Tibial Tuberosity Advancement (TTA) System: Yemazuvano Kuvhiya Technique yeCanine Cruciate Ligament Repair
Nhanganyaya
Iyo anterior cruciate ligament (ACL) ndeimwe yezvinonyanya kukuvadzwa ligaments mu canine hind gumbo, zvichiita kuti kubatana kusagadzikana, kurwadziwa, uye pakupedzisira degenerative joint disease (DJD). Kupindira kwekuvhiya kunowanzodiwa kuti udzorere kugadzikana uye kudzivirira kumwe kukanganisa kujoini. Imwe yemazuva ano ekuvhiya maitiro ekugadzirisa canine ACL ndeyeTibial Tuberosity Advancement (TTA) system, iyo yakawana mukurumbira nekuda kwekubudirira kwayo mukuvandudza kushanda kwemajoini, kuderedza marwadzo, uye kuderedza matambudziko epashure. Muchinyorwa chino, isu tichanyura zvakadzama muTTA system, misimboti yayo, mashandisirwo, mabhenefiti, uye zvisingakwanisi.
Anatomy uye Physiology yeCanine Stifle Joint
Tisati tapinda muTTA system, zvakakosha kuti tinzwisise anatomy uye physiology ye canine stifle joint. The stifle joint yakaenzana nebvi remunhu uye inoumbwa nefemur, tibia, uye patella mapfupa. Iyo ACL ine basa rekudzikamisa mubatanidzwa nekudzivirira tibia kubva kutsvedza kuenda kumberi kune femur. Mune imbwa, ACL iri mukati mejojo capsule uye inoumbwa ne collagen fibers inonamatira kune femur uye tibia mapfupa.
Pathogenesis ye ACL Kuputika muImbwa
ACL kuputika mumbwa kunogona kuitika nekuda kwezvikonzero zvakasiyana-siyana, kusanganisira genetics, zera, kufutisa, kuita muviri, uye kushungurudzika. Apo ACL inoputika, bhonzo retibia rinotsvedza mberi, zvichiita kuti chibatanidza chive chisina kugadzikana, uye chinokonzera kurwadziwa, kuzvimba, uye pakupedzisira DJD. Conservative management, yakadai sekuzorora, mishonga, uye kurapa kwepanyama, inogona kubatsira kuderedza marwadzo, asi haigadziri dambudziko guru rekusagadzikana kwemajoini. Kupindira kwekuvhiya kunowanzodiwa kuti udzorere kugadzikana uye kudzivirira kumwe kukanganisa kujoini.
Nheyo dzeTTA System
Iyo TTA system inzira yemazuva ano yekuvhiya ye canine ACL kugadzirisa iyo ine chinangwa chekudzorera kugadzikana kwemajoini nekushandura kona yetibial plateau. The tibial plateau inzvimbo yepamusoro yetibia bone iyo inotaura nefemur bone kuti iite mubatanidzwa wakaoma. Muimbwa dzine ACL dzakatsemuka, tibial plateau inotsveruka ichidzika, zvichiita kuti tibia bhonzo ritsvedze kumberi maererano nebhonzo remukadzi. Iyo TTA system inosanganisira kucheka tibial tuberosity, iyo bony mukurumbira iri pasi pemabvi akabatanidzwa, uye kuifambisa mberi kuti iwedzere kona yetibial plateau. Iko kufambira mberi kunogadziriswa uchishandisa titanium cage uye screws, izvo zvinokurudzira kuporesa kwemapfupa uye fusion.
Zvakanakira zveTTA System
Iyo TTA system inopa akawanda mabhenefiti pamusoro pechinyakare ACL kugadzirisa matekiniki, senge tibial plateau leveling osteotomy (TPLO) uye extracapsular kugadzirisa. Kutanga, iyo TTA system inowedzera biomechanically sound, sezvo inoshandura kona yetibial plateau kudzivirira mberi tibial thrust, iyo ndiyo inonyanya kukonzera ACL kuputika. Chechipiri, hurongwa hweTTA hunochengetedza chizvarwa cheACL, zvichideredza njodzi yezvinetso zvakadai sehutachiona, kukundikana kwegraft, uye kukundikana kwekudyara. Chechitatu, iyo TTA system inobvumira kutanga kwemashure ekuremera-kuremera uye kugadzirisa, iyo inovandudza kushanda pamwe chete uye inoderedza nguva yekudzorera. Chechina, iyo TTA sisitimu yakanakira imbwa dzeese hukuru uye dzinza, sezvo inogona kugadziridzwa kune zvinodiwa nemunhu.
Kuganhurirwa kweTTA System
Kufanana nechero nzira yekuvhiya, iyo TTA system ine painogumira uye zvinogona kunetsa. Dambudziko rinonyanya kuitika nderokutadza kuisirwa, izvo zvinogona kuitika nekuda kwekushushikana kwemagetsi, hutachiona, kana kupora kwemapfupa asina kunaka. Kutadza kuisirwa kunogona kukonzera kusagadzikana kwemajoini, kurwadziwa, uye kudikanwa kwekuvhiyazve.
Zvimwe zvinogona kunetsa zveTTA system zvinosanganisira tibial crest fracture, patellar tendonitis, uye kubatana kwekubatana. Pamusoro pezvo, iyo TTA system inzira yakaoma yekuvhiya inoda kudzidziswa kwehunyanzvi uye hunyanzvi, izvo zvinogona kudzikisira kuwanikwa kwayo mune mamwe makiriniki ezvipfuyo. Uyezve, iyo TTA system inodhura kupfuura dzimwe nzira dzekugadzirisa ACL, izvo zvingave zvisingagoneke kune vamwe varidzi vezvipfuyo.
Vanokwikwidza kuTTA System
Iyo TTA system inokodzera imbwa dzine ACL kuputika uye kusagadzikana kwemajoini, pamwe neaya ane meniscal misodzi yakabatana kana DJD. Mumiriri akakodzera weTTA system imbwa ine huremu hwemuviri hunodarika 15 kg, sezvo imbwa diki dzingave dzisina kukwana bhonzo kutsigira titanium keji. Zvakare, iyo TTA system haikurudzirwe kune imbwa dzakaomarara patellar luxation, yakanyanya cranial cruciate ligament (CCL) degeneration, kana medial patellar luxation.
Preoperative Evaluation uye Kuronga
Isati yapinda muhurongwa hweTTA, imbwa inofanira kuongororwa zvakakwana preoperative evaluation, kusanganisira kuongorora kwakakwana kwemuviri, radiographic imaging, uye laboratory test. Iyo radiographic imaging inofanirwa kusanganisira ese ari maviri anobata majoini maonero uye hudyu maonero kuti abvise panguva imwe chete hip dysplasia kana arthritis. Uyezve, chiremba anovhiya anofanira kunyatsoronga kuvhiyiwa, kusanganisira ukuru uye nzvimbo yetitanium cage, uwandu hwetibial tuberosity kufambira mberi, uye rudzi rweanesthesia uye marwadzo ekugadzirisa.
Kuvhiya Technique
Iyo TTA sisitimu inyanzvi inoda hunyanzvi yekuvhiya inoda kudzidziswa kwehunyanzvi uye hunyanzvi. Kuvhiyiwa kunoitwa pasi peanesthesia, uye imbwa inoiswa mudorsal recumbency. Chiremba anovhiya anoita incision pamusoro petibial tuberosity uye anobvisa patellar tendon kubva ku tuberosity. Iyo tuberosity inochekwa pachishandiswa saha yehunyanzvi, uye keji yetitanium inoiswa pamusoro pecheka. Iyo cage inochengetedzwa uchishandisa screws, uye iyo patellar tendon inobatanidzwa zvakare kune tuberosity. Iko kubatanidzwa kunotariswa kugadzikana, uye incision inovharwa uchishandisa sutures kana staples.
Postoperative Care uye Rehabilitation
Mushure mekuvhiyiwa, imbwa inoiswa pamushonga wemarwadzo nemishonga inorwisa mabhakitiriya, uye mubatanidzwa unotariswa kuzvimba, kurwadziwa, kana hutachiona. Imbwa inobvumirwa kutakura uremu pamakumbo akabatwa pakarepo mushure mekuvhiyiwa, asi basa rinorambidzwa rinokurudzirwa kwemavhiki mashomanana okutanga. Imbwa inofanira kuchengetwa patambo uye kudziviswa kusvetuka, kumhanya, kana kukwira masitepisi. Physical therapy, kusanganisira passive range yekufamba maekisesaizi uye inodzorwa kurovedza muviri, kunofanirwa kutanga mukati memazuva mashoma mushure mekuvhiyiwa kuvandudza kushanda kwemajoini uye kudzivirira tsandanyama atrophy. Kugara uchitevera kushanya nachiremba anovhiya kunodiwa kuti utarise maitiro ekuporesa uye kuona zvinogona kunetsa.
Mhedziso
Iyo Tibial Tuberosity Advancement (TTA) inyanzvi yemazuva ano yekuvhiya ye canine ACL kugadzirisa iyo ine chinangwa chekudzorera kugadzikana kwemajoini nekushandura kona yetibial plateau. Iyo TTA system inopa akawanda mabhenefiti pamusoro pechinyakare ACL kugadzirisa matekiniki, kusanganisira biomechanical kunzwika, kuchengetedzwa kweiyo yemuno ACL, uye yekutanga postoperative rehabilitation. Nekudaro, iyo TTA sisitimu ine painogumira uye zvinogona kunetsa, uye inoda hunyanzvi kudzidziswa uye hunyanzvi. Naizvozvo, sarudzo yekuenda kuchirongwa cheTTA inofanirwa kuitwa mushure mekuongorora kwakanyatso kusati kwaitwa uye kubvunzana nachiremba wezvipfuyo anokwanisa.
