Ekifo ky’ekinnansi: UKA prosthesis Overhang ejja kuleeta biki ebivaamu?

Okulongoosa amagumba mu kitundu ekimu (UKA) ngeri ya kulongoosa mu kifo ky’okulongoosa amagulu gonna (TKA) okujjanjaba obulwadde bw’amagumba mu kitundu ekimu. Wabula, ebikwata ku muwendo gw’okulemererwa kwa UKA biraga nti omuwendo gw’okuwangaala mu myaka 7 gwa bitundu 74%, nga kino kiri wansi nnyo okusinga ogwa TKA (92%). Wadde ng’ensonga z’abalwadde bennyini zongera ku bulabe bw’okulemererwa, gamba ng’abalwadde abato n’omuwendo gw’omubiri ogw’amaanyi (BMI) guyinza okwongera ku bulabe bw’okulemererwa kwa UKA, ensobi z’ekikugu mu kulongoosa zibadde zitwalibwa ng’ensonga enkulu ez’obulabe eri okulemererwa amangu. Mu UKA, kizibu okutuuka ku kukwatagana okulungi kw’ebitundu by’omubiri ebikoleddwa mu ngeri ey’ekinnansi n’okuwanvuwa waggulu (overhang). Ekisenge ky’omugongo (tibial prosthesis) kirina okuba n’obunene n’okuteekebwa mu ngeri ekendeeza ku kunyiiga kw’ebitundu ebigonvu, era okuwanvuwa kw’ekisambi okw’omu makkati okusukka mm 3 kiragiddwa okuba eky’obulabe ennyo eri okukendeeza ku Oxford Knee Score (OKS) n’okweyongera kw’obulumi. Ekigendererwa ekikulu eky’okunoonyereza kuno kyali kya kwekenneenya ebiva mu bujjanjabi n’okukuba ebifaananyi okutwalira awamu ebya UKA. Ekigendererwa ekyokubiri kyali kya kwekenneenya ekikolwa ky’obutakwatagana n’okugulu kw’ebitundu by’omubiri ebisukkulumye ku bulamu bw’okusimbibwa.Okulongoosa amagumba mu kitundu ekimu (UKA) ngeri ya kulongoosa mu kifo ky’okulongoosa amagumba gonna (TKA) okujjanjaba obulwadde bw’amagumba mu kitundu ekimu. Wabula, ebikwata ku muwendo gw’okulemererwa kwa UKA biraga nti omuwendo gw’okuwangaala mu myaka 7 gwa bitundu 74%, nga kino kiri wansi nnyo okusinga ogwa TKA (92%). Wadde ng’ensonga z’abalwadde bennyini zongera ku bulabe bw’okulemererwa, gamba ng’abalwadde abato n’omuwendo gw’omubiri ogw’amaanyi (BMI) guyinza okwongera ku bulabe bw’okulemererwa kwa UKA, ensobi z’ekikugu mu kulongoosa zibadde zitwalibwa ng’ensonga enkulu ez’obulabe eri okulemererwa amangu. Mu UKA, kizibu okutuuka ku kukwatagana okulungi kw’ebitundu by’omubiri ebikoleddwa mu ngeri ey’ekinnansi n’okuwanvuwa waggulu (overhang). Ekisenge ky’omugongo (tibial prosthesis) kirina okuba n’obunene n’okuteekebwa mu ngeri ekendeeza ku kunyiiga kw’ebitundu ebigonvu, era okuwanvuwa kw’ekisambi okw’omu makkati okusukka mm 3 kiragiddwa okuba eky’obulabe ennyo eri okukendeeza ku Oxford Knee Score (OKS) n’okweyongera kw’obulumi. Ekigendererwa ekikulu eky’okunoonyereza kuno kyali kya kwekenneenya ebiva mu bujjanjabi n’okukuba ebifaananyi okutwalira awamu ebya UKA. Ekigendererwa eky’okubiri kyali kya kwekenneenya ekikolwa ky’obutakwatagana bulungi n’okuwanvuwa kw’ebitundu by’omubiri ebikoleddwa mu ngeri ey’ekinnansi ku bulamu bw’ebintu ebiteekeddwa mu mubiri.

Enkola

Okunoonyereza kuno kwali kunoonyereza kwa kifo kimu okwalimu abalwadde abasajja n’abakazi abaakolebwako UKA ey’omu makkati mu kitongole kyaffe okuva mu January 2008 okutuuka mu December 2017, era abalwadde bonna baakola UKA nga bakozesa enkola eza bulijjo.Emisingi gy’okuggyibwako UKA gyalimu okulema kw’ennywanto okw’ekigero oba okw’amaanyi, obulwadde bw’enkizi mu kitundu ky’omugongo, okusengulwa kw’amagulu okw’emabega, n’obutabeera mu ntebenkevu. Ebivudde mu bujjanjabi n’okukuba ebifaananyi byafunibwa okuva mu kwekenneenya ebiwandiiko by’obujjanjabi n’ebifo eby’ebitongole. Femoral coronal and sagittal angles (FCA ne FSA) ne tibial coronal ne sagittal angles (TCA ne TSA) byapimibwa ku radiographs ku UKA zonna eza fixed-platform ne movable-platform, nga bwe kiragibwa.

Alizaati

Okugoberera okwa wakati kwali kwa myaka 4.9 (emyaka 0.03 okutuuka ku 10.2). Twazuula okulongoosa 36 okuddamu okulongoosebwa nga kwa myaka 3.7 (emyaka 0.03 okutuuka ku 8.7) oluvannyuma lw’okulongoosebwa ate nga omuwendo gw’okulemererwa okukuŋŋaanyizibwa gwali 14.2%. Okuwangaala kw’emyaka 5 kwali 88.0% (95% confidence interval [CI]=82.0% okutuuka ku 91.0%) ate okuwangaala okw’emyaka 10 kwali 70.0% (95% CI=56.0% okutuuka ku 80.0%).

Ensonga ezisinga okuvaako okuddamu okutunula zaali okukwatagana obubi/obutali bunywevu (31%), okulemererwa kw’ebyuma (22%), okukula kw’obulwadde bw’amagumba (14%), n’obulumi obutannyonnyolwa (8%).

Ebitundu 11.9% byokka ku UKAs bye byatuuka ku kukwatagana kwonna okwagala n’okubikka kw’ebitundu by’omubiri ebikolebwa mu ngeri ey’ekinnansi. Okugulumizibwa okw’omu maaso okw’ekiwanga tekyali kintu kya bulabe nnyo eri okulemererwa kwa UKA (10.0% omuwendo gw’okulemererwa, p=0.090), n’okuguluka okw’emabega okw’ekiwanga (25.0%, p=0.006) n’okuwanvuwa okw’omu makkati okw’ekiwanga (38.2%, p<0.001) byali bintu bya bulabe nnyo eri UKA okulemererwa.

Okwogerako

Mu kunoonyereza kuno, twekenneenya ebiva mu bujjanjabi n’okukuba ebifaananyi mu UKA ey’omu makkati n’enkosa y’okukwatagana kw’ebitundu by’omubiri ebikoleddwa mu ngeri ey’ekinnansi n’okuwanvuwa. Emiwendo gy’okuwangaala mu myaka 5 ne 10 gyali 88% ne 70%, era gyali wansi nnyo okusinga ku TKA. ebisinga okulaga nti bigenda kuddamu okutunulwamu byali nti ebitundu by’omubiri ebitali bituufu tebikwatagana bulungi, ebyuma okulemererwa, n’okukula kw’obulwadde bw’amagumba. Okukwatagana obubi kw’ebitundu by’omubiri ebikola omubiri n’okuwanvuwa okw’emabega n’okw’omu makkati bye bintu ebikulu eby’akabi eri okuddamu okutunula mu UKA.

Mu biwandiiko ebifulumiziddwa, ebikulu ebibiri ebivaako UKA okulemererwa kwe kusumululwa kw’obutafaali (aseptic loosening) n’okukulaakulana kw’amagumba, nga byombi birina ensaasaanya y’emigugu etali ya bwenkanya, ekiraga nti ebivaako UKA okulemererwa ebyogeddwako waggulu biyinza okuba nga bya makanika mu butonde. Obujulizi buno bulaga nti okukwatagana obubi kw’ebitundu by’omubiri ebikola omubiri (prosthesis) kye kiyinza okuvaako UKA okulemererwa amangu. N’olwekyo, tukkiriza nti kaweefube alina okukolebwa okulongoosa obukodyo bw’okulongoosa okulongoosa okukwatagana kw’ebitundu by’omubiri eby’ekika kya UKA n’okukendeeza ku kubeerawo kw’okuwanvuwa.

Ebizuuliddwa mu kiseera kino biraga nti akakwate ak’amaanyi wakati w’okukwatagana obubi/okuwanvuwa kw’ebitundu by’omubiri ebitali bimu n’akabi k’okuddamu okutunula kiraga enkola eyinza okubaawo ku muwendo gw’okulemererwa ogw’amaanyi ogwalabibwa mu kunoonyereza kuno. Obusobozi bw’omusawo alongoosa okubeera omutuufu obutakyukakyuka mu kuteeka ekiwanga ky’omubiri (prosthesis) nsonga nkulu mu kuyamba okulongoosa emiwendo gy’abalamu mu UKA.

Engeri y'okugulamu amagumba agateekebwamu amagumba n'ebikozesebwa mu kuzimba amagumba) .

A CZMEDITECH , tulina ekintu ekijjuvu ennyo eky'ebintu ebiteekebwa mu kulongoosa amagumba n'ebikozesebwa ebikwatagana, ebintu omuli Ebisimbibwa omugongo ., Emisumaali egy'omu lubuto ., Ekipande ky’okulumwa obuvune ., Essowaani y’okusiba ., Omutwe-Maxillofacial ., Prosthesis ., Ebikozesebwa mu maanyi ., Abatereeza eby’ebweru ., Okukebera ebinywa ., Obulabirizi bw’ebisolo n’ebikozesebwa byabwe ebibayamba.

Okugatta ku ekyo, twewaddeyo okukola ebintu ebipya obutasalako n’okugaziya layini z’ebintu, okusobola okutuukiriza ebyetaago by’okulongoosa eby’abasawo n’abalwadde abawera, era n’okufuula kkampuni yaffe okuvuganya ennyo mu nsi yonna ey’amagumba n’amakolero g’amagumba.

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