ACI - Autondous Chondrocyte Implantation

Maselo Osindikizidwa Amachititsa Kuwonongeka kwa Kateteti

Kumanga thupi lachilombo, kapena ACI, ndi ndondomeko yomwe inakhazikitsidwa kumapeto kwa zaka za m'ma 1980 kuti athetse kuwonongeka kwa kadoti pamondo. ACI imagwiritsidwanso ntchito mobwerezabwereza m'magulu ena, monga bulu, koma kawirikawiri imachitidwa pamondo.

Lingaliro la ndondomeko ya ACI ndikutenga maselo angapo a kadoti kuchokera pa bondo, kukulitsa iwo mu labu, ndipo kamodzi kamodzi ka maselo atakula mwakuya amalowetsedwa m'dera la kuwonongeka kwa kakoti.

Mwachidule

ACI ndi ndondomeko iwiri, ndikusowa opaleshoni iwiri masabata angapo. Maselo oyamba amakololedwa, ndiye amaikidwa.

Khwerero 1: Arthroscopy

Gawo loyamba la ACI ndi kuchita opaleshoni yodziwika bwino kuti mudziwe malo owonongeka a kanyumba, ndikudziwitseni ngati kuli koyenera njira ya ACI.

Pa njira yopangira nyamakazi, maselo a cartilage amasonkhanitsidwa. Maselo amenewa amatumizidwa ku labotolo yowonjezera maselo kumene amachulukitsidwa ndi kukula m'chikhalidwe. Kukula maselo okwanira kumatenga pafupifupi masabata anayi kapena asanu ndi limodzi. Maselo okwanira akakula, amatumizidwa kwa opaleshoniyo, ndipo opaleshoni yachiwiri imakonzedweratu.

Khwerero 2: Opaleshoni Yoyambitsa

Kamodzi kake kakang'ono kakang'ono kakang'ono kakulakitsidwa, opaleshoni yachiwiri imakonzedwa. Panthawi ya opaleshoniyi, chimbudzi chachikulu chimagwiritsidwa ntchito poona malo owonongeka kwa kanyumba (osati khunyu kakang'ono). Kuwombera kwachiwiri kumapangidwira pa fupa lasi ndi malo amodzi omwe amatchedwa periosteum amakololedwa.

Pulosisteum ndi minofu yambiri yomwe imaphatikizapo fupa. Chigawo cha "periosteal patch," pafupifupi kukula kwake kwa malo osokoneza bongo, chimakololedwa.

Chigamba cha periosteal chimadulidwa pamalo owonongeka. Kamodzi kokha chisindikizo cholimba chimakhazikitsidwa pakati pa chigamba ndi kanyumba kazungulira, maselo okhwimitsa amtundu omwe amaloledwa pansi pa chigambacho.

Chigamba cha periosteal chimagwiritsidwa ntchito kugwira maselo atsopano a kanyumba komwe kumakhala kuwonongeka kwa karotila.

Olemba

ACI ndizofunika kwambiri. Kuchulukitsa ndi kotalika, ndipo odwala ayenera kukhala okonzeka kuchita nawo mankhwala opatsirana . ACI ndi yoyenera kwa odwala omwe ali ndi madera aang'ono owononga khungu, osati chovala chokwanira cha kagawoti kamene kali ndi nyamakazi ya knee . Odwala akulingalira za ACI ayenera kukwaniritsa zochitika izi:

• Malo owonongeka a kadoti, osati ambiri a nyamakazi
• Kukhala ndi ululu kapena kutupa kumachepetsa ntchito yawo
• Bondo lokhazikika popanda kuwonongeka kwa ligament
• Kunenepa koyenerera kutalika (osati kunenepa)

Kuwonjezera pamenepo, odwala ayenera kuyesa mankhwala ena osamalidwa asanayambe kukambirana njirayi. Kuwonjezera pamenepo, odwala ayenera kumvetsetsa bwino ntchito yobwezeretsa ntchito kuchokera ku ACI opaleshoni. Gawo ili ndilofunika kwambiri kuti ndondomeko ya ACI ipambane. Popanda kuyambiranso bwino zotsatira zake nthawi zambiri sizingakhale zabwino.

Mavuto

Kupambana kwa ACI kumakhala kosiyana, ndi opaleshoni osiyana omwe amafotokoza zosiyanasiyana zosiyanasiyana. Chovuta kwambiri chimakhala chifukwa cha minofu yofiira pamphepete mwa chigawo cha periosteal, chotchedwa periosteal hypertrophy.

Vuto limeneli nthawi zambiri limafuna opaleshoni yowonjezera yowonjezera kuchotsa minofu yambiri.

Zovuta zina zikuphatikizapo kulephera kwa maselo opangidwa kuti agwirizane bwino, matenda a bondo, ndi kuuma kwa mawondo .

Kukonzekera

Kukonzekera kwa ACI kukufanana kwambiri ndi kukonzanso kumene kumayambira ma microfracture ndipo zimadalira kukula ndi malo a malo owonongeka. Mfundo zofunikira zowonongeka kuchokera kwa ACI ndi izi:

• Kulemera kwa kulemera kwa thupi: Kunenepa kumayenera kukhala kochepa pa malo opangira mafuta. Chifukwa cholepheretsa kulemera kwake ndi chakuti maselo ayenera kuloledwa kuti azigwirizana ndi dera lomwe lachita mchitidwe wa ACI.

  Mmene mungachepetse kulemera kwa dera la ACI kumadalira malo. Pamene ACI ili pa tibia (pamwamba pa fupa fupa) kapena femur (mapeto a ntchafu fupa), kulemera kuli kochepa pokhala wodwala amagwiritsa ntchito zingwe . Pamene ACI ili pamphepete (patella) kapena mkati mwa pulasitiki ya patella (trochlea), zoyendetsa ziyenera kuchepetsedwa chifukwa izi zidzachititsa kupanikizika pa maselo omwe alowetsedwa.

• Mtundu wa Maulendo: Nthaŵi zambiri kayendetsedwe ka kayendetsedwe kamangoyambika mofulumira pambuyo pa opaleshoni. Komabe, monga tafotokozera pamwambapa, ngati dera la ACI mankhwala lili pawondo kapena pansi, pamakhala masabata asanu ndi limodzi kapena asanu ndi atatu.

  Chifukwa choyambira kuyendayenda mwamsanga ndiko kuti kayendetsedwe kamene kamathandizira kukweza kukula kwa kadotila. Komabe, zotsatirazi ziyenera kukhala zolimbitsa ndi zovuta chifukwa cha kuyenda. Muyenera kutsatira mwatsatanetsatane malingaliro a dokotala wanu monga momwe adzakhalire okhudza kuvulaza kwanu ndi mankhwala.

Kulemera kwa thupi kumakhala kokha kwa masabata asanu ndi limodzi kapena asanu ndi atatu, kenako pang'onopang'ono kupita patsogolo. Pambuyo pa miyezi itatu kapena sikisi, maphunziro amatha kuwonjezeka ndi katundu. Zochitika zenizeni zamasewera zingayambike patatha miyezi 12 kuchokera opaleshoni. Othamanga ambiri samabwerera kumaseŵera onse mpaka pafupi miyezi 16 pambuyo pa opaleshoni.

_Zotsatira:

_{Jones DG, Peterson L. "Kupanga mavitamini ovomerezeka a Autologous chondrocyte" Instr Course Lect. 2007; 56: 429-45.}