I.Cov pob txha hloov txheej txheem
Tus pob txha sib xyaw txoj kev yog tsim nyog rau cov neeg mob me Aori hom kuv pob txha tsis xws luag thiab cov haujlwm nquag ua haujlwm.
Cov pob txha hloov yooj yim yuav tsum muaj kev ntxuav pob txha hauv cov pob txha hauv lub pob txha ua kom nruj nrog cov pob txha sib npaug.
Txoj kev tshwj xeeb ntawmBibCement +SCrew Technology yog kom huv si cov pob txha pob txha kom huv, thiab ceev faj kom tsis txhob cia cov ntsia hlau ntsia hlau saum npoo av tom qab ostotomy; Tom qab ntawd sib tov cov pob txha xis mas, sau cov pob txha pob txha hauv lub khob noom cookie theem, thiab qhwv cov ntsia hlau. Ritter ma li al. Siv txoj kev no txhawm rau txhim kho lub ntxiab pob txha tsis xws luag, thiab cov tshuaj tuab mus txog 9 hli, thiab tsis muaj loosening 3 xyoos tom qab ua haujlwm. Pob txha ua pob txha filling thev naus laus zis tshem tawm cov pob txha tsawg, thiab tom qab ntawd siv cov nqi kho mob txom nyem vim tias siv cov txiaj ntsig prostheses, uas muaj qee yam nqi.
Cov txheej txheem tshwj xeeb ntawm cov pob txha xis + ntsia hlau tshuab ua kom huv si cov pob txha pob txha, thiab xyuam xim rau cov pob txha heard yuav tsum tsis txhob ntau dua cov pob txha sib luag tom qab ostotomy; Tom qab ntawd sib tov cov pob txha xis mas, sau cov pob txha pob txha hauv lub khob noom cookie theem, thiab qhwv cov ntsia hlau. Ritter ma li al. siv txoj kev no kom rov tsim kho lub ntxiab pob txha tsis xws luag, thiab cov tshuaj thickness mus txog 9mm, thiab tsis muaj loosening 3 xyoos tom qab phais tas. Cov pob txha ua pob txha filling thev naus laus zis tshem tawm cov pob txha tsawg, thiab tom qab ntawd siv cov nqi kho mob txom nyem, yog li siv cov nqi kho mob prosthesis, uas muaj qee yam cov nqi (daim duabI-1).
Naj npawbI-1Cov pob txha xis tso thiab ntsia hlau lub zog
Ii.Cov txheej txheem sib xyaw ua pob txha
Cov pob txha compression grafting tuaj yeem siv los kho cov kev kho lossis tsis muaj pob txha tsis sib xws hauv caug kho. Nws yog feem ntau haum rau kev rov tsim kho ntawm aroi hom kuv rau iii pob txha tsis xws luag. Hauv kev kho mob phais, txij li cov neeg phais mob thiab qib pob txha muaj mob hnyav thiab feem ntau yog cov pa roj ntsha raug tshem tawm thaum phais mob txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhawm rau txhim kho cov pob txha loj. Yog li ntawd, cov pob txha pab noob pob txha granidene feem ntau siv rau cov pob txha compression grafting thaum kho kev phais mob.
Qhov zoo ntawm cov pob txha compression grafting yog: khaws cov pob txha loj ntawm cov pob txha host; Kho kho kom yooj yim lossis cov pob txha ua pob txha complex.
Qhov tsis zoo ntawm cov thev naus laus zis no yog: lub lag luam yog siv sijhawm; Tshuab rov tsim kho dua tshiab yog qhov xav tau (tshwj xeeb yog thaum siv cov tawb loj mesh); Muaj lub peev xwm rau kis tau tus kab mob.
Yooj yim cabress pob txha grafting:Cov pob txha yooj yim pob txha grafting feem ntau yog siv rau cov pob txha pob txha tsis sib xws. Qhov sib txawv ntawm cov pob txha compression grafting thiab cov pob txha pob txha grafting yog tias cov pob txha granular ua ke tsim los ntawm kev ua pob txha pob txha ua kom sai thiab hloov kho rov qab.
Mesh Hlau tawb + Compression Cov Pob Kws Grafting:Cov pob txha tsis muaj feem cuam tshuam feem ntau yuav tsum tau tsim kho cov tawb hlau hlau kom cog cov pob txha cog cancellous. Kev tsim kho ntawm Femur yog feem ntau nyuaj dua kev rov tsim dua ntawm tus ntugia. Xoo hluav taws xob qhia tau tias cov pob txha sib xyaw ua ke thiab pob txha ntawm cov khoom siv hluav taws xob yog maj mam ua tiav (daim duabII-1-1, Daim DuabII-1-2).
Naj npawbII-1-1Mesh Tawb Sab hauv Compression Point Grafting los kho Tibial Cov Txiaj Ntsig. Kev nkag mus; B Posterative X-Ray
NtawvE II-1-2Kev kho ntawm cov poj niam thiab tibia pob txha tsis xws luag nrog titanium mesh sab hauv cov pob txha compressting. Kev nkag mus; B Posterative X-Ray
Thaum lub sij hawm kho mob hauv caug, Allogeneic cov pob txha tsuas yog siv los tsim kho Aori hom II lossis III pob txha tsis xws luag. Ntxiv rau kev muaj cov kev pab phais mob zoo tshaj plaws thiab kev nplua nuj hauv kev hloov pauv ntawm lub ntsej muag nyuaj, tus kws phais yuav tsum tau ceev faj thiab cov phiaj xwm npaj npaj ua ntej. Cov pob txha txheem vaj tse tuaj yeem siv los kho cov pob txha pob txha cortical tsis xws luag thiab nce cov pob txha loj.
Qhov zoo ntawm cov thev naus laus zis no suav nrog: nws tuaj yeem ua rau txhua qhov loj thiab cov duab kom yoog cov pob txha sib txawv ntawm cov duab geometric sib txawv; Nws muaj cov txiaj ntsig zoo ntawm kev kho mob prostheses; Thiab kev sib xyaw ntev ntev kev sib xyaw ua ke tuaj yeem ua tiav ntawm allogeneic pob txha thiab cov pob txha host.
Qhov tsis zoo suav nrog: lub sijhawm ua haujlwm ntev thaum txiav cov pob txha alogeneic; txwv cov chaw ntawm cov pob txha pab pawg; Kev pheej hmoo ntawm kev tsis ncaj thiab ncua sij hawm vim muaj ntau yam xws li lub pob txha rov qab thiab nkees zom ua ntej tus txheej txheem kev koom ua ke ua tiav; Cov teeb meem nrog kev nqus thiab kis tau cov khoom siv hloov; muaj peev xwm rau tus kab mob kis tau tus kab mob; thiab tsis muaj qhov txaus ntawm cov pob txha sib luag. Allogeneic cov pob txha yog muab sau los ntawm cov distal femur femur, ua rau tibia, lossis poj niam taub hau. Yog tias cov khoom siv hloov tau yog qhov loj, ua kom tiav revascularization feem ntau tsis tshwm sim. Allogeneic femoral taub hau tuaj yeem siv los kho femoral condyle thiab tib leeg pob txha qhov tsis xws luag, thiab yog tsau los ntawm xovxwm-haum tom qab trimming thiab shaping. Cov qauv tshuaj kho thaum ntxov ntawm kev siv cov pob txha tiv thaiv pob txha los kho pob txha tsis xws luag uas tau kho kom zoo ntawm cov pob txha hloov pauv (daim duabII-1-3, Daim DuabII-1-4).
Naj npawbIi-1-3Kho ntawm cov poj niam pob txha pob txha tsis muaj zog nrog Allogeneic femoral poj niam qauv pob txha txuas
Naj npawbII-1-4Kev kho cov pob txha txuas lub pob txha tiv thaiv nrog Allogeneic femoral taub hau pob txha pob txha xa
III.Hlau Filling Tshuab
Modular Technology txhais tau tias cov hlau ua ke ua ke tau sib sau ua ke nrog prostheseses thiab intramedullary stems. Cov tub faus neeg suav nrog ntau tus qauv los pab txhawb kev rov tsim kho cov pob txha tsis thiab ntau.
Nws yog xim hlau Tus loj Tshem tawm:Lub ntsej muag modular hlau feem ntau haum rau Aori hom II tsis muaj pob txha pob txha tsis muaj qhov cuam tshuam nrog lub thickness ntawm li 2 cm.Kev siv cov hlau nqus kom kho pob txha tsis xws luag yooj yim, yooj yim, thiab muaj kev txhim khu kev qha cov kev kho mob.
Cov kab txuas dav hlau tuaj yeem ua tau ntxig lossis tawv, thiab lawv cov duab xws li cov plaub hau lossis cov block. Cov kab txuas dav hlau tuaj yeem txuas nrog cov protthesis los ntawm screws lossis tsau los ntawm cov pob txha xis. Qee cov kws tshawb fawb ntseeg tias cov pob txha ua kom tsis txhob muaj cov hlau thiab pom zoo cov pob txha sib xyaw ua ke. Qee cov kws tshawb fawb kuj tau tawm tswv yim ntawm txoj kev siv pob txha ua ntej thiab tom qab kev txhawb nqa nrog cov ntsia hlau nruab nrab ntawm lub raj raj thiab cov insthesis. Cov maum tsis xws luag feem ntau tshwm sim nyob rau hauv cov posterior thiab distal feem ntawm cov femoral condyle, yog li cov tog raj txuas dav yog feem ntau muab tso rau hauv qhov cub posior thiab distal ntawm cov poj niam lub siab. Rau txhaws pob txha tsis meej, wedges lossis blocks tuaj yeem raug xaiv los tsim kom yoog kom haum rau cov duab sib txawv. Cov ntawv xov xwm ntaub ntawv uas tau hais txog zoo heev thiab zoo yog qhov siab li 84% mus rau 98%.
Cov thaiv cov npoo npoo yog siv thaum cov pob txha pob txha yog wedge-puab, uas tuaj yeem khaws ntau dua cov pob txha host. Txoj kev no yuav tsum muaj tseeb osteotomy thiaj li hais tias osteotomy nto sib tw lub block. Ntxiv rau kev ntxhov siab compressive, tseem muaj cov khoom siv shear ntawm kev sib cuag. Yog li ntawd, lub kaum sab xis ntawm cov npoo yuav tsum tsis pub tshaj 15 °. Piv nrog cov nplais ntoo-puab thaiv, cov hlau sib tsoo muaj qhov tsis zoo ntawm kev ua haujlwm ntawm osteotomy, tab sis kev phais mob yooj yim thiab yooj yim, thiab cov txiaj ntsig zoo, thiab cov kev ua haujlwm yooj yim, thiab cov txiaj ntsig zoo, thiab cov nyhuv yooj yimIII-1-1A, b).
Naj npawbIII-1-1Hlau Lub Txiab: ib lub ntsej muag zoo li tus kab mob los kho cov tsis xws luag; B kem-puab cov kab txuas rau kev kho mob ntsuas
Vim tias cov kab hlau yog tsim hauv ntau cov duab thiab ntau thiab tsawg, lawv tau siv dav hauv cov pob txha uas tsis muaj xws li cov duab, thiab muab cov pob txha uas muaj kev ruaj khov. Txawm li cas los xij, kev tshawb nrhiav ntev ntev tau pom tias cov hlau txuas tsis poob vim kev tiv thaiv kev tiv thaiv. Piv nrog cov pob txha grafts, yog tias cov hlau txuas nrog thiab yuav tsum tau hloov kho, lawv yuav ua rau cov pob txha loj dua.
Lub Sijhawm Post: Oct-28-2024
