Prosthesis gyinabea: UKA prosthesis Overhang de nea ebefi mu aba bɛn na ɛde bɛba?

Nnompe mu ntini a wɔde si baabi biako (UKA) yɛ oprehyɛn a wɔde si kotodwe mu ntini a wɔde yɛ no nyinaa ananmu (TKA) a wɔde sa nnompe mu yare a ɛwɔ baabi biako. Nanso, nsɛm a ɛfa UKA huammɔdi dodow ho kyerɛ sɛ mfe 7 nkwa nna yɛ 74%, a ɛba fam koraa sen TKA de no (92%). Ɛwom sɛ ayarefo ankasa nneɛma ma asiane a ɛwɔ hɔ sɛ wobedi nkogu no yɛ kɛse, te sɛ ayarefo nkumaa ne nipadua mu duru a ɛkɔ soro (BMI) betumi ama asiane a ɛwɔ hɔ sɛ UKA bedi nkogu no ayɛ kɛse de, nanso wɔabu oprehyɛn mu mfiridwuma mu mfomso ahorow sɛ asiane a ɛho hia ma huammɔdi ntɛm. Wɔ UKA no, ɛyɛ den sɛ wobenya prosthetic alignment ne overhang (overhang) a eye sen biara. Ɛsɛ sɛ wɔyɛ tibial prosthesis no kɛse na wɔde hyɛ mu wɔ ɔkwan a ɛbɛma ntini a ɛyɛ mmerɛw no ayɛ mmerɛw so, na wɔada no adi sɛ medial tibial overhang bɛboro mm 3 no yɛ asiane kɛse a ɛma Oxford Knee Score (OKS) so tew na ɛyaw no kɔ soro. Na nhwehwɛmu yi botae titiriw ne sɛ wɔbɛhwehwɛ nea efi UKA mu ba wɔ ayaresabea ne mfoniniyɛ mu nyinaa mu. Na botae a ɛto so abien ne sɛ wɔbɛhwɛ nkɛntɛnso a prosthetic malalignment ne overhang nya wɔ implant nkwagye so.Unicompartmental knee arthroplasty (UKA) yɛ oprehyɛn a wɔde si kotodwe a wɔde yɛ no nyinaa ananmu (TKA) de sa unicompartmental osteoarthritis. Nanso, nsɛm a ɛfa UKA huammɔdi dodow ho kyerɛ sɛ mfe 7 nkwa nna yɛ 74%, a ɛba fam koraa sen TKA de no (92%). Ɛwom sɛ ayarefo ankasa nneɛma ma asiane a ɛwɔ hɔ sɛ wobedi nkogu no yɛ kɛse, te sɛ ayarefo nkumaa ne nipadua mu duru a ɛkɔ soro (BMI) betumi ama asiane a ɛwɔ hɔ sɛ UKA bedi nkogu no ayɛ kɛse de, nanso wɔabu oprehyɛn mu mfiridwuma mu mfomso ahorow sɛ asiane a ɛho hia ma huammɔdi ntɛm. Wɔ UKA no, ɛyɛ den sɛ wobenya prosthetic alignment ne overhang (overhang) a eye sen biara. Ɛsɛ sɛ wɔyɛ tibial prosthesis no kɛse na wɔde hyɛ mu wɔ ɔkwan a ɛbɛma ntini a ɛyɛ mmerɛw no ayɛ mmerɛw so, na wɔada no adi sɛ medial tibial overhang bɛboro mm 3 no yɛ asiane kɛse a ɛma Oxford Knee Score (OKS) so tew na ɛyaw no kɔ soro. Na nhwehwɛmu yi botae titiriw ne sɛ wɔbɛhwehwɛ nea efi UKA mu ba wɔ ayaresabea ne mfoniniyɛ mu nyinaa mu. Na botae a ɛto so abien ne sɛ wɔbɛhwɛ nkɛntɛnso a afiri a wɔde yɛ nipadua no a ɛnyɛ pɛpɛɛpɛ ne nea ɛsensɛn so nya wɔ nkwa a wɔde hyɛ nipadua mu no so.

Akwan a wɔfa so yɛ

Saa nhwehwɛmu yi yɛ nhwehwɛmu a wɔyɛe wɔ beaeɛ baako a ɛfa mmarima ne mmaa ayarefoɔ a wɔyɛɛ wɔn medial UKA wɔ yɛn asoɛeɛ no mu firi Ɔpɛpɔn 2008 kɔsi December 2017, na ayarefoɔ no nyinaa yɛɛ UKA denam akwan a wɔahyɛ da ayɛ so.Exclusion criteria for UKA no bi ne valgus deformity a ɛkɔ fam kɔsi kɛseɛ, patellofemoral compartment arthritis, posterior tibial displacement, ne instability. Wonyaa nea efii ayaresabea ne mfoninitwa mu bae fii nhwehwɛmu a wɔyɛe wɔ ayaresabea kyerɛwtohɔ ne asoɛe ahorow mu nsɛm a wɔakora so no akyi. Wɔsusuu femoral coronal ne sagittal angles (FCA ne FSA) ne tibial coronal ne sagittal angles (TCA ne TSA) wɔ radiographs so maa fixed-platform ne movable-platform UKAs nyinaa, sɛnea wɔakyerɛ no.

Nsunsuansoɔ

Nnipa a wodii wɔn akyi no yɛ mfe 4.9 (mfe 0.03 kosi 10.2). Yɛhunuu oprehyɛn 36 a wɔsan yɛeɛ a sɛ wɔkyekyɛ mu a, ɛyɛ mfeɛ 3.7 (mfeɛ 0.03 kɔsi 8.7) wɔ oprehyɛn no akyi na ne huammɔdi dodoɔ a wɔaboaboa ano yɛ 14.2%. Mfeɛ 5 nkwa nna yɛ 88.0% (95% ahotosoɔ ntamgyinafoɔ [CI]=82.0% kɔsi 91.0%) na mfeɛ 10 nkwa yɛ 70.0% (95% CI=56.0% kɔsi 80.0%).

Nneɛma a ɛtaa ma wɔsan hwɛɛ mu ne nipadua a wɔde yɛ nipadua no a ɛnyɛ pɛpɛɛpɛ/entumi nnyina (31%), mfiri a entumi nyɛ adwuma yiye (22%), nnompe mu yare a ɛkɔ so (14%), ne ɛyaw a wontumi nkyerɛkyerɛ mu (8%).

UKAfoɔ 11.9% pɛ na wɔtumi nyaa alignment ne prosthetic coverage a wɔpɛ nyinaa. Anterior overhang of the prosthesis no nyɛ asiane titiriw a ɛbɛma UKA adi nkogu (10.0% huammɔdi dodow, p=0.090), na akyi overhang of the prosthesis (25.0%, p=0.006) ne medial overhang of the prosthesis (38.2%, p<0.001) yɛ asiane kɛse a ɛma UKA di nkogu.

Pɛnsɛpɛnsɛ mu

Wɔ saa nhwehwɛmu yi mu no, yɛhwehwɛɛ nea efi medial UKA mu ba wɔ ayaresabea ne mfoniniyɛ mu ne nkɛntɛnso a prosthetic alignment ne overhang nya no mu. Mfeɛ 5 ne 10 nkwa nna yɛ 88% ne 70%, na na ɛba fam koraa sene TKA. na nneɛma a wɔtaa kyerɛ sɛ wɔbɛsan ahwɛ mu ne sɛnea nnompe a wɔde yɛ nipadua no nhyia yiye, mfiri a entumi nyɛ adwuma yiye, ne nnompe mu yare a ɛkɔ so yɛ kɛse. Prosthesis a ɛnyɛ pɛpɛɛpɛ ne akyi ne mfinimfini overhang yɛ asiane ahorow a ɛho hia ma UKA revision.

Wɔ nhoma ahorow a wɔatintim mu no, nneɛma atitiriw abien a ɛde UKA di huammɔ ne aseptic loosening ne osteoarthritic progression, a abien no nyinaa wɔ adesoa kyekyɛ a ɛnteɛ, na ɛkyerɛ sɛ ebia nneɛma a yɛaka ho asɛm wɔ atifi hɔ a ɛde UKA di huammɔ no yɛ mfiri. Saa adanse yi kyerɛ sɛ afiri a wɔde yɛ nipadua no a ɛnyɛ pɛpɛɛpɛ no yɛ ade a ebetumi ama UKA adi nkogu ntɛm. Enti, yegye di sɛ ɛsɛ sɛ wɔbɔ mmɔden sɛ wɔbɛma oprehyɛn akwan atu mpɔn na ama UKA prosthesis a ɛne ne ho hyia no atu mpɔn na wɔatew overhang a ɛba no so.

Mprempren nea wɔahu no kyerɛ sɛ abusuabɔ a emu yɛ den a ɛda prosthesis a ɛnyɛ pɛpɛɛpɛ/overhang ne asiane a ɛwɔ hɔ sɛ wɔbɛsan ahwɛ mu no ntam no kyerɛ sɛ ɔkwan bi betumi aba ama huammɔdi dodow a ɛkɔ soro a wɔahu wɔ nhwehwɛmu yi mu no. Tumi a oduruyɛfo a ɔyɛ oprehyɛn no tumi yɛ pɛpɛɛpɛ bere nyinaa wɔ afiri a wɔde yɛ nipadua no a wɔde si hɔ no mu no yɛ ade titiriw a ɛboa ma UKA nkwa nna tu mpɔn.

Sɛnea Wɔtɔ Nnompe a Wɔde Si Nnompe Mu ne Nnompe Ho Nnwinnade!

Ma CZMEDITECH , yɛwɔ nneɛma a edi mũ yiye a ɛyɛ nnompe oprehyɛn a wɔde hyɛ nipadua mu ne nnwinnade a ɛne no hyia, nneɛma no ka ho akyi berɛmo mu nneɛma a wɔde hyɛ nipadua mu, nnadewa a ɛwɔ medullary mu, trauma mprɛte, mprɛte a wɔde to mu, cranial-maxillofacial a ɛwɔ anim, afiri a wɔde yɛ nipadua no, nnwinnade a wɔde anyinam ahoɔden yɛ, abɔnten so fixators, ntini mu nhwehwɛmu, mmoa ho ayaresa ne nnwinnade a wɔde boa wɔn.

Bio nso, yɛasi yɛn bo sɛ yɛbɛkɔ so ayɛ nneɛma foforo na yɛatrɛw nneɛma ahorow mu, sɛnea ɛbɛyɛ a yebedi nnuruyɛfo ne ayarefo pii oprehyɛn ahiade ho dwuma, na yɛama yɛn adwumakuw no nso asi akan kɛse wɔ wiase nyinaa nnompe a wɔde hyɛ nipadua mu ne nnwinnade adwuma no nyinaa mu.

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