Osteochondritis dissecans, omwe nthawi zambiri amatchedwa OCD mwachidule, ndi chikhalidwe chomwe chimayambitsa kutulutsa khungu ndi mafupa ake. OCD kaŵirikaŵiri imapezeka pamagolo, ngakhale kuti ikhoza kuchitika m'magulu ena kuphatikizapo bondo ndi chigoba.
Chifukwa cha OCD sichimveka bwino. Chimene chimachitika kwa odwala omwe ali ndi OCD, ndikuthamanga kwa magazi kumphongo kuzungulira palimodzi kumakhala kosazolowereka.
Akatswiri ambiri apeza kuti chifukwa cha kusokonezeka kwa magazi, ndipo akuganiza kuti ndi ofanana ndi kubwezeretsa nkhawa kapena kuvulaza mafupa. Pamene magazi akupita ku fupa amachepetsedwa, karotilayi imatha kusiyana ndi fupa.
Mbalame Yogwirizana
Cartilage yokhazikika ndi yofunika kukhala ndi mgwirizano womwe umayenda bwino komanso wopanda ululu. Pamene karoti yowonongeka, mavuto ambiri angabwere. M'mawonekedwe oyenera, mawonekedwe a cartilage omwe ndi ma millimita angapo akuda kwambiri amavala mapafu. Katemera wamba ndi wosalala komanso woderera komanso wokhudzana kwambiri ndi fupa lakuya.
Odwala omwe ali ndi OCD amakhala osasinthasintha magazi kupita ku fupa lozungulira. Kuperewera kwa kayendedwe ka magazi kumapweteka mafupa omwe amathandiza mchere wambiri. Izi zingapangitse fupa kukhala chidutswa ndi karotila kuti asiyane ndi chida chake chokhazikika.
Oxic lesion ('zilonda' ndi cartilage ndipo fupa lililonse lophatikizidwa ndi chidutswa cha cartilage) akhoza kumasula ndi kuchoka pamtanda pamwamba. Zizindikiro zoopsa zikhoza kuchitika pamene pali chidutswa cha karoti choyandama chozungulira.
Zizindikiro za OCD wa Knee
Zizindikiro za OCD ndizo:
- Kutseka kothamanga
- Kukhazikika kwa mgwirizano
Kuchiza kwa OCD wa Knee
Pali zifukwa zingapo zomwe ziyenera kuganiziridwa pakuwona chithandizo chabwino cha OCD.
M'badwo Wodwala: Chinthu chofunika kwambiri cholosera ndi zaka za wodwalayo. Odwala omwe ali ndi mabala otsegula (ana ndi achinyamata) ali ndi matenda abwino kwambiri ochiritsa OCD ndi mankhwala opaleshoni komanso osapereka chithandizo.
Kukula ndi Malo: Zagawo zazikulu ndi zidutswa zikuluzikulu m'zigawo zovuta kwambiri za mgwirizano nthawi zambiri zimagwiritsidwa ntchito mopitirira muyeso ndi opaleshoni.
Mgwirizano wa Kugawidwa / Kutchinga: Zagawo za OCD zimagwiritsidwa ntchito kukhala zowakhazikika kapena zosasunthika, malingana ndi kuthekera kwa chidutswa chosiyana ndi fupa. Zidutswa zosasunthika zomwe zimakhala zovuta kugawikana nthawi zambiri zimakonzedweratu. Zagawo zokhazikika zimatha kuchiza ndi mankhwala ochepa.
Malinga ndi kuphatikiza kwazifukwa, dokotala wanu wa opaleshoni amatha kupanga uphungu wa mankhwala. Pamene chidutswa cha OCD chingachiritse, chithandizo chopanda opaleshoni chingakhale chogwira ntchito. Ngakhale adokotala angakulimbikitseni mankhwala oundana , anti-inflammatory , ndi mankhwala ena amachiritso, mbali yovuta ya chithandizo chopanda opaleshoni ndi kupuma pamodzi kuti mulole kuchiritsidwa.
Izi zikutanthauza kuchepetsa ntchito ndipo zingatanthawuze kugwiritsa ntchito zikhoto kuti muchepetse kulemera.
Cholinga cha chithandizo cha opaleshoni ndicho kukhala ndi kanyumba kokhala pamtunda. Ngati amaganiza kuti fragment ikhoza kuchiza, dokotala wanu akhoza kuyesa kukonzanso vuto la OCD, nthawi zambiri pogwiritsira ntchito zikopa kapena mapepala kuti agwire chidutswacho. Zokopa zamakono ndi mapepala amapangidwa ndi bioabsorbable material (osati zitsulo) kotero kuti sangayambitse mavuto a m'tsogolo kumalo otsekemera.
Ngati mwayi wochiritsidwa ndi wotsika, khungu lotayirira lidzachotsedwa pa bondo, ndipo chithandizocho chidzapangika kukulitsa kukula kwa kanyumba katsopano pamtunda.
Pali njira zingapo zomwe zingayesetse kukweza katemera watsopano, ndipo aliyense ali ndi ubwino ndi zokwanira:
Kuchulukitsa Microfracture : Kuchita opaleshoni ya microfracture ikuchitidwa pofuna kuti magazi alowe m'malo owonongeka, omwe angalole kuti tizilombo timachiritse. Mankhwalawa sagwiritsidwa ntchito mobwerezabwereza kwa OCD achinyamata chifukwa sagwiritsanso ntchito nthawi.
OATS / Mtembo Wosakaniza : Mankhwala othandizira mafuta a mchere amachititsa khunyu ndi mafupa kuchokera kumalo osakaniza omwe safunikira katsamba komwe kumakhala kovulaza .
Autologous Chondrocyte Implantation (ACI) : ACI ndi njira yomwe imakula maselo a kadoti mu labata, ndiyeno imayika kaloti kakang'ono kumene kakangoyamba kumene.
> Zotsatira:
> Chambers HG, et al. "Kuzindikira ndi Chithandizo cha Osteochondritis Dissecans" J Am Acad Orthop Surgery May 2011 vol. 19 ayi. 5 297-306.
> Crawford DC ndi Safran MR. "Osteochondritis Dissecans a Knee" J Am Acad Orthop Surgery February 2006 vol. 14 ayi. 2 90-100