Sistemu Tibial Tuberosity Advancement (TTA): Usoro ịwa ahụ nke ọgbara ọhụrụ maka mmezi nke Canine Cruciate Ligament
Okwu mmalite
Ọkpụkpụ azụ azụ (ACL) bụ otu n'ime akwara ndị a na-emerụkarị na azụ azụ azụ azụ, na-eduga na nkwonkwo nkwonkwo, mgbu, na n'ikpeazụ ọrịa nkwonkwo degenerative (DJD). A na-achọkarị enyemaka ịwa ahụ iji weghachi nkwụsi ike ma gbochie mmebi ọzọ na nkwonkwo. Otu n'ime usoro ịwa ahụ kachasị ọhụrụ maka nrụzi ACL canine bụ usoro Tibial Tuberosity Advancement (TTA), nke nwetarala ewu ewu n'ihi irè ya n'ịkwalite ọrụ nkwonkwo, ibelata ihe mgbu, na ibelata nsogbu ndị na-esote postoperative. N'isiokwu a, anyị ga-enyocha miri emi n'ime usoro TTA, ụkpụrụ ya, ngwa ya, uru na njedebe.
Anatomi na Physiology nke nkwonkwo Canine Stifle
Tupu anyị abanye n'ime usoro TTA, ọ dị oke mkpa ịghọta ihe anatomi na physiology nke nkwonkwo stifle canine. Mkpịsị aka ahụ bụ ihe jikọrọ ikpere mmadụ ma bụrụ nke ọkpụkpụ femur, tibia, na ọkpụkpụ patella mejupụtara. ACL na-ahụ maka ime ka nkwonkwo kwụsie ike site n'igbochi tibia si na-aga n'ihu n'akụkụ femur. N'ime nkịta, ACL dị n'ime capsule nkwonkwo ma mejupụtara eriri collagen nke na-ejikọta na ọkpụkpụ femur na tibia.
Pathogenesis nke ACL mgbawa na Nkịta
Mgbawa ACL na nkịta nwere ike ime n'ihi ihe dị iche iche, gụnyere mkpụrụ ndụ ihe nketa, afọ, oke ibu, mmega ahụ, na trauma. Mgbe ACL na-agbaji, ọkpụkpụ tibia na-aga n'ihu, na-eme ka nkwonkwo ahụ ghara ịdị n'otu, na-akpata mgbu, mbufụt, na n'ikpeazụ DJD. Nlekọta nchekwa, dị ka izu ike, ọgwụ, na ọgwụgwọ anụ ahụ, nwere ike inye aka belata ihe mgbu, ma ọ dịghị edozi nsogbu dị n'okpuru nke nkwonkwo nkwonkwo. A na-achọkarị enyemaka ịwa ahụ iji weghachi nkwụsi ike ma gbochie mmebi ọzọ na nkwonkwo.
Ụkpụrụ nke Sistemụ TTA
Usoro TTA bụ usoro ịwa ahụ nke oge a maka nrụzi ACL canine nke na-achọ iweghachi nkwụsi ike nkwonkwo site n'ịgbanwe akụkụ nke tibial plateau. Plateau tibial bụ elu elu nke ọkpụkpụ tibia nke na-eji ọkpụkpụ femur na-akọwapụta ihe na-eme ka ọ bụrụ ihe nkwụsịtụ. N'ime nkịta nwere mgbawa ACL, tibial plateau na-agbadata ala, na-eme ka ọkpụkpụ tibia na-aga n'ihu n'akụkụ ọkpụkpụ femur. Usoro TTA na-agụnye igbutu tuberosity tibial, ọkpụkpụ ọkpụkpụ nke dị n'okpuru ikpere ikpere, ma na-aga n'ihu iji mee ka akụkụ nke tibial plateau dịkwuo elu. A na-eme ka ọganihu ahụ guzosie ike site na iji oghere titanium na kposara, nke na-akwalite ọgwụgwọ ọkpụkpụ na njikọ.
Uru nke Sistemụ TTA
Usoro TTA na-enye ọtụtụ uru karịa usoro nrụzi ACL ọdịnala, dị ka osteotomy plateau larịị osteotomy (TPLO) na nrụzi extracapsular. Nke mbụ, usoro TTA na-ada ụda nke ọma karị, ebe ọ na-agbanwe n'akuku nke tibial plateau iji gbochie ntugharị tibial na-aga n'ihu, nke bụ isi ihe kpatara nkwụsị ACL. Nke abụọ, usoro TTA na-echekwa ACL nke obodo, na-ebelata ihe ize ndụ nke nsogbu ndị dị ka ọrịa, nkwụsị aka, na ọdịda ịkụnye. Nke atọ, usoro TTA na-enye ohere maka ịmalite ibu ibu na nhazigharị nke mbụ, nke na-eme ka ọrụ nkwonkwo dịkwuo mma ma belata oge mgbake. Nke anọ, usoro TTA kwesịrị ekwesị maka nkịta nke nha na ụdị dị iche iche, n'ihi na enwere ike ịhazi ya maka mkpa onye ọ bụla.
Mgbochi nke Sistemụ TTA
Dị ka usoro ịwa ahụ ọ bụla, usoro TTA nwere njedebe ya na nsogbu ndị nwere ike ime. Mgbagwoju anya na-emekarị bụ ọdịda ịkụnye, nke nwere ike ime n'ihi nrụgide ọrụ, ọrịa, ma ọ bụ ọgwụgwọ ọkpụkpụ na-adịghị mma. Ọdịda nke etinyere nwere ike ibute nkwonkwo nkwonkwo, mgbu, na mkpa maka ịwa ahụ ngbanwe.
Nsogbu ndị ọzọ nwere ike ime na usoro TTA gụnyere mgbaji ọkpụkpụ tibial, tendonitis patellar, na nkwonkwo nkwonkwo. Na mgbakwunye, usoro TTA bụ usoro ịwa ahụ dị mgbagwoju anya nke chọrọ ọzụzụ na nka pụrụ iche, nke nwere ike belata ịdị adị ya na ụfọdụ ụlọ ọgwụ anụmanụ. Ọzọkwa, usoro TTA dị ọnụ karịa usoro mmezi ACL ndị ọzọ, nke nwere ike ọ gaghị ekwe omume maka ụfọdụ ndị nwe anụ ụlọ.
Ndị Candidates maka Sistemụ TTA
Usoro TTA dị mma maka nkịta nwere mgbawa ACL na nkwonkwo nkwonkwo, yana ndị nwere anya mmiri meniscal ma ọ bụ DJD. Onye kacha mma maka usoro TTA bụ nkịta nwere oke ahụ karịa 15 n'arọ, n'ihi na obere nkịta nwere ike ọ gaghị enwe oke ọkpụkpụ zuru oke iji kwado oghere titanium. Ọzọkwa, a naghị atụ aro usoro TTA maka nkịta nwere oke patellar luxation, nnukwu cranial cruciate ligament (CCL) degeneration, ma ọ bụ medial patellar luxation.
Ntụle na atụmatụ tupu ime ya
Tupu ịmalite usoro TTA, nkịta ahụ ga-enwerịrị nyocha nke ọma tupu oge eruo, gụnyere nyocha anụ ahụ zuru oke, onyonyo redio, na nyocha ụlọ nyocha. Onyonyo redio kwesịrị ịgụnye ma echiche nkwonkwo na-akpachi anya yana echiche hip iji kpochapụ dysplasia hip ma ọ bụ ogbu na nkwonkwo. Ọzọkwa, dọkịta na-awa ahụ kwesịrị iji nlezianya mee atụmatụ ịwa ahụ, gụnyere nha na ọnọdụ nke oghere titanium, ọnụ ọgụgụ nke ọganihu tuberosity tibial, na ụdị nrịanrịa na nchịkwa mgbu.
Usoro ịwa ahụ
Usoro TTA bụ usoro ịwa ahụ na-achọ teknụzụ nke chọrọ ọzụzụ na nka pụrụ iche. A na-arụ ọrụ ịwa ahụ n'okpuru mgbakasị izugbe, a na-edobe nkịta ahụ n'azụ azụ azụ. Dọkịta na-awa ahụ na-ebebe n'elu tuberosity tibial ma wepụ akaị patellar na tuberosity. A na-egbutu tuberosity ahụ site na iji nhịahụ pụrụ iche, a na-etinyekwa oghere titanium n'elu ịkpụ. A na-echekwa oghere ahụ site na iji kposara, a na-ejikọtakwa akwara patellar na tuberosity. A na-enyocha nkwonkwo ahụ maka nkwụsi ike, a na-emechikwa mbepụ ahụ site na iji sutures ma ọ bụ staples.
Nlekọta na mmezigharị arụ ọrụ mgbe arụchara ọrụ gasịrị
Mgbe ịwachara ahụ, a na-etinye nkịta ahụ na ọgwụ mgbu na ọgwụ nje, a na-enyocha nkwonkwo maka ọzịza, mgbu, ma ọ bụ ọrịa. A na-ahapụ nkịta ka ọ buru ibu na akụkụ ahụ emetụtara ozugbo a wachara ya ahụ, mana a na-akwado ọrụ mmachi maka izu ole na ole mbụ. Ekwesịrị idowe nkịta ahụ na ntanye ma gbochie ịwụ elu, ịgba ọsọ, ma ọ bụ ịrịgo steepụ. Usoro ọgwụgwọ anụ ahụ, gụnyere usoro mmegharị mmegharị ahụ na mmega ahụ a na-achịkwa, kwesịrị ịmalite n'ime ụbọchị ole na ole mgbe ịwachara ahụ iji melite ọrụ nkwonkwo ma gbochie atrophy muscle. Nleta na-esochi mgbe niile na dọkịta na-awa ahụ dị mkpa iji nyochaa usoro ọgwụgwọ ma chọpụta nsogbu ndị nwere ike ime.
Mmechi
Usoro Tibial Tuberosity Advancement (TTA) bụ usoro ịwa ahụ nke oge a maka nrụzi ACL canine nke na-achọ iweghachi nkwụsi ike nkwonkwo site n'ịgbanwe nkuku nke tibial plateau. Usoro TTA na-enye ọtụtụ uru karịa usoro nrụzi ACL ọdịnala, gụnyere ụda biomechanical, ichekwa ACL ala nna, na nhazigharị mmalite mgbe emechara ya. Otú ọ dị, usoro TTA nwere njedebe ya na nsogbu ndị nwere ike ime, ọ na-achọkwa ọzụzụ na nka pụrụ iche. Ya mere, a ga-eme mkpebi nke ịme usoro TTA mgbe nyochachara nke ọma na nyocha ya na onye dọkịta na-awa ahụ ruru eru.
