Pūnaehana Tibial Tuberosity Advancement (TTA): He ʻano hana ʻoki ʻoki hou no ka hoʻoponopono ʻana i ka ligament Canine Cruciate.
Hoʻolauna
ʻO ka anterior cruciate ligament (ACL) kekahi o nā ligaments i hōʻeha pinepine ʻia i ka lālā hope o ka canine, e alakaʻi ana i ka paʻa ʻole o ka hui, ʻeha, a me ka maʻi degenerative joint joint (DJD). Pono pinepine ʻia ka hana ʻokiʻoki e hoʻihoʻi i ke kūpaʻa a pale i ka pōʻino hou aʻe i ka hui. ʻO kekahi o nā ʻenehana hou loa no ka hoʻoponopono ʻana i ka canine ACL ʻo ia ʻo Tibial Tuberosity Advancement (TTA) ʻōnaehana, i loaʻa i ka kaulana ma muli o kona pono i ka hoʻomaikaʻi ʻana i ka hana hui, hōʻemi i ka ʻeha, a me ka hōʻemi ʻana i nā pilikia postoperative. Ma kēia ʻatikala, e ʻimi hohonu mākou i ka ʻōnaehana TTA, kona mau loina, nā noi, nā pōmaikaʻi, a me nā palena.
Anatomy a me Physiology o ka Canine Stifle Joint
Ma mua o ko mākou komo ʻana i ka ʻōnaehana TTA, he mea koʻikoʻi ka hoʻomaopopo ʻana i ke anatomy a me ka physiology o ka hui stifle canine. ʻO ka hui stifle ka mea like me ka hui kuli kanaka a ua hana ʻia me nā iwi femur, tibia, a me nā iwi patella. ʻO ka ACL ke kuleana no ka hoʻopaʻa ʻana i ka hui ma ka pale ʻana i ka tibia mai ka holo ʻana i mua e pili ana i ka femur. I loko o nā ʻīlio, aia ka ACL i loko o ka capsule hui a ua haku ʻia me nā fiber collagen e pili ana i ka iwi femur a me ka iwi tibia.
Pathogenesis o ka ACL Rupture i nā ʻīlio
Hiki i ka ACL rupture i nā ʻīlio ma muli o nā kumu like ʻole, me ka genetics, ka makahiki, ka momona, ka hana kino, a me ka trauma. I ka wā e haki ai ka ACL, e paheʻe ka iwi tibia i mua, e lilo ai ka hui i paʻa ʻole, a me ka hopena i ka ʻeha, ka mumū, a me ka DJD. ʻO ka hoʻokele Conservative, e like me ka hoʻomaha, ka lāʻau lapaʻau, a me ka hoʻomaʻamaʻa kino, hiki ke kōkua i ka hoʻohaʻahaʻa ʻana i ka ʻeha, akā ʻaʻole ia e hoʻoponopono i ka pilikia kumu o ka hui pū ʻana. Pono pinepine ʻia ka hana ʻokiʻoki e hoʻihoʻi i ke kūpaʻa a pale i ka pōʻino hou aʻe i ka hui.
Nā Kumu o ka Pūnaehana TTA
ʻO ka ʻōnaehana TTA kahi ʻenehana hana hou no ka hoʻoponopono ʻana i ka canine ACL e manaʻo nei e hoʻihoʻi i ke kūpaʻa hui ma o ka hoʻololi ʻana i ke kihi o ka pāpū tibial. ʻO ka pāpū tibial ka ʻili luna o ka iwi tibia e kamaʻilio me ka iwi femur e hana ai i ka ʻāʻī. I nā ʻīlio me ka haki ʻana o ka ACL, piʻi ka pāpū tibial i lalo, e hoʻoneʻe ai ka iwi tibia i mua e pili ana i ka iwi femur. ʻO ka ʻōnaehana TTA e pili ana i ka ʻoki ʻana i ka tuberosity tibial, ʻo ke koʻikoʻi o ka iwi ma lalo o ka hui kuli, a me ka neʻe ʻana i mua e hoʻonui i ke kihi o ka pāpū tibial. Hoʻopaʻa ʻia ka holomua me ka hoʻohana ʻana i ka hīnaʻi titanium a me nā screws, e hāpai ana i ka ho'ōla iwi a me ka hui ʻana.
Nā pōmaikaʻi o ka Pūnaehana TTA
Hāʻawi ka ʻōnaehana TTA i nā mea maikaʻi ma mua o nā ʻenehana hoʻoponopono ACL kuʻuna, e like me ka tibial plateau leveling osteotomy (TPLO) a me ka hoʻoponopono extracapsular. ʻO ka mea mua, ʻoi aku ka maikaʻi o ke kani biomechanically o ka ʻōnaehana TTA, no ka mea, hoʻololi ia i ke kihi o ka pāpū tibial e pale ai i ka hoʻouka ʻana o ka tibial i mua, ʻo ia ke kumu nui o ka haki ʻana o ACL. ʻO ka lua, mālama ka ʻōnaehana TTA i ka ACL maoli, e hōʻemi ana i ka pilikia o nā pilikia e like me ka maʻi, ka hana ʻole ʻana, a me ka hāʻule ʻole o ka implant. ʻO ke kolu, ʻo ka ʻōnaehana TTA ka mea e hiki ai i ka lawe ʻana i ke kaumaha a me ka hoʻoponopono hou ʻana, e hoʻomaikaʻi ai i ka hana hui a hoʻemi i ka manawa hoʻōla. ʻO ka hā, ua kūpono ka ʻōnaehana TTA no nā ʻīlio o nā ʻano nui a me nā ʻano like ʻole, no ka mea hiki ke hoʻololi ʻia i nā pono pilikino.
Nā palena o ka Pūnaehana TTA
E like me nā ʻano hana ʻokiʻoki, aia i ka ʻōnaehana TTA kona mau palena a me nā pilikia e hiki mai ana. ʻO ka hoʻopiʻi maʻamau ʻo ka implant hemahema, hiki ke hana ʻia ma muli o ke koʻikoʻi mechanical, ka maʻi, a i ʻole ka hoʻōla ʻana o ka iwi. Hiki i ka hemahema o ka implant ke alakaʻi i ka hui pū ʻana, ʻeha, a me ka pono no ka hoʻoponopono hou ʻana.
ʻO nā pilikia ʻē aʻe o ka ʻōnaehana TTA e pili ana i ka haʻihaʻi o ka tibial crest, tendonitis patellar, a me ka hui pū ʻana. Eia kekahi, ʻo ka ʻōnaehana TTA he ʻano hana ʻokiʻoki paʻakikī e koi ana i ka hoʻomaʻamaʻa kūikawā a me ka ʻike, hiki ke kaupalena i kona loaʻa ʻana i kekahi mau keʻena lapaʻau holoholona. Eia kekahi, ʻoi aku ka pipiʻi o ka ʻōnaehana TTA ma mua o nā ʻenehana hoʻoponopono ACL ʻē aʻe, ʻaʻole hiki ke hiki i kekahi mau mea mālama holoholona.
Nā Moho no ka Pūnaehana TTA
He kūpono ka ʻōnaehana TTA no nā ʻīlio me ka haki ʻana o ACL a me ka hui pū ʻana, a me nā mea me nā waimaka meniscal concurrent a i ʻole DJD. ʻO ka moho kūpono no ka ʻōnaehana TTA he ʻīlio me ke kaumaha o ke kino ma mua o 15 kg, ʻoiai ʻaʻole lawa ka iwi iwi i nā ʻīlio liʻiliʻi e kākoʻo i ka hale titanium. Eia kekahi, ʻaʻole ʻōlelo ʻia ka ʻōnaehana TTA no nā ʻīlio me ka patellar luxation koʻikoʻi, cranial cruciate ligament (CCL) degeneration, a i ʻole medial patellar luxation.
ʻO ka loiloi mua a me ka hoʻolālā
Ma mua o ke komo ʻana i ka ʻōnaehana TTA, pono ka ʻīlio e hana i ka loiloi mua o ka hana, me ka hoʻokolokolo kino piha, ke kiʻi radiographic, a me ka hoʻāʻo ʻana. Pono nā kiʻi radiographic e hoʻokomo i nā manaʻo a me nā hiʻohiʻona hiʻohiʻona e hoʻokuʻu i ka dysplasia āpau a i ʻole arthritis. Eia kekahi, pono e hoʻolālā pono ke kauka lapaʻau i ke kaʻina hana, me ka nui a me ke kūlana o ka hale titanium, ka nui o ka piʻi ʻana o ka tibial tuberosity, a me ke ʻano o ka anesthesia a me ka hoʻokele ʻeha.
ʻenehana ʻokiʻoki
ʻO ka ʻōnaehana TTA kahi ʻenehana koi ʻenehana e koi ai i ka hoʻomaʻamaʻa kūikawā a me ka ʻike. Hana ʻia ke ʻoki ma lalo o ka anesthesia maʻamau, a ua hoʻonoho ʻia ka ʻīlio ma ke kua. Hana ke kauka lapaʻau i kahi ʻoki ma luna o ka tuberosity tibial a wehe i ka tendon patellar mai ka tuberosity. A laila ʻoki ʻia ka tuberosity me ka hoʻohana ʻana i kahi ʻike kūikawā, a kau ʻia kahi hale titanium ma luna o ka ʻoki. Hoʻopaʻa ʻia ka hale paʻa me ka hoʻohana ʻana i nā screws, a hoʻopili hou ʻia ka tendon patellar i ka tuberosity. A laila nānā ʻia ka hui no ke kūpaʻa, a pani ʻia ka ʻoki ʻana me ka hoʻohana ʻana i nā sutures a i ʻole staples.
Ka mālama a me ka hoʻoponopono hou
Ma hope o ka ʻoki ʻana, kau ʻia ka ʻīlio ma luna o ka lāʻau ʻeha a me nā lāʻau antibiotic, a nānā ʻia ka hui no ka pehu, ʻeha, a i ʻole ka maʻi. Ua ʻae ʻia ka ʻīlio e amo i ke kaumaha ma ka lālā i hoʻopilikia ʻia ma hope koke o ke ʻoki ʻana, akā ua ʻōlelo ʻia ka hana kaohi ʻia no nā pule mua. Pono e mālama ʻia ka ʻīlio ma ke kaula a pale ʻia mai ka lele ʻana, ka holo ʻana, a me ka piʻi ʻana i ke alapiʻi. Pono e hoʻomaka ka hoʻomaʻamaʻa kino, me ka hoʻoikaika kino holoʻokoʻa a me ka hoʻoikaika kino ʻana, i loko o kekahi mau lā ma hope o ke kaʻina e hoʻomaikaʻi i ka hana hui a pale i ka atrophy ʻiʻo. Pono nā mākaʻikaʻi maʻamau me ke kauka lapaʻau e nānā i ke kaʻina hana ho'ōla a ʻike i nā pilikia e hiki mai ana.
Ka hopena
ʻO ka ʻōnaehana ʻo Tibial Tuberosity Advancement (TTA) kahi ʻenehana hana hou no ka hoʻoponopono ʻana i ka canine ACL e manaʻo nei e hoʻihoʻi i ka paʻa hui ma o ka hoʻololi ʻana i ke kihi o ka pāpū tibial. Hāʻawi ka ʻōnaehana TTA i nā mea maikaʻi ma mua o nā ʻenehana hoʻoponopono ACL kuʻuna, me ke kani biomechanical, mālama i ka ACL maoli, a me ka hoʻoponopono hou ʻana ma hope o ka hana. Eia nō naʻe, loaʻa i ka ʻōnaehana TTA kona mau palena a me nā pilikia e pono ai, a pono ia i ka hoʻomaʻamaʻa kūikawā a me ka ʻike. No laila, pono e hana ʻia ka hoʻoholo no ka hoʻokō ʻana i ka ʻōnaehana TTA ma hope o ka loiloi mua ʻana a me ke kūkākūkā ʻana me kahi kauka lāʻau lapaʻau kūpono.
