Ke kūlana Prosthesis: UKA prosthesis Overhang e lawe mai i nā hopena?

ʻO ka unicompartmental knee arthroplasty (UKA) kahi ʻokoʻa ʻokoʻa i ka holo ʻana o ke kuli kuli (TKA) no ka mālama ʻana i ka osteoarthritis unicompartmental. Eia naʻe, hōʻike ka ʻikepili i ka helu hāʻule o UKA i ka helu ola 7 makahiki o 74%, ʻoi aku ka haʻahaʻa ma mua o ka TKA (92%). ʻOiai ʻo nā kumu ponoʻī o ka poʻe maʻi e hoʻonui i ka pilikia o ka hāʻule ʻole, e like me nā poʻe maʻi ʻōpio a me ka helu helu kino kiʻekiʻe (BMI) hiki ke hoʻonui i ka pilikia o ka hiki ʻole o ka UKA, ua manaʻo ʻia nā hewa ʻenehana i nā mea koʻikoʻi koʻikoʻi no ka hāʻule mua. Ma UKA, paʻakikī ka hoʻokō ʻana i ka alignment prosthetic maikaʻi loa a me ka overhang (overhang). Pono e hoʻonui ʻia ka prosthesis tibial a hoʻokomo ʻia i ke ʻano e hōʻemi ai i ka hoʻonāukiuki ʻana o ka ʻiʻo palupalu, a ʻo ka medial tibial overhang ʻoi aku ma mua o 3 mm ua hōʻike ʻia he kumu pilikia nui no ka emi ʻana o ka Oxford Knee Score (OKS) a me ka hoʻonui ʻana i ka ʻeha. ʻO ka pahuhopu nui o kēia noiʻi ʻana ʻo ia ka loiloi i nā hopena lapaʻau āpau a me nā kiʻi kiʻi o UKA. ʻO ka pahuhopu lua, ʻo ia ka nānā ʻana i ka hopena o ka prosthetic malalignment a me ka overhang ma luna o ke ola implant. ʻO ka unicompartmental knee arthroplasty (UKA) he mea ʻokoʻa ʻē aʻe i ka holoʻokoʻa o ke kuli arthroplasty (TKA) no ka mālama ʻana i ka osteoarthritis unicompartmental. Eia naʻe, hōʻike ka ʻikepili i ka helu hāʻule o UKA i ka helu ola 7 makahiki o 74%, ʻoi aku ka haʻahaʻa ma mua o ka TKA (92%). ʻOiai ʻo nā kumu ponoʻī o ka poʻe maʻi e hoʻonui i ka pilikia o ka hāʻule ʻole, e like me nā poʻe maʻi ʻōpio a me ka helu helu kino kiʻekiʻe (BMI) hiki ke hoʻonui i ka pilikia o ka hiki ʻole o ka UKA, ua manaʻo ʻia nā hewa ʻenehana i nā mea koʻikoʻi koʻikoʻi no ka hāʻule mua. Ma UKA, paʻakikī ka hoʻokō ʻana i ka alignment prosthetic maikaʻi loa a me ka overhang (overhang). Pono e hoʻonui ʻia ka prosthesis tibial a hoʻokomo ʻia i ke ʻano e hōʻemi ai i ka hoʻonāukiuki ʻana o ka ʻiʻo palupalu, a ʻo ka medial tibial overhang ʻoi aku ma mua o 3 mm ua hōʻike ʻia he kumu pilikia nui no ka emi ʻana o ka Oxford Knee Score (OKS) a me ka hoʻonui ʻana i ka ʻeha. ʻO ka pahuhopu nui o kēia noiʻi ʻana ʻo ia ka loiloi i nā hopena lapaʻau āpau a me nā kiʻi kiʻi o UKA. ʻO ka pahuhopu lua ʻo ia ka loiloi i ka hopena o ka malalignment prosthetic a me ka overhang i ke ola implant.

Nā ʻano hana

ʻO kēia haʻawina he haʻawina hoʻokahi i hoʻokomo ʻia i nā kāne a me nā wahine maʻi i loaʻa i ka UKA medial ma kā mākou keʻena mai Ianuali 2008 a hiki i Dekemaba 2017, a ua loaʻa nā maʻi āpau i UKA me ka hoʻohana ʻana i nā ʻano maʻamau. Ua loaʻa nā hopena maʻi a me nā kiʻi mai kahi loiloi retrospective o nā moʻolelo lapaʻau a me nā waihona waihona. Ua ana ʻia nā kihi Femoral coronal a me sagittal (FCA a me FSA) a me tibial coronal a me nā kihi sagittal (TCA a me TSA) ma nā radiographs no nā UKA paʻa paʻa a me ka movable-platform UKA, e like me ka mea i hōʻike ʻia.

Ka hopena

ʻO ka maʻamau o ka hahai ʻana he 4.9 mau makahiki (0.03 a 10.2 mau makahiki). Ua ʻike mākou i 36 mau hana hoʻoponopono hou me ka mean o 3.7 mau makahiki (0.03 a 8.7 mau makahiki) ma hope o ka hana a me ka huina o ka hemahema o 14.2%. ʻO 5-makahiki ola he 88.0% (95% confidence interval [CI] = 82.0% a hiki i 91.0%) a he 10-makahiki ola he 70.0% (95% CI = 56.0% a 80.0%).

ʻO nā kumu maʻamau o ka hoʻoponopono ʻana, ʻo ia ka alignment prosthesis maikaʻi ʻole / paʻa ʻole (31%), ka hana ʻole o ka mīkini (22%), ka piʻi ʻana o ka osteoarthritis (14%), a me ka ʻeha i wehewehe ʻole ʻia (8%).

ʻO 11.9% wale nō o nā UKA i loaʻa i ka alignment makemake a me ka uhi prosthetic. ʻAʻole ʻo ka hoʻokuʻu mua ʻana o ka prosthesis i mea koʻikoʻi koʻikoʻi no ka hāʻule ʻana o UKA (10.0% failure rate, p = 0.090), a me ka overhang hope o ka prosthesis (25.0%, p = 0.006) a me ka overhang medial o ka prosthesis (38.2%, p<0.001) he mau mea pilikia nui no ka UKA hemahema.

Kūkākūkā

I loko o kēia haʻawina, ua loiloi mākou i nā hopena lapaʻau a me nā kiʻi o ka medial UKA a me ka hopena o ka alignment prosthetic a me ka overhang. ʻO 5- a me 10-makahiki ola ola he 88% a me 70%, a ua emi loa ma mua o ka TKA. ʻO nā hōʻailona maʻamau no ka hoʻoponopono ʻana, ʻo ia ka alignment prosthetic maikaʻi ʻole, ka hemahema mechanical, a me ka piʻi ʻana o ka osteoarthritis. ʻO ka alignment prosthesis maikaʻi ʻole a me ka postterior a me ka medial overhang nā kumu pilikia nui no ka hoʻoponopono UKA.

I loko o nā puke i paʻi ʻia, ʻo nā kumu nui ʻelua o ka hāʻule ʻana o ka UKA ʻo ia ka aseptic loosening a me ka holomua osteoarthritic, ʻo ia mau mea ʻelua i ka puʻunaue like ʻole, e manaʻo ana ʻo nā kumu i ʻōlelo ʻia ma luna o ka UKA hiki ʻole ke ʻano mechanical. Ke hōʻike nei kēia hōʻike i ka maikaʻi ʻole o ka alignment prosthesis kahi kumu kūpono o ka hiki ʻole o ka UKA mua. No laila, ke manaʻoʻiʻo nei mākou e hoʻoikaika ʻia ka hoʻomaikaʻi ʻana i nā ʻenehana hana e hoʻomaikaʻi i ka alignment prosthesis UKA a hoʻemi i ka hiki ʻana o ka overhang.

Hōʻike nā ʻike i kēia manawa ʻo ka hui ikaika ma waena o ka alignment prosthesis maikaʻi ʻole / overhang a me ka pilikia o ka hoʻoponopono hou ʻana e hōʻike ana i kahi hana kūpono no ka nui o ka hemahema i ʻike ʻia ma kēia noiʻi. ʻO ka hiki i ke kauka lapaʻau ke pololei mau i ka hoʻokomo ʻana i ka prosthesis he mea nui ia i ke kōkua ʻana i ka hoʻomaikaʻi ʻana i nā helu ola UKA.

Pehea e kūʻai aku ai i nā mea hoʻokomo orthopedic a me nā mea hana orthopedic?

No ka mea CZMEDITECH , loaʻa iā mākou kahi laina huahana piha loa o nā implants orthopedic surgery a me nā mea hana like, nā huahana me implants iwi kuamoʻo, nā kui intramedullary, pāʻehaʻeha, pā paʻa, cranial-maxillofacial, hoʻopaʻapaʻa, mea hana mana, nā mea hoʻoponopono waho, ʻāʻili ʻāʻī, mālama lāʻau lapaʻau a me kā lākou mau mea hana kākoʻo.

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