana-siyana zvinokonzeresa kupatsanurana zvakavanzika zvinokonzeresa zvekunze, nepo autoimmune maitiro, Cartilage Dystrophy, uye shanduko mukumanikidza intraveous zvinhu zvemukati zvinokonzeresa zve chondRomalacia.
Ii.Iyo yakakosha chinhu cheChondRomalacia Patellae ndiyo chaiyo yekuchinja kwethalological shanduko. Saka kubva pamaonero ekuchinja kwechipatara, sei ChondRomalacia patellae?
Insall yakarondedzerwa mana pathological matanho eCART: Stage i ndeye cartilage svutugadzike, Stage II ndeyekukomba munzvimbo yakanyoroveswa, Stage III Uku ndiko kupatsanurwa kwehunyanzvi cartilage; Stage IV inoreva kushandurwa kwekuchinja kweiyo osteoarthritis uye kufumurwa kwepfupa rechikamu pane iyo articular pamusoro.
Iyo yekunze grading system inonyanya kubatsira pakuongorora patellar articular cartilage maronda pasi pekuonekwa kwakananga kana kuoneka. Iyo yekunze grading system iri seinotevera:
Giredhi I: Chete chete cartilage yakanyoroveswa (yakavharwa cartilage nyoro). Izvi zvinowanzoda mhinduro yetsiva ne probe kana chimwe chimbo chekuongorora.
Giredhi II: Chikamu-ukobvu hurema husiri kupfuura 1.3 cm (0.5 in) mune diameter kana kusvika pakadzika pfupa.
Giredhi III: Iyo cartilage fissure yakakura kupfuura 1.3 cm (1/2 inch) mune diameter uye inowedzera kune iyo subchondral pfupa.
Giredhi IV: Subchondral Bone kuratidzwa.
III. Zvese zvevatengesi uye grading inoratidza kukosha kweChondRomalacia Patella. Saka ndezvipi zviratidzo zvine musoro uye zviongorori zvekuongorora chondromalacia patella?
Iko kuongororwa kunonyanya kuve kwakavakirwa pakurwadziwa kuseri kwePatella, iyo inokonzerwa neye patellar yekuyevedza bvunzo uye iyo yeganho-yeganhu-gumbo squat bvunzo. Iko kutarisisa kunoda kuve kwekusiyanisa kana paine kukuvara kwevanhurume kukuvara kwevanhurume uye kushungurudza arthritis. Nekudaro, hapana kuwirirana pakati pekushungurudzika kwe patellar chondromalacia uye zviratidzo zvechiratidzo zveantherior knee kurwadziwa kwesyndrome. Mri izira yakanyanya kunaka yekuongorora.
Chiratidzo chaicho chinonyanya kufarirwa kusimba kuseri kwePatella uye mukati mebvi, inowedzera mushure mekushanda nesimba kana kuenda kumusoro kana kudzika masitepisi.
Kuongorora kwepanyama kunoburitsa pachena pachena mune patella, peripatella, patellar margin uye patefela patella, iyo inogona kuperekedzwa ne patellar inotsvedza uye patellar friction kurira. Panogona kunge paine kubatana uye quadriceps atrophy. Mune zviitiko zvakanyanya, mabvi ebvi uye kuwedzerwa zvinoganhurirwa uye murwere haagoni kumira pagumbo rimwe. Munguva yePatellar compression test, pane kurwadziwa kwakanyanya kuseri kwePatella, zvichiratidza patellar articular cartilage kukuvara, iko kune kukosha kwekuongorora. Muedzo unonetseka kazhinji kazhinji, uye bvunzo ye squat yakanaka. Kana ibvi rakachinjirwa 20 ° kusvika makumi matatu Kuyera iyo q angle ye90 ° iyo ibvi yekubhururuka inogona kuratidza zvisina kujairika patellar yekufambisa trajectory.
Iyo yakanyanya kuvimbika yekuongorora ndeye MRI, iyo zvishoma nezvishoma yakatsiva arthroscopy uye ikaita isingasviki uye yakavimbika nzira yeCMP. Kufungidzira bvunzo kunonyanya kutarisisa pane iyi parameter yekutanga cmp.
X-ray uye mri yakashandiswa kuyera patellar kureba (caton index, ph): a. Axial x-ray mukuremerwa nzvimbo yakamira yakamira nebvi dzakabiwa pa30 °, b. Mri munzvimbo ine ibvi rakachinjika pa30 °. L1 ndiyo patelar yekuda kushambadzira, iyo iri kureba kubva kune yakaderera nzvimbo yePatefemil Yenzvimbo yeTibial Plateau contour, uye Caton Index = L1 / L1 / L1 / L1 / L1 / L1 / L1 / L1 / L2.
Femery trochlear Groove Anga uye Patellar Fit Angle (PCA) akayerwa ne X-ray uye MRI: A. Axial x-ray ine ibvi yakachinjika pa30 ° mukuremerwa-kutakura nzvimbo yekumira; b. MRI ine ibvi rakachinjika pa30 °. Iyo femeral trochlear groove inoumbwa nemitsetse miviri, kureva yakaderera nzvimbo yeiyo femerlear grochlear grochlear ∠bac ndiye wechikadzi trochlear groove angle. Chikadzi trochlear groove yakakwenenzverwa pane iyo axial mufananidzo wePatella, uye ipapo bisector ad ye ∠bac yakakweverwa. Ipapo mutsara wakananga AE yakakweverwa kubva pane yakaderera poda yeiyo femori trochlear groove seyakadzika pakaderera e yeiyo patellar crest. Kona pakati peiyo yakatwasuka mutsara ad uye AE (∠dae) ndiyo patellar fit kona.
X-Ray uye MRI aishandiswa kuyera iyo Patellar Tilt Angle (PTA): a. Axial x-ray mukuremerwa nzvimbo yakamira yakamira nebvi dzakabiwa pa30 °, b. Mri munzvimbo ine ibvi rakachinjika pa30 °. Patellar Tilt angle iri kukona pakati pemutsara unobatanidza mapoinzi epamusoro emu medial uye akazotevera echikadzi condyles uye iyo transverse axis ye patella, kureva ∠abc.
Radiographs yakaoma kuongororwa CAP mumatanho ekutanga kusvika pamatanho epamberi, apo yakawedzera kurasikirwa nzvimbo, uye inosanganiswa subone bone sclerosis uye shanduko yechikadzi inoonekwa. Arthroscopy inogona kuzadzisa kuongororwa kwakavimbika nekuti inopa hukuru hwakanakisa hwekuona kwePatelloferal Joint; Nekudaro, hapana kuwirirana kwakajeka pakati peiyo kuomarara kwe patellar chondromalacia uye iyo degree rezviratidzo. Naizvozvo, izvi zviratidzo hazvifanirwe kuve chiratidzo cheArthroscopy. Mukuwedzera, arthrography, seyisingaoneki yekuongorora nzira uye maitiro, inongoshandiswa chete mumatanho epamberi ezvirwere. Mri is isinginvasive nzira inovimbisa kugona kwakasiyana kuti uone maronda emaroto pamwe nekufamba kwemukati kwekaramu asati arara cartilage gore risina kuoneka kuzadza neziso rakashama.
Iv. ChondRalacia Patellae inogona kuve ichishanduka kana kufambira mberi kuenda kuPatelloFemory arthritis. Kubudirira kwekuchengetedza kurapa kunofanirwa kupihwa nekukurumidza mumatanho ekutanga echirwere. Saka, kuronga kwekuchengetedza kunosanganisirei?
Izvo zvinowanzofungidzirwa kuti munguva yekutanga (Stage i kusvika II), iyo Patellar Cartilage ichine kugona kugadzirisa, uye inoshanda isiri-yekuvhiya yekuvhiya inofanira kuitwa. Izvi zvinonyanya kusanganisira kurambidzwa kwebasa kana kuzorora, uye kushandiswa kwezvinodhaka zvinodhaka zvinodhaka zvinodhaka pazvinenge zvichidikanwa. Mukuwedzera, varwere vanofanirwa kukurudzirwa kurovedza muviri pasi pekutarisirwa kwemanyorero ekurapa kusimbisa iyo quadriceps tsandanyama uye kusimudzira mabvi kugadzikana.
Izvo zvakakosha kucherechedza kuti panguva yekusvibisa, mabvi ebvi kana mabvi eksethes inowanzo kupfeka, uye gadziriso yeplaster inodzivirirwa zvakanyanya sezvinobvira, sezvo inogona nyore kutungamira kukuvadzwa kweiyo articular cartilal Kunyangwe kurapa kurapa kunogona kudzoreredza zviratidzo, mahormone haafanire kushandiswa kana kushandiswa zvishoma, sezvavanotadzisa synthesis ye glycropolateins uye collagen uye kukanganisa iyo yekugadziriswa kwe cartilage; Kana ichipinda nekuzvimba uye kurwadziwa kamwe kamwe zvakawedzera, ice compress inogona kuiswa, uye kurapa kwemuviri uye kudziya kudziya kunogona kuiswa mushure maawa makumi mana nemasere.
V. Mune varwere vepamhepo vanononoka, kugona kwekugadzira kweiyo cartilage ndeye murombo, saka kurapa kwekurapa kunowanzoitika uye kurapa kwekuvhiya kunodiwa. Kurapa kwekuvhiya kunosanganisirei?
Zviratidzo zvekuvhiyiwa zvinosanganisira: Mushure memwedzi yakati wandei yekuchengetedza kwakaringana, muripo wekurwadziwa achiri kuripo; Kana paine kuremara kwakazvarwa kana kuwanikwa, kurapwa kwekuvhiya kunogona kutariswa. Kana Outerbridge III-IV CARILAFILGE kukuvadza kunoitika, urema hadzizombofi hwakazadzwa neicho chaicho cartilalar. Panguva ino, kungoveura cartilage nzvimbo yekukuvara ine nzvimbo isiriyo haigoni kudzivirira maitiro ekugadzirisa kwehunyanzvi hwekugadzirisa.
Nzira dzekuvhiya dzinosanganisira:
. Inogona kutarisa zvakananga shanduko muchikamu che cartilage pasi pemicroscope. Muzviitiko zvinyoro, zvidiki zvidiki marara pane patellar articular cartilage inogona kutsemuka kusimudzira kugadziriswa.
(2) yakazotevera femori centyle kukwirira; (3) Patellar cartilage pamusoro pekodhi. Uku kuvhiya kunoitwa kune varwere vane diki cartilage kukuvara kusimudzira cartilage kugadzirisa; .
Kutumira Nguva: Nov-15-2024
