Kuwedzerwa Maseku Kubata Cartilage Damage
Autologous chondrocyte implantation, kana ACI, ndiyo nzira yakagadzirwa kuma1980 ekupera kwekutora nzvimbo dzekuvara kweti cartilage mumabvi. ACI yakashandiswawo kazhinji mune mamwe masangano, akadai semakumbo, asi inowanzoitwa mumabvi.
Pfungwa yeAACI nzira ndeyokutora mashomanana emaseroti kubva pamabvi, kukura iwo mubasa, uye kana mamiriyoni emasero akakurira anowanikwa munzvimbo yekuvhiringidza maronda.
Overview
ACI inzira mbiri, inoda mavhivhi maviri mavhiki mashoma. Kutanga masero ari kukohwa, saka anowanikwa.
Danho Rokutanga: Arthroscopy
Danho rokutanga re ACI nderekuvhiya arthroscopic kuti ione nzvimbo yechipfuti chekuvadza, uye sarudza kana zvakakodzera kugadzirisa ACI.
Penguva yemaitiro e arthroscopic, musweti wetiketeti anounganidzwa. Aya masero anotumirwa kusero rinowedzera laboratori iyo inowedzera nekukura mune tsika. Kukura masero anokwana anotora maawa mana kusvika matanhatu. Pane imwe nguva masero akakwana akakura, anotumirwa kumuchiremba, uye chirwere chechipiri chinorongwa.
Nhanho yechipiri: Kuisa Chirongwa
Pane imwe nguva maseroti akakwana anokwidziridzwa, chirwere chechipiri chinorongwa. Munguva yekuvhiyiwa iyi, kusanganisa kukuru kunoshandiswa kutarisa zvakananga nzvimbo yekatekiti kukuvara (kwete arthroscopy). Chimwe chechipiri chinoshandiswa pamusoro pechepa bone uye nzvimbo yemaviri inonzi periosteum inotorwa.
Iyo periosteum ndiyo miviri yakareba inobata pfupa. A "periosteal patch," inenge yakaenzana nehukuru hwemharaunda yekushungurudza, inokukohwa.
Iyo periosteal patch inobva yatumirwa pamusoro penharaunda yekartilage yakaora. Pane imwe nguva chisimbiso chakasimba chinosikwa pakati pechikwata uye goroti rakapoteredza, iyo yakagadzirwa nekatetilagi masero inorohwa pasi peganda.
Iyo periosteal patch inoshandiswa kubata mutsva mutsva inokonzerwa nekatekete.
Vadzidzi
ACI inzira inokosha. Kuwana kwenguva refu, uye varwere vanofanira kunge vakazvigadzirira kupindira mune remishonga yakasimba yepanyama . ACI yakakodzera chete kuvarwere vane zvidiki zviduku zvinokanganisa marara, kwete hupfeko hwakapararira hwehutakiti hunofanirwa nemabvi arthritis . Varwere vanofunga ACI vanofanira kufanana nehuwandu hwehuwandu huno:
- Nzvimbo yakakosha yekatetila kukuvara, kwete kupararira arthritis
- Iva nemarwadzo kana kuvhara kunogumira basa ravo
- Bhabhironi rakasimba risina kubatana ligament kuparadza
- Kurema kwakakodzera kukwirira (kwete kuwedzera)
Mukuwedzera, varwere vanofanira kunge vakaedza dzimwe mishonga dzisingabatsiri vasati vanyatsoongorora iyi nzira inokosha. Uyezve, varwere vanofanira kuva nekunzwisisa kwakasimba kwekugadziriswa kwemashure ekugadzirisa kubva kuAIDS. Iyi danho inokosha pakubudirira kweAACI nzira. Pasina kukodzera kugadzirisa migumisiro kazhinji kazhinji pane zvisingatarisirwi.
Matambudziko
Kubudirira kwe ACI kwakasiyana-siyana, nevechiremba vakasiyana-siyana vanotaura maitiro akasiyana ekubudirira. Kunyanya kunetseka kunokonzerwa nekuvhara mishonga yekugadzira kumativi ose emucheto we periosteal patch, unonzi periosteal hypertrophy.
Dambudziko iri rinowanzoda kuti chirwere chezvechirwere chiwedzere chibvise kubvisa zvakanyanya.
Zvimwe zvinetso zvinosanganisira kukanganisa kwemasero akaiswa kuti aenzaniswe zvakakodzera, hutachiona hwemabvi, uye kuoma kwemabvi .
Kuvandudza
Kuvandudzwa kweAIDS kunofanana nekugadziriswa kunotevera kushandiswa kwemakumbo uye zvichienderana nekukura uye nzvimbo yenharaunda yekushungurudza. Nheyo dzemitemo yekuvandudza kubva kuAIDS ndeyokuti:
- Kurema-Kubereka: Kurema kunofanira kunge kusinganiswi munzvimbo yekateti inogadzirwa. Chikonzero chekudzivirira kuyerwa ndechokuti masero anofanirwa kubvumirwa kutevedzera kunzvimbo yakagadzirirwa nzira ye ACI.
Nzira yekuderedza uremu panzvimbo ye ACI inobva pane nzvimbo. Apo ACI iri pane tibia (pamusoro pebhinhi bone) kana kuti femur (kuguma kwechidya chehudyu), kuyerwa kunogumira kuburikidza nekuti murwere achishandisa michina . Apo ACI iri pamabvikete (patella) kana mukati me groove ye patella (the trochlea), kufamba kunofanira kuve kwakakwana nokuti izvi zvinokonzera kukonzerwa pamasero akaiswa.
- Range-of-Motion: Range of motion inowanzotangwa mushure mekuvhiyiwa. Zvisinei, sezvakataurwa pamusoro apa, kana nzvimbo yeAACI kurapa iri pamabvikete kana mukati megungwa rayo, ipapo kufamba kunenge kwemavhiki masere kusvika masere.
Chikonzero chekutangira kufamba nekukurumidza ndechokuti sangano rinobatsira kukurudzira hutano hwakakosha hukura. Zvisinei, izvi zvinofanirwa kuve zvakaenzana nekudzvinyirirwa kunokonzerwa nekufamba. Iwe unofanira kunyatsoteerera zviongororwa zvechiremba wako sezvavanenge vanyatsotaura nezvekukuvara nekurapa kwako.
Kurema kwekutakura kunowanzosara kwemavhiki masere kusvika masere, uye zvishoma nezvishoma zvakapfuurira mberi kwenguva. Pashure pemwedzi mitatu kusvika kumitanhatu, kurovedza kunogona kuwedzera mumutoro uye kusimba. Mabasa ezvimwe zvemitambo anogona kutanga pamwedzi gumi nemaviri mushure mekuvhiyiwa. Vatambi vakawanda havatendeuki kumitambo yakakwana kusvikira anenge mwedzi gumi mushure mekuvhiyiwa.
Sources:
Jones DG, Peterson L. "Autologous chondrocyte implantation" Instr Course Lect. 2007; 56: 429-45.