Ulapha: Ikhaya » Izindaba » Okuhlangene » Ukuhlaziywa okuphelele kwe-Femoral Stem kanye nabathengisi be-Femoral Stem abaphezulu abangu-5

Ukuhlaziywa okuphelele kwe-Femoral Stem kanye nabathengisi bohlobo lwe-Femoral Stem abaphezulu abangu-5

Ukubuka: 0 Umbhali: Isikhathi Sokushicilela Isihleli Sesayithi: 2025-01-18 Umsuka: Isayithi

1.Iyini isiqu sesifazane

Isingeniso:

Isiqu sesifazane (Isiqu Sowesifazane) siyingxenye yengxenye yensimbi esetshenziselwa ukumiselela ingxenye engaphezulu yethambo lesifazane (ithambo lethanga) ekuhlinzweni kokubuyisela inqulu. Ingenye yezingxenye ezibaluleke kakhulu zesistimu ye-hip yokwenziwa futhi inesibopho sokuxhuma ekhanda lesifazane nokuthatha imithwalo nokunyakaza kokuhlangana kwe-hip. Indima eyinhloko ye-femoral stem iwukudlulisa ukunyakaza kwe-hip joint kanye nengxenye engezansi kuyo yonke inhlanganisela ye-hip yokwenziwa, ukuqinisekisa ukuthi ukuhlanganyela kuzinzile, kukhululekile futhi kusebenza kahle.

股骨柄使用图

Isakhiwo kanye nomsebenzi wesiqu sesifazane

Isimo:

Isiqu se-femoral ngokuvamile siyacindezelwa noma si-cylindrical futhi siklanyelwe ukufanisa ukuma kwe-anatomical ye-femur yomuntu. Ibuyisela umsebenzi we-hip joint ngokufakwa ku-femur futhi ixhume ekhanda lesifazane (enye ingxenye ye-hip joint).

Indima:

Isiqu sesifazane sithwala ingxenye enkulu yesisindo somzimba esingaphezulu, ngakho sidinga ukuba namandla okuthwala umthwalo oqinile nokuzinza. Kumelwe futhi kube i-biocompatible ukuze kuqinisekiswe i-osseointegration ngesikhathi sokusetshenziswa kwesikhathi eside.

Izinhlobo nemiklamo yeziqu zesifazane

Izinhlobo ze-femoral stem

Kunezinhlobo ezahlukene ze-shanks femoral futhi ezivamile zihlanganisa:

I-Round shank:

Ifanele iziguli ezine-anatomy ye-femoral cishe eyindilinga, kulula ukuyifaka, kodwa ingase ingaboshelwa ngokuvikelekile kwezinye iziguli ezine-osteoporosis.
Ngaphezu kwalokho, izinzuzo zama-shanks ayindilinga zihlanganisa izinqubo ezilula zokuhlinza kanye nezikhathi ezimfushane zokufakelwa. Kodwa-ke, kufanele kuqashelwe ukuthi ezigulini ezine-low bone mineral density noma i-osteoporosis, ezinye izinhlobo ze-femoral stem ezifanelekile zingadinga ukucatshangelwa ukuze kuqinisekiswe ukuzinza kwesikhathi eside.

I-tapered shank:

Ngokuvamile isetshenziswa ezigulini ezine-femoral anatomy ethe xaxa kanye nesiqu sesifazane esicijile noma esincane ukuze kusizwe ukuvikela isiqu sesifazane.

Ama-shanks alungisekayo:

Amanye ama-femoral shanks aklanywe ngezici ezilungisekayo ezingavunyelaniswa nesimo somzimba wesiguli.

Amashanki aqhubekayo:

Lawa mashanki aklanyelwe ukuhlinzeka ngamazinga ahlukene okuzinza nokusabalalisa umthwalo ukuze kuhlangatshezwane nezimfanelo ezihlukahlukene zamathambo kanye nezidingo zesiguli.

Ama-shanks we-Femoral ane-coatings:

Okufana nosimende noma okungenasimende (okungukuthi, i-osseointegrated), kuye ngekhwalithi yethambo lesiguli kanye nesakhiwo sesifazane. Inguqulo enosimende ifanele iziguli ezindala, kuyilapho inguqulo ye-osseointegrated ifanele iziguli ezinekhwalithi engcono yamathambo.

Ukwakhiwa kwesiqu sesifazane ngokuvamile kuhlanganisa:

Ukucatshangelwa kokuzijwayeza kwe-anatomical, njenge-engeli, ubude, nokugoba kwesiqu sesifazane. Kukhethwa ukuthi kuqinisekiswe ukuthi isiqu sesifazane sithintana kahle ne-femur futhi sihlale sizinzile.
Idizayini eguquguqukayo: Ezinye iziqu zesifazane ziklanywe ngezici ezilungisekayo ezivumela ukulungiswa okuthile ngesikhathi sokuhlinzwa ukuze kuzivumelanise nezakhiwo ezihlukahlukene ze-anatomical.

2.Umehluko phakathi kwezinto ezihlukene zesiqu sesifazane

股骨柄类型图

2.1. I-Titanium Alloy (Titanium Alloy)

Izici:

I-Titanium alloy ingenye yezinto ezivame ukusetshenziswa kakhulu zeziqu zesifazane njengamanje, ngenxa yezinzuzo zayo zokuvumelana okuhle kwe-biocompatibility, isisindo esincane kanye nokumelana nokugqwala okuqinile. I-modulus ye-elasticity ye-titanium alloy iseduze nethambo lomuntu, okunciphisa ukugxila kwengcindezi phakathi kwesiqu sesifazane nethambo ngemva kokufakelwa futhi kunciphisa ingozi yokuphuka.

Izinzuzo:

I-biocompatible kakhulu futhi mancane amathuba okuba ibangele ukusabela komzimba.
Ilula, isiza ukunciphisa umthwalo ngemuva kokuhlinzwa.
Ukumelana nokugqwala okuphezulu, kulungele ukufakelwa isikhathi eside.

Ububi:

Iqinile kancane kunezinye izinsimbi (isb. i-cobalt-chromium), ngakho-ke kungase kudingeke into eqinile ezigulini ezithwele kanzima.

2.2. Ingxubevange ye-Cobalt-Chromium

Izici:

I-Cobalt-Chromium Alloy insimbi enamandla kakhulu futhi ivamise ukusetshenziselwa izingxenye zokwenziwa ezihlanganyelwe ezidingekayo ukuze zimelane nemithwalo ephezulu. Inokumelana nokugqwala okungcono futhi inikeza amandla aphezulu kakhulu nokuqina.

Okuhle:

Iqine kakhulu, ifanele iziguli ezinemithwalo ephezulu futhi ezikwazi ukubamba isisindo ngokuzinza isikhathi eside.
Ukumelana nokugqwala okuphezulu, kulungele ukufakelwa isikhathi eside.
Ukumelana ne-abrasion ephezulu, okukwazi ukwehlisa ukuguga nokudabuka.

Ububi:

I-biocompatible kancane kancane kune-titanium alloys, ingase ibangele ukungakhululeki okuncane kwezinye iziguli.
Isinda kune-titanium alloys, engase ikhulise umthwalo esigulini ngemva kokuhlinzwa.

2.3. Insimbi engagqwali (Stainless Steel)

Izici:

Insimbi engagqwali iyinto evamile yensimbi evame ukusetshenziselwa umthwalo ophansi noma ukushintshwa kwamanyonga okuqala. Inamandla futhi inenani elithe xaxa ngokwezomnotho.

Izinzuzo:

Iqinile, ifanele iziguli ezinemithwalo elula.
Kungabizi kakhulu.
Kulula ukucubungula nokukhiqiza.

Ububi:

Insimbi engagqwali ingase ibangele ukusabela okuphawulekayo kwamasosha omzimba noma izinkinga zokugqwala ngenxa yokungahambelani kahle kwayo nezinto eziphilayo.
Ukumelana nokugqwala okungalungile uma kuqhathaniswa nama-alloys e-titanium futhi kungase kube yingozi ekusebenziseni isikhathi eside.

2.4. I-Chromium-Cobalt Alloy (Chromium-Cobalt Alloy)

Izici:

Lezi zinto ziqukethe ikakhulukazi izakhi ze-chromium ne-cobalt futhi zinamandla aphezulu nokumelana nokugqoka. Ngokufanayo nama-alloys e-cobalt-chromium, ama-alloys e-chrome-cobalt avame ukusetshenziswa kuma-femoral shanks angaphansi kwemithwalo ephezulu.

Okuhle:

Iqine ngokwedlulele futhi ayigugi, ikwazi ukumelana nemithwalo ephezulu isikhathi eside.
Imelana kakhulu nokugqwala futhi ilungele ukusetshenziswa isikhathi eside.

Ububi:

I-biocompatibility engalungile ngokuqhathaniswa, ingase ibangele ukungezwani komzimba.
Isisindo esiphezulu, singadala ukungakhululeki kwezinye iziguli.

2.5. I-Ceramic

Izici:

Izinto ze-Ceramic ngezinye izikhathi zisetshenziswa njenge-surface coating ye-femoral stem noma njengempahla yekhanda le-femur ngenxa yobunzima babo obukhulu nokumelana nokugqoka. I-Ceramics ine-coefficient ephansi yokungqubuzana, okunciphisa ukugqoka okuhlangene.

Izinzuzo:

Ukuqina okuphezulu, ukumelana kakhulu nokuguga, kunciphisa ukungqubuzana ezindaweni ezihlangene.
I-coefficient ephansi kakhulu yokungqubuzana kunciphisa ukuguga kanye nokuphuka kwesikhathi eside.

Ububi:

I-brittleness ephezulu, ejwayele ukuphuka noma ukuqhekeka, ngakho-ke ngokuvamile isetshenziselwa ukumboza noma izingxenye eziyingxenye kunesiqu sonke sesifazane.

2.6. Izinto zokumboza ezingaphezulu (isb. I-HA coating, titanium nitride, njll.)

Izici:

Izembatho ezikhethekile ezifana ne-calcium aminophosphate (HA) enamathela noma i-titanium nitride coating ngokuvamile yengezwa ebusweni besiqu sesifazane. Inhloso eyinhloko yalezi zembatho ukukhuthaza ukuhlanganiswa kwesiqu sesifazane ethanjeni, ukuthuthukisa i-biocompatibility nokusiza ekukhuleni kwamathambo.

Izinzuzo:

Ikhuthaza ukuhlanganiswa kwe-osseo futhi inikele ekuzinzeni kwesikhathi eside kwesiqu sesifazane.
Ithuthukisa i-biocompatibility futhi inciphisa ukusabela komzimba.

Ububi:

Ama-coatings angase aguge ngokuhamba kwesikhathi, anciphise ukusebenza kwawo.
Okunye ukumboza kungase kwandise ubunkimbinkimbi nezindleko zenqubo.

Izincomo:

Ukukhethwa kwezinto zesiqu sesifazane kuncike kakhulu esigulini ngasinye (isb, ikhwalithi yamathambo, ubudala, izinga lomsebenzi, njll.), uhlobo lokuhlinzwa, izidingo zokuklama, kanye nolwazi lukadokotela ohlinzayo. Ama-alloys e-Titanium kanye nama-cobalt chromium alloys yizinto ezisetshenziswa kakhulu ngenxa yamandla azo aphakeme, ukuqina kwawo, kanye nokuvumelana kwe-biocompatibility. Iziguli ezithile ezinemithwalo ephezulu zingakhetha izinto zokwakha ze-cobalt chromium alloy, kuyilapho i-titanium ingase ibe ukukhetha okungcono ezigulini ezincane ezinekhwalithi engcono yamathambo. Kungakhathaliseki ukuthi iyiphi impahla, ikhwalithi yokuklama kanye nekhono lethambo ukuhlanganisa ngemva kokuhlinzwa kuyisihluthulelo sokuqinisekisa ukuzinza kwesiqu sesifazane nokubuyiselwa komsebenzi we-hip.

3.Iziphi izimo ezingasebenzisa isiqu sesifazane

Lapho ungasebenzisa isibambo sesifazane

3.1. I-osteoarthritis ye-hip (i-Osteoarthritis)

Incazelo Yesimo:

Lesi yisimo esivame kakhulu lapho kusetshenziswa khona isiqu sesifazane. Uqwanga lwenyonga yesiguli luyawohloka, okubangela ubuhlungu bamalunga, ukunyakaza okulinganiselwe, kanye ne-dyskinesia. Njengoba isimo siqhubeka, izindawo ezingaphezulu ze-femur ne-acetabulum zingaphansi kokuguga okukhulu, okuholela ekulahlekelweni okukhulu komsebenzi ohlangene.

Inhloso Yokuhlinza:

Ngokuhlinza i-hip esikhundleni sokwenziwa, isiqu sesifazane sisetshenziselwa ukufaka esikhundleni sengxenye eyonakele ye-femur, ngaleyo ndlela kubuyiselwe ukusebenza kwelunga le-hip, ukukhulula ubuhlungu, nokuthuthukisa izinga lempilo yesiguli.

3.2. I-Femoral necrosis yekhanda (i-Avascular Necrosis, AVN)

Incazelo Yesimo:

I-femoral head necrosis ukufa kwezicubu zethambo ekhanda lesifazane ngenxa yokuphazamiseka kokunikezwa kwegazi. Lokhu kuvame ukuphumela ezinhlungwini ezinzima zamalunga kanye nokulahlekelwa umsebenzi. I-Necrosis yekhanda lesifazane ingabangelwa izizathu ezihlukahlukene, njengokusetshenziswa isikhathi eside kwemithi ye-steroid, ukuhlukumezeka, nokusebenzisa kabi utshwala.

Inhloso Yokuhlinza:

Lapho i-necrosis yekhanda lesifazane ingakwazi ukutholakala ngokwelashwa okulondolozayo, ukuhlinzwa kokufakelwa kwe-hip esikhundleni kuba inketho yokwelapha. Isiqu sesifazane sisetshenziselwa ukufaka esikhundleni sengxenye ye-necrotic yekhanda lesifazane kanye nokubuyisela ukusebenza okuhlangene.

3.3. Ukuphuka Kwezinsikazi

Incazelo Yesimo:

Ikakhulukazi ezigulini esezikhulile, ukuphuka kwentamo yesifazane noma ukuhlukana kwe-femoral stem fractures evamile ye-hip fractures. Ikakhulukazi, i-femoral neck fractures ingase idinge ukushintshwa kwe-hip yokwenziwa uma ukuphuka kuhluleka ukuphulukisa noma uma kunezinkinga ezifana ne-osteoporosis.

Inhloso Yokuhlinza:

Ukubuyisela ingxenye eyonakele ye-femur ngokubeka i-femoral stem ukuze ubuyisele ukusebenza kwe-hip yesiguli, ukunciphisa ubuhlungu, nokuthuthukisa ukuhamba. Isiqu sesifazane siyindlela edingekayo ezigulini ezinokuphuka okuyinkimbinkimbi noma ukululama okunzima.

3.4. I-Hip Joint Infection (HJI)

Incazelo Yesimo:

Kwezinye izimo, ilunga lenyonga lingase lilimale ngokuhlanganyela ngenxa yokutheleleka ngegciwane, ikakhulukazi okulandela ukutheleleka okwenzeka ngemva kokuhlinzwa inqulu (isb. ukutheleleka kwe-hip prosthesis). Lokhu kutheleleka kungaholela ekulimaleni okukhulu kwezicubu ezithambile namathambo, noma ngisho nokulahlekelwa okuphelele kokusebenza kwamalunga.

Inhloso Yokuhlinza:

Ngemuva kokuthi ukutheleleka kulawulwe, kungase kudingeke ukushintshwa kwe-hip yokwenziwa ukuze kubuyiselwe ukusebenza okuhlangene. Kulokhu, isiqu sesifazane sizosetshenziswa esikhundleni sengxenye eyonakele noma enegciwane le-femur.

Izimo zokusetshenziswa kwesiqu sesifazane

3.5. Ukukhubazeka Kwe-Hip noma i-Developmental Dysplasia ye-Hip (DDH)

Incazelo Yesimo:

Ezinye iziguli zingase zizalwe zine-dysplasia yokuthuthukiswa kwe-hip (isb, ukukhishwa kwe-hip noma i-acetabular asymmetry), futhi lokhu kukhubazeka kungaholela ekuxhumaneni okungalungile phakathi kwe-femur ne-acetabulum, okuholela ekuwohlokeni kokuqala kokuhlangana, ubuhlungu, noma ukungasebenzi.

Izinjongo Zokuhlinza:

Ezimweni zokuthuthukiswa kwe-hip dislocation noma okunye ukukhubazeka kwe-hip okuthinta kakhulu izinga lokuphila, kungase kudingeke ukuhlinzwa okwenziwe esikhundleni se-hip, lapho i-femoral stem isetshenziselwa khona esikhundleni sengxenye eyonakele ye-femur nokubuyisela umsebenzi ohlangene.

3.6. I-Rheumatoid Arthritis (i-Rheumatoid Arthritis)

Incazelo Yesimo:

I-Rheumatoid arthritis yisifo sokuzivikela komzimba esivame ukuholela ekuvuvukeni okungapheli kanye nokulimala kwe-cartilage emalungeni. Lapho i-hip ithinteka, ukunyakaza kwelunga kulinganiselwe futhi ubuhlungu nokungasebenzi kuya ngokuya kuba kubi kakhulu.

Inhloso Yokuhlinza:

Ukushintshwa kwe-hip yokwenziwa kuyindlela yokwelapha ephumelelayo yokulimala okukhulu kwe-hip joint ebangelwa i-rheumatoid arthritis. Isiqu sesifazane sisetshenziselwa ukuhlinzwa ukuze kushintshwe ingxenye eyonakele ye-femur, ngaleyo ndlela kuncishiswe ubuhlungu nokubuyisela ukuhamba kwamalunga.

3.7 I-Slipped Capital Femoral Epiphysis (SCFE)

Incazelo Yesimo:

I-Slipped Capital Femoral Epiphysis (SCFE) ivamise ukwenzeka ngesikhathi sokukhula nokukhula kwentsha, ikakhulukazi phakathi nokuthomba, futhi ingase ibangele ukungaboni ngasolinye noma ukushelela phakathi kwekhanda lesifazane nesiqu sesifazane. Lesi simo, uma sishiywe singalashwa, singase siholele ekuwohlokeni kwamalunga noma ukulahlekelwa umsebenzi.

Inhloso Yokuhlinza:

Kwezinye izimo, amakhanda ezinsikazi ashelelayo awakwazi ukutholakala ngokwelashwa okulondolozayo futhi angadinga ukuhlinzwa okushintshwa kwenyonga. Isiqu sesifazane singasetshenziswa esikhundleni sengxenye eyonakele ye-femur futhi sibuyisele ukusebenza okujwayelekile okuhlangene.

3.8. Ukubuyekeza noma Ukushintshwa Ngemva kwe-Hip Arthroplasty (I-Revision Hip Arthroplasty)

Incazelo Yesimo:

Ukuhlinzwa kokufakelwa kwe-hip esikhundleni kungase kube yimpumelelo kakhulu, kodwa ngokuhamba kwesikhathi i-prosthesis ingase iguge, ixege, noma ihluleke, okuholela ekulahlekelweni kokusebenza kwamalunga noma ubuhlungu obuqhubekayo. Ukulungisa i-hip noma ukuhlinzwa esikhundleni kungase kudingeke kuleli phuzu.

Inhloso Yokuhlinza:

Ngesikhathi sokuhlinzwa noma ukushintshwa, isiqu sesifazane singase sidinge ukushintshwa noma siqondiswe kabusha ukuze kuhlangatshezwane nezidingo ezintsha zesiguli. Ngokuvamile, isiqu sesifazane sizokhethwa ngomklamo omusha noma impahla esekelwe ekugqokeni nasekukhululekeni kwe-prosthesis.

Inqubo ye-Hip necrosis

4.Indlela yokukhetha uphawu

4.1. I-Stryker (Stryker)

史赛克

Isingeniso esifushane:

I-Stryker ingenye yezinkampani zemishini yezokwelapha ehamba phambili emhlabeni, ehlinzeka ngezinhlobonhlobo zezifakelo zamathambo zekhwalithi ephezulu, ikakhulukazi emkhakheni wamajoyinti e-hip okwenziwa. Iziqu zesifazane zika-Stryker ziklanywe ngendlela entsha ngezinketho eziningi ezahlukene zezidingo zomtholampilo.

Izici:

Ubuchwepheshe obuhamba phambili, ukuzinza kwesikhathi eside, izicelo ezibanzi zomtholampilo kanye nokuqinisekiswa.

4.2. I-Elbo (Zimmer Biomet)

爱尔博

Iphrofayela:

I-Zimmer Biomet iyinkampani ehamba phambili yemishini yezokwelapha emhlabeni wonke egxile kwezamathambo nemithi yezemidlalo, enemikhiqizo emboza izimila zokwenziwa zamalunga okuhlanganisa neziqu zesifazane.

Izici:

Imikhiqizo yenkampani esungula izinto ezintsha futhi eklanywe ngokuqinile iyenza ikwazi ukunikeza izinketho ezimbalwa ukuze ihlangabezane nezidingo zesiguli ezihlukene, futhi inedumela elihle kakhulu emhlabeni wonke.

4.3. I-Oslo Technologies (Ottobock)

奥斯陆科技

Iphrofayela:

I-Oslo Technologies yinkampani yaseJalimane egxile ekufakweni kwekhwalithi ephezulu kwamathambo namadivayisi zokusiza, ehlinzeka ngezixazululo ze-hip zokwenziwa ezihlanganisa iziqu zesifazane.

Izici:

Izinto zokwakha nemiklamo yekhwalithi ephezulu, ukuzibophezela ekusungulweni komkhiqizo kanye nokuthuthukiswa kwezimo eziningi zomtholampilo.

4.4.South East Medical (Smith & Nefew)

东南医疗

Iphrofayela:

I-Southeast Medical yinkampani eyaziwayo yemishini yezokwelapha yamazwe ngamazwe egxile ekufakeni amathambo namathuluzi okuhlinza, nemikhiqizo yayo ehlangene yenyonga yokwenziwa esetshenziswa emhlabeni wonke.

Izici:

Inedumela eliphakeme emkhakheni wokufakelwa kwamalunga okwenziwa, futhi ukwakheka komkhiqizo wayo kugxile ekululameni kwesiguli nokuhamba isikhathi eside.

4.5.meditech(Czmeditech)

迈玛瑞

Iphrofayela:

I-Czmeditech iyisisetshenziswa sezokwelapha esigxile ku-orthopaedic kanye nomkhiqizi wokufakelwa ngokuzibophezela okuqinile ekunikezeni izixazululo zokufakelwa kwamathambo ezisezingeni eliphezulu, ezintsha, ngokugxila ngokukhethekile emalungeni e-hip namadolo okwenziwa. I-Maimaritech inikeza izimila kanye nezinsiza zokusiza ezibhedlela nakodokotela abahlinza amathambo ezindaweni eziningana zomhlaba.

Izici:

Ngokuvamile esetshenziselwa ukuhlinzwa esikhundleni se-hip esikhundleni, iziqu zesifazane ezikhiqizwa uMcMurry zenziwe ngezinto eziqinile, ezimelana nokugqwala ezifana ne-titanium ne-cobalt-chromium alloys ukuze kuqinisekiswe ukuzinza nokuqina kwazo. Isiqu sesifazane siklanywe ngezindlela ezihlukahlukene ukuze sivumelane nokwakheka kwesiguli kanye nezidingo zokuhlinzwa.

Isiphetho

Ngaphezulu kweminyaka engama-20 yesipiliyoni, ubuchwepheshe obusezingeni eliphezulu, nokuzibophezela kwikhwalithi nokuhambisana, i-CZMEDITECH imi njengozakwethu othembekile kubahlinzeki bezempilo emhlabeni wonke. Izimila zethu ze-maxillofacial steel plate ziphakathi kwezinga eliphezulu kakhulu emakethe, zinikeza ukuqina, ukunemba, kanye nenani kumakhasimende ethu.

Kungakhathaliseki ukuthi uyisibhedlela, umtholampilo, noma udokotela ohlinzayo, sinikeza izixazululo ezithembekile nezingabizi ezidingekayo ukuze ulethe ukunakekelwa okungcono kakhulu ezigulini zakho.