Kugadziriswa kweCLL inzira yekuvhiya yekuita mutsva mutsva kune mumwe munhu akatsigira dambudziko re ACL . Kana mumwe munhu akasarudza kuvhiyiwa, ivo vachafanira kusarudza kuti chirwere ichi chichaitwa sei. Nyaya inowanzovhiringidzirwa nevarwere ndeyokuti: ndeupi rudzi rwe ACL graft vanofanira kusarudza?
IAACL graft ndiyo mhando yemashizha inoshandiswa kugadzira mutsara .
Kugadziriswa kweCLL kunogona kuitwa nekusarudzwa kwakasiyana-siyana kwemahofisi. Izvi zvinowanzosarudzwa zvinosanganisira patellar tendon, hamstring tendon, uye mhuka dzinopa (allograft). Chimwe nechimwe chezvisarudzo izvi zvine zvakanakira uye zvisingabatsiri.
Kugadzirisa vs. Kuvandudzwa
Kuvhiya kweCLL kwakajairika, asi kwete nenzira yakarurama, inonzi sekugadzirisa ACL. Kugadziriswa kunoratidza kuti iwe unogona kugadzirisa chimwe chinhu chakakoromoka. Kana ACL yakabvamburwa zvachose, migumo yeguriti yakabvamburwa haigoni kuporesa pamwe chete, kunyange kana mitsetse yakabvamburwa yakasimbiswa pamwechete.
Chii chinoshanda zvakanaka, ndechokubvisa migumo yakabvamburwa yeAACL uye kuchinja iyo ligament nechinangwa chakasiyana-chinonzi ACL graft. Chibatanidzwa chimiro chinobva kune imwe nzvimbo kuenda kune imwe. Apo chinyorwa chekubatanidzwa chinobva kune mumwe munhu ane chirwere, chinonzi autograft. Apo chinyorwa chinobva kune anopa (cadaver), inonzi an allograft.
Kuti uchengetedze mazamu akabatanidzwa muchinzvimbo cheAACL chaiyo, tunnels yakaitwa shin bone (tibia) nejecha bone (femur), uye kubatanidzwa kunopfurikidza nematanho ekugadzirisa dambudziko racho.
Patellar Tendon Autograft
Iyo patellar tendon ndiyo yakagadzirirwa mberi kwebvi rako iyo inobatanidza kneecap (patella) kune shin bone (tibia). Iyo patellar tendon inosvika pakati pe25 kusvika ku30 mm muhupamhi. Apo patellar tendon graft inosarudzwa, chikamu chepakati chechina chetellar patellar chinobviswa (anenge 9 kana 10 mm) pamwe nebhokisi refu pane zvikamu zvekubatanidza pamabviketi uye tibia.
- Makomborero: Vanachiremba vazhinji vanodaro vanosarudza patellar tendon graft nokuti inonyatsofanana neAACL yakabvamburwa. Kureba kwetellar patellar inenge yakafanana neAACL, uye mapfupa emagumo ekubatanidza anogona kuiswa mufupa apo ACL inosunga. Izvi zvinobvumira "bone pfupa" kuporesa, chimwe chinhu chiremba vazhinji vanovhiya vanofunga kuti vane simba kupfuura imwe nzira ipi zvayo yekuporesa.
- Kukanganisa: Apo patellar tendon graft inotorwa, chikamu chemapfupa chinobviswa pamabvikipap, uye chinenge chikamu chetatu chetendon chinobviswa. Pane njodzi yekuparara kwepellar kana kuti patellar tendon misodzi mushure mekuvhiyiwa uku. Uyewo, dambudziko rinowanzoitika mushure mekuvhiyiwa uku ndiko kurwadziwa pamberi kwebvi ( kurwadziwa kwemabvi anterior ). Mune dzimwe nguva, varwere dzimwe nguva vanoti vanorwadziwa pavanofugama, kunyange makore mushure mekuvhiyiwa.
Hamstring Tendon Autograft
Misi yemisumbu ishure reboka remasumbu mushure kwehudyu yako. Apo hamstring tendon inoshandiswa mukuvhiya kweAACL, maviri ematendoni emasumbu aya anobviswa, uye "akabatanidzwa" pamwe chete kuumba ACL itsva. Kwemakore, nzira dzekugadzirisa mabrasi aya munzvimbo dzakagadziridzwa.
- Kubatsira: Dambudziko rinowanzosangana nekuvhiya kweAACL kushandisa tete patellar ishungu pamusoro pebvi. Mamwe emarwadzo aya anozivikanwa kuti ndeyekuda kwekubatanidzwa uye pfupa rinobviswa. Iyi haisi dambudziko kana uchishandisa hamstring tendon. Iko kusungirwa kuwana gorofiti idiki, uye marwadzo ose ari pakarepo postoperative nguva uye pasi pemugwagwa, anofungidzirwa kuva shoma.
- Kukanganisa: Dambudziko guru reyi graft ndiyo kugadziriswa kwemafuro mumatinha emapfupa. Apo patellar tendon inoshandiswa, pfupa rinopera kuporesa kumapfupa emapfupa ("bone kusvika pfupa" kuporesa). Ne hamstring grafts, nguva yakareba yakakosha kuti kubatanidza kuve kwakasimba. Nokudaro, vanhu vane hamstring graft vanowanzochengetedzwa kwenguva yakareba apo huwandu hunoporesa munzvimbo.
Allograft (Donor Tissue)
Allograft ndiyo inowanzoshandiswa nevatambi vechivaraidzo (kunze kwevatambi vanokwikwidzana), kana varwere vari kuchinjwa kuongororwa ACL (apo kugadziriswa kwe ACL kunokundikana).
Dzidzo dzakaratidza zvakajeka kuti allograft (michina yezvipo kubva kune cadaver) haisi yakasimba seyamapfupa ega (autograft). Kune varwere vakawanda, zvisinei, simba rekuvakazve ACL kushandisa allograft rinokwana zvavanoda. Saka izvi zvingave nzira yakanakisisa kune varwere vasina kuronga kuita nhepfenyuro yemitambo yepamusoro (semuja webasa, basketball, nezvimwewo).
- Makomborero: Kuita chirongwa cheAACL kushandisa allograft kunobvumira kuderedza nguva yekushanda, pasina chikonzero chekubvisa dzimwe mhuka kuti dzishandise kubatanidzwa, zviduku zviduku, uye kurwadziwa kwemashure mushure mekuita. Uyezve, kana kubatanidzwa kwacho kuchikundikana, kuongororwa kuvhiyiwa kwaigona kuitwa uchishandiswa patellar tendon kana hamstring grafts.
- Kukanganisa: Nhoroondo, mazamu aya aive asina kunaka uye akatakura dambudziko guru rekutapurirwa kwezvirwere. Munguva pfupi yapfuura, maitiro e allograft kugadzirira akashandura zvinoshamisa, uye izvi zvinonetsa hazviitiki. Zvisinei, nzira yekugadzira kubatanidzwa (kufungidzira-kuoma), inouraya masero anorarama uye inoderedza simba remuviri. Kunewo hutano hwekutapurika kwezvirwere . Kunyange zvazvo kushandiswa nekugadzirisa nekugadzira kubatanidzwa kuderedza izvi, hazvibvisi zvachose.
Nzira Yokusarudza ACL Graft
Vanachiremba vazhinji vane chirongwa chinoshandiswa chekubatanidzwa kwezvikonzero zvakasiyana. Simba re patellar tendon uye hamstring grafts zvakakosha zvakaenzana. Hapana mhinduro yakarurama pamusoro pokuti chii chakanakisisa, zvisinei kwete chimwe chave chakaonekwa muzvidzidzo zvezesayenzi.
Simba reallograft tissue harusi pasi peimwe shinje, asi simba reese patellar tendon uye hamstring tendon grafts rinopfuura simba reAACL chaiyo. Chinokosha ndeyekuti 85% kusvika ku 95% yevarwere vachave nemabvi akachengeteka muchipatara mushure mekuvhiya kweAACL yekuvandudza.
Kunobva:
ACL Kukuvadza: Inoda Kuti Chiremba Chidimbu? American Academy of Orthopedic Surgeons, Nyamavhuvhu 2009