I.Bone cenment kuzadza maitiro
Iyo pfupa remapundu rinozadza nzira yakakodzera kune varwere vane madiki aori mhando i pfupa urema uye zvisingaite zviitiko zvinoshanda.
Simendi yepaimba yemwenje yepafudzi.
Nzira chaiyo yeBPoshiCEMENTI +STekinoroji yeCrew ndeyenyatsochenesa pfupa kuremara kwepfupa, wozogadzirisa banga racho host pfupa, uye chenjera kuti urege screw cap inokonzeresa pfupa rezvikamu zvakabatana mushure meimweotomy; Wobva wasanganisa iyo Bone SEENT, zadza iyo pfupa kuremara mune danho remupfu, uye kuputira banga racho. Ritter ma et al. Akashandisa nzira iyi kuti utorezve tibial Plateau hurema, uye hurema hwakakora hwakasvika 9mm, uye pakanga pasina kusunungura makore matatu mushure mekuvhiyiwa. Bone SEENGE kuzadza tekinoroji inobvisa zvishoma pfupa, uyezve zvinoshandisa kudzokorora kwepamhepo, nekudaro kuderedza kurapwa kwemitengo nekuda kwekushandiswa kwekudzokorora mapurokiti, iyo ine imwe kukosha inoshanda.
Nzira yakatarwa yeProiment + Screw Technology ndeyechenesa hurema, gadzirisa iyo pfupa racho, uye utarise kuti screw cap Wobva wasanganisa iyo Bone SEENT, zadza iyo pfupa kuremara mune danho remupfu, uye kuputira banga racho. Ritter ma et al. Akashandisa nzira iyi kuti utorezve tibial Plateau hurema, uye hurema hwakavapo 9mm, uye pakanga pasina kusunungura makore matatu mushure mekuvhiyiwa. Bone SEENGE kuzadza tekinoroji inobvisa zvishoma pfupa, uyezve zvinoshandisa kudzokororwa kwepamutemo, nekudaro kuderedza kurapwa kwemutengo nekuda kwekushandiswa kwekudzokorora prostises, iyo ine imwe kukosha inoshanda (nhambaI-1).
MufananidzoI-1Bone SEENCE kuzadza uye screw kusimbisa
Ii.Bone Grofing Techniquees
Kudzvinyirira Bone Grofting kunogona kushandiswa kugadziridza kubatanidza kana zvisiri-zvisina kujairika pfupa zvinoremara mukuvhiya kwebvi. Izvo zvinonyanya kukodzera kuvakwazve kwaAroi mhando ini kuenda kuIII PONDO PENYU. Mukuvhiyiwa kwekuvhiyiwa, sezvo chiyero chemafupa uye huwandu hwepfupa zvinowanzosora, huwandu hwepfupa hwakawanikwa idiki uye zvakanyanya sclertheth pfupa kana prosthesis site panguva yekuvhiya kuti ichengetedze pfupa. Naizvozvo, granular Allogeneic pfupa rinowanzoshandiswa kuitira kuti abatanidzwe pfupa rekuisa panguva yekuvhiya kwekuvhiya.
Zvakanakira zvekumanikidza kweparamende yechiitiko ndeye: Kuchengeta pfupa rekofu yeiyo host pfupa; kudzorera yakakura kana yakaoma pfupa kuremara.
Zvinokuvadza zveiyi tekinoroji ndeiyi: Iko kuvhiya kuri kupedza nguva; Tekinoroji yekuvakazve ndeyekuti irida (kunyanya kana ichishandisa mesh yakakura); Pane mukana wekutapurirwa kwechirwere.
Kureruka kwakareruka pfupaYakareruka compones bone grofting inowanzoshandiswa kune inobatanidza pfupa kuremara. Musiyano uripo pakati pekumanikidza brofiting uye kurongedza pfupa rekugadzira ndekwekuti granular bone graft zvinhu zvakagadzirwa nekumanikidza pfupa rinogona kuve nekukurumidza uye revanyatso rumirana.
Mesh Metal Cage + Compression Bone GraFting:Isiri-inobatanidza pfupa kuremara kazhinji inoda kuvakwazve uchishandisa mesh mesheni yekuisa magero ekuisa mari. Kuvakazve kwe femur kunowanzo kuve kwakaoma pane kuvakazve kweTibia. X-Rays dzinoratidza kuti kupepeta uye pfupa kuumbwa kweiyo graft zvinhu zvinopedzwa zvishoma nezvishoma (nhambaII-1-1, NhambaII-1-2).
MufananidzoII-1-1Mesh cage yemukati yekumanikidza pfupa rekugadzira kugadzirisa tibial pfupa kuremara. Kupindira; B Postoperative X-Ray
FinurEI-1-2Kugadziriswa kweiyo femeral uye tibia pfupa kuremara neTitanium mesh yemukati yekumanikidza confers pfupa. Kupindira; B Postoperative X-Ray
Munguva yekudzokorora mabvi arthroplasty, allogeneic yakarongedzwa pfupa rinonyanya kushandiswa kudzoreredza Aori Type II kana III pfupa repfupa. Pamusoro pekuve nehunyanzvi hwekuvhiya hwekuvhiya uye hupfumi hwekutsiva kwebvi, chiremba anovhiya anofanirwawo kungwarira uye akaronga zvakarongeka zvirongwa. Kurongeka kwepfupa kwepa pfupa kunogona kushandiswa kugadzirisa cortical pfupa kuremara uye kuwedzera pfupa.
Zvakanakira tekinoroji iyi zvinosanganisira: Inogona kuitwa mune chero saizi uye chimiro kuti uwirirane kune pfupa kuremara kweiyo geometric mauti; Iyo ine kutsigira kwakanaka kune kudzokorora prosties; uye kwenguva refu biological yekubatanidzwa inogona kuwanikwa pakati peAllegeneic pfupa uye host pfupa.
Zvinokanganisika zvinosanganisira: kwenguva refu yekushanda nguva kana uchicheka allogeneiic pfupa; mashoma masosi eAllogeneiic Bone; njodzi yekusaona uye kunonoka Union nekuda kwezvinhu zvakaita sepfupa rinorwadza uye kupera simba kutapudzwa kwekubatanidza kwepfupa kwapera; matambudziko nekunyora uye hutachiona hwezvinhu zvakashandurwa; kugona kwekutengeswa kwechirwere; uye isina kukwana yekutanga kugadzikana kweAllogeneic Bone. Allogeneic Starural Bone anokohwa kubva kune distal femur, proximal tibia, kana musoro wechikadzi. Kana iyo nzvimbo yekuchinjika yakakura, yakakwana revasculation kazhinji haiitike. Allogeneic echikadzi inokwanisa kushandiswa kugadzirisa kondoti echikadzi uye tibial Plateu pfupa Mhedzisiro dzechiriniki dzekutanga dzekushandisa Allogeneic Starural Bone kuti ugadzirise pfupa repfupa yakaratidza huwandu hwakanyanya hwekupora hwemapfupa akashandurwa.II-1-3, NhambaII-1-4).
MufananidzoII-1-3Kugadziriswa kwefuma yechikadzi kuremara neallogeneic echikadzi musoro mamiriro epafuma
MufananidzoII-1-4Kugadziriswa kwe tibial pfupa kuremara neAllogeneic Chemorers Musoro Bone Graft
III.Metal Kuzadza Technology
Modular Technology Modular Technology zvinoreva kuti simbi mafirita inogona kuunganidzwa nemapurasitiki uye intrameduutllary stems. Vafiridzi vanosanganisira dzakasiyana siyana mhando kuti vafambise kuvakazve kwepfupa hurema hwehukuru hwakasiyana.
Metallic Prosthetic Augments:Iyo Modular Metal Spacer inonyanya kukodzera Aori Type II isiri-ine mafupa pfupa kuremara nekobvu dzinosvika 2 cm.Iko kushandiswa kwezvinhu zvesimbi kuti ugadzirise pfupa kuremara kwakanakira, zviri nyore, uye zvine marimu akavimbika.
Metal Scesers inogona kuve yakasimba kana yakasimba, uye maumbirwo avo anosanganisira wedges kana zvidhinha. Iyo simbi scesers inogona kubatana kune iyo Joint prostisheis ne screws kana yakarongedzwa neBone cement. Vamwe vadzidzi vanofunga kuti ficha yepafupa remapundu rinogona kudzivirira kupfeka pakati pemasimbi uye kurudzira kugadziriswa kwepafupa. Vamwe nyanzvi vanotsigirawo nzira yekushandisa bone cement kutanga uye wozosimbisa ne screws pakati peSpacer uye prosthesa. Kuremara kwesimba kunowanzoitika munzvimbo yepashure uye distal vechikadzi vechikadzi, saka masimbi masisitimu anowanzoiswa munzvimbo yepashure uye distal zvikamu zvechikadzi. Kune tibial pfupa kuremara, wedges kana zvidhinha zvinogona kusarudzwa kuvakazve kuti uwirirane kune dzakasiyana kuremara. Zvinyorwa zvinoshupazve kuti huwandu hwakanakisa uye hwakanaka hwakanyanya kusvika 84% kusvika 98%.
Wedge-akaumbwa maburi anoshandiswa kana hurema hwepfupa hwaro-hwakaumbwa, hunogona kuchengetedza yakawanda host pfupa. Iyi nzira inoda precise osteotomy kuitira kuti iyo osteotomy pamusoro peblock. Pamusoro pekumanikidza kushushikana, kune zvakare shea yekumanikidza pakati pekusangana kwekutaurirana. Naizvozvo, kona yeDutu haifanire kupfuura gumi neshanu. Kuenzaniswa neWedge-Yakavezwa Blocks, cylindrical simbi mabhuru ane kusagadzikana kwekuwedzera huwandu hwessteomy, asi kushanda kwekuvhiya kwakaringana uye kwakareruka, uye maitiro ezvekuita ari pedyo neyakajairika (III-1-1A, b).
MufananidzoIII-1-1Simbi Scesers: Wedge-yakagadzirirwa spacer yekugadzirisa tibial urema; B column-yakaumbwa spacer yekugadzirisa tibial urema
Nekuti masimbi masangano akagadzirwa mumhando dzakasiyana siyana uye saizi, ivo vanoshandiswa zvakanyanya mune vasina-vaine pfupa kuremara uye pfupa kuremara kwemhando dzakasiyana-siyana, uye kupa yakanaka yekugadzirisa michina kugadzikana. Nekudaro, zvidzidzo zvenguva refu zvakawana kuti scesers simbi inotadza nekuda kwekudzivirira kushushikana. Kuenzaniswa neBone Brafts, kana simbi simbi ikakundikana uye inoda kugadziridzwa, ivo vanokonzera zvikonzero zvikuru pfupa.
Kutumira Nguva: Oct-28-2024
