Tibial Tuberosity Advancement System (TTA): Njira Yamakono Yopangira Opaleshoni ya Canine Cruciate Ligament Repair
Mawu Oyamba
The anterior cruciate ligament (ACL) ndi imodzi mwa mitsempha yomwe imavulazidwa kwambiri m'mphepete mwa canine, zomwe zimayambitsa kusakhazikika kwa mgwirizano, kupweteka, ndipo pamapeto pake matenda olowa m'thupi (DJD). Kuchita opaleshoni nthawi zambiri kumafunika kubwezeretsa bata ndikuletsa kuwonongeka kwina kwa mgwirizano. Imodzi mwa njira zamakono zopangira opaleshoni yokonza canine ACL ndi dongosolo la Tibial Tuberosity Advancement (TTA), lomwe ladziwika bwino chifukwa cha mphamvu zake popititsa patsogolo ntchito zogwirizanitsa, kuchepetsa ululu, ndi kuchepetsa mavuto omwe amabwera pambuyo pa opaleshoni. M'nkhaniyi, tifufuza mozama mu dongosolo la TTA, mfundo zake, ntchito, ubwino, ndi malire.
Anatomy ndi Physiology ya Canine Stifle Joint
Tisanalowe mu dongosolo la TTA, ndikofunikira kuti timvetsetse momwe thupi limakhalira komanso thupi la canine stifle joint. Cholumikizira chomatacho ndi chofanana ndi bondo la munthu ndipo chimapangidwa ndi mafupa a femur, tibia, ndi patella. ACL ili ndi udindo wokhazikitsa mgwirizanowu poletsa tibia kuti isasunthike kutsogolo kwa femur. Mu agalu, ACL ili mkati mwa kapsule yolumikizana ndipo imapangidwa ndi ulusi wa collagen womwe umagwirizanitsa ndi mafupa a femur ndi tibia.
Pathogenesis ya ACL Rupture in Agalu
Kuphulika kwa ACL mu agalu kumatha kuchitika chifukwa cha zifukwa zosiyanasiyana, kuphatikizapo chibadwa, zaka, kunenepa kwambiri, kuchita masewera olimbitsa thupi, ndi kuvulala. Pamene ACL ikuphulika, fupa la tibia limasunthira patsogolo, kuchititsa kuti mgwirizanowo ukhale wosakhazikika, ndipo umayambitsa ululu, kutupa, ndipo pamapeto pake DJD. Kusamalira kodziletsa, monga kupuma, mankhwala, ndi chithandizo chamankhwala, kungathandize kuchepetsa ululu, koma sikuthetsa vuto lalikulu la kusakhazikika kwamagulu. Kuchita opaleshoni nthawi zambiri kumafunika kubwezeretsa bata ndikuletsa kuwonongeka kwina kwa mgwirizano.
Mfundo za TTA System
Dongosolo la TTA ndi njira yamakono yopangira opaleshoni ya canine ACL yomwe cholinga chake ndi kubwezeretsa kukhazikika kwa mgwirizano mwa kusintha mbali ya tibial plateau. Mphepete mwa tibial ndi pamwamba pa fupa la tibia lomwe limagwirizanitsa ndi fupa lachikazi kuti likhale lolumikizana. Agalu omwe ali ndi ACL rupture, tibial Plateau amatsetsereka pansi, zomwe zimapangitsa kuti fupa la tibia lisunthike kutsogolo poyerekeza ndi fupa lachikazi. Dongosolo la TTA limaphatikizapo kudula tibial tuberosity, kutchuka kwa bony komwe kuli pansi pa bondo, ndikupita patsogolo kuti awonjezere mbali ya tibial plateau. Kupititsa patsogolo kumakhazikika pogwiritsa ntchito khola la titaniyamu ndi zomangira, zomwe zimalimbikitsa kuchiritsa kwa mafupa ndi kuphatikizika.
Ubwino wa TTA System
Dongosolo la TTA limapereka maubwino angapo kuposa njira zachikhalidwe zokonzetsera ACL, monga tibial plateau leveling osteotomy (TPLO) ndi kukonza extracapsular. Choyamba, dongosolo la TTA ndilomveka bwino kwambiri, chifukwa limasintha mbali ya tibial plateau kuti iteteze kutsogolo kwa tibial thrust, yomwe ndi chifukwa chachikulu cha kupasuka kwa ACL. Chachiwiri, dongosolo la TTA limasunga ACL mbadwa, kuchepetsa chiopsezo cha zovuta monga matenda, kulephera kwa graft, ndi kulephera kwa implant. Chachitatu, dongosolo la TTA limalola kuti pakhale kulemera koyambirira pambuyo pa opaleshoni ndikukonzanso, zomwe zimathandizira kugwira ntchito limodzi ndikuchepetsa nthawi yochira. Chachinayi, dongosolo la TTA ndi loyenera kwa agalu amitundu yonse komanso amitundu, chifukwa amatha kusinthidwa malinga ndi zosowa zawo.
Zochepa za TTA System
Monga njira iliyonse yopangira opaleshoni, dongosolo la TTA lili ndi malire ake komanso zovuta zomwe zingakhalepo. Chovuta chofala kwambiri ndikulephera kwa implant, komwe kumatha kuchitika chifukwa cha kupsinjika kwamakina, matenda, kapena kuchiritsa bwino kwa mafupa. Kulephera kwa implant kungayambitse kusakhazikika kwa mafupa, kupweteka, komanso kufunikira kwa opaleshoni yokonzanso.
Mavuto ena omwe angakhalepo a dongosolo la TTA ndi monga fracture ya tibial crest, patellar tendonitis, ndi kuphatikizika pamodzi. Kuphatikiza apo, dongosolo la TTA ndi njira yovuta yopangira opaleshoni yomwe imafunikira maphunziro apadera komanso ukadaulo, zomwe zingachepetse kupezeka kwake m'zipatala zina zachinyama. Komanso, dongosolo la TTA ndi lokwera mtengo kuposa njira zina zokonzera ma ACL, zomwe sizingakhale zotheka kwa eni ziweto.
Otsatira a TTA System
Dongosolo la TTA ndi loyenera kwa agalu omwe ali ndi ACL kupasuka ndi kusakhazikika kwa mgwirizano, komanso omwe ali ndi misozi ya meniscal kapena DJD. Oyenera kutsata dongosolo la TTA ndi galu wolemera kwambiri kuposa ma kilogalamu 15, chifukwa agalu ang'onoang'ono sangakhale ndi mafupa okwanira kuti athandizire khola la titaniyamu. Kuphatikiza apo, kachitidwe ka TTA sikuvomerezeka kwa agalu omwe ali ndi vuto lalikulu la patellar, kuwonongeka koopsa kwa cranial cruciate ligament (CCL), kapena medial patellar luxation.
Kuwunika ndi Kukonzekera Kusanachitike
Asanachite dongosolo la TTA, galuyo ayenera kuyesedwa bwino asanachite opaleshoni, kuphatikizapo kuyezetsa thupi lonse, kujambula kwa radiographic, ndi kuyesa kwa labotale. Kujambula kwa radiographic kuyenera kukhala ndi mawonedwe osagwirizana ndi chiuno kuti athetse dysplasia ya m'chiuno kapena nyamakazi. Komanso, dokotalayo ayenera kukonzekera mosamala opaleshoniyo, kuphatikizapo kukula ndi malo a khola la titaniyamu, kuchuluka kwa tibial tuberosity kupita patsogolo, ndi mtundu wa anesthesia ndi kusamalira ululu.
Njira Yopangira Opaleshoni
Dongosolo la TTA ndi njira yopangira opaleshoni yomwe imafunikira maphunziro apadera komanso ukadaulo. Opaleshoniyo imachitidwa pansi pa anesthesia wamba, ndipo galuyo amaikidwa mu dorsal recumbency. Dokotala wa opaleshoni amapanga chotupa pa tibial tuberosity ndikuchotsa patellar tendon kuchokera ku tuberosity. Kenako tuberosity imadulidwa pogwiritsa ntchito macheka apadera, ndipo khola la titaniyamu limayikidwa pamwamba pake. Kholalo limatetezedwa ndi zomangira, ndipo tendon ya patellar imalumikizidwanso ku tuberosity. Cholowacho chimafufuzidwa kuti chikhale chokhazikika, ndipo chodulidwacho chimatsekedwa pogwiritsa ntchito sutures kapena staples.
Chisamaliro cha Postoperative and Rehabilitation
Pambuyo pa opaleshoni, galuyo amapatsidwa mankhwala opweteka ndi maantibayotiki, ndipo cholumikizira chimayang'aniridwa ngati kutupa, kupweteka, kapena matenda. Galu amaloledwa kulemera pa mwendo womwe wakhudzidwa mwamsanga pambuyo pa opaleshoni, koma ntchito zoletsedwa zimalimbikitsidwa kwa masabata angapo oyambirira. Galuyo ayenera kumangiriridwa pa chingwe kuti asadumphe, kuthamanga, kapena kukwera masitepe. Thandizo lolimbitsa thupi, kuphatikizapo masewera olimbitsa thupi osasunthika komanso kuchita masewera olimbitsa thupi, kuyenera kuyamba pakangopita masiku angapo mutatha opaleshoni kuti azitha kugwira bwino ntchito limodzi ndikuletsa kufooka kwa minofu. Kuyendera pafupipafupi ndi dokotala wa opaleshoni ndikofunikira kuti muyang'ane machiritso ndikuwona zovuta zomwe zingakhalepo.
Mapeto
Njira ya Tibial Tuberosity Advancement (TTA) ndi njira yamakono yopangira opaleshoni ya canine ACL yomwe cholinga chake ndi kubwezeretsa kukhazikika kwa mgwirizano mwa kusintha mbali ya tibial plateau. Dongosolo la TTA limapereka maubwino angapo kuposa njira zachikhalidwe zokonzetsera ACL, kuphatikiza kumveka bwino kwa biomechanical, kusunga ACL mbadwa, ndi kukonzanso koyambirira kwa opaleshoni. Komabe, dongosolo la TTA lili ndi malire ake komanso zovuta zomwe zingachitike, ndipo zimafunikira maphunziro apadera komanso ukadaulo. Choncho, chigamulo chotsatira dongosolo la TTA chiyenera kupangidwa pambuyo powunikiridwa mwatsatanetsatane ndi kukambirana ndi dokotala wodziwa bwino za Chowona Zanyama.
