Ukushintsha idolo elingenasimende, okungenye indlela yokuhlinzwa okushintshwa kwedolo elisikiwe ngokwesiko, kuthola isithakazelo emkhakheni wokuhlinzwa kwamathambo. Abacwaningi eSibhedlela Sokuhlinzwa Okukhethekile (HSS) benze ucwaningo lokuqhathanisa imiphumela yokufakelwa kwamadolo angenasimende yesimanje nokufakelwa kwedolo okujwayelekile okudinga usimende wethambo ukuze kulungiswe.

Udokotela ohlinzayo we-hip namadolo we-HSS uGeoffrey H. Westrich, MD, kanye nozakwabo abatholanga mehluko ekuhlaleni esibhedlela isikhathi eside, izinkinga, ukubuyiselwa esibhedlela phakathi nezinsuku ze-90 zokuhlinzwa, noma amanani okuhlinzwa okubukeziwe ekulandeleni isiguli seminyaka emibili. Okutholakele kwethulwe namuhla e-American Academy of Orthopedic Surgeons 2022 Annual Meeting e-Chicago.

Ngokuphathelene nesikhathi esichithwe egunjini lokuhlinza (OR), abacwaningi bathola ukuthi ukusebenzisa isigxivizo esingenasimende kunciphisa NOMA isikhathi ngo-25%, konga isilinganiso semizuzu engama-27. "Ekushintsheni kwamadolo angenasimende, akudingekile ukuthi ulinde usimende ukuthi uqine futhi wome njengoba wenza esikhundleni sikasimende esishintshwayo," kuchaza uBrian P. Chalmers, MD, udokotela ohlinza inqulu namadolo e-HSS kanye nomlobi ohlanganyela wocwaningo. .

"Isikhathi esincishisiwe ku-OR ngaphansi kwe-anesthesia sinenzuzo ezigulini, kodwa lokho akuyona ukuphela kwenzuzo engase ibe khona ye-prosthesis engenasimende," kunezela uDkt. “Ngokushintshwa kwedolo elingenasimende, izakhi ziyacindezela ukuze zilungele 'i-biologic fixation,' okusho ngokuyisisekelo ukuthi ithambo lizokhula libe into efakwayo. Uma kukhona ukulungiswa kokuqala kwe-biologic, ukufakwa kwe-implant kukhululeka ngokuhamba kwesikhathi kufanele kube mancane amathuba futhi ukushintshwa kwedolo okuphelele kungase kuhlale isikhathi eside. "

Ekushintsheni kwamadolo endabuko, izingxenye zokufakelwa zivikelekile ekuhlanganyeleni kusetshenziswa usimende wethambo. Kuyisu elizanyiwe neliyiqiniso elisebenze kahle amashumi eminyaka. Kodwa ekugcineni, ngokuhamba kwesikhathi, usimende uqala ukukhululeka ethanjeni kanye/noma ekufakweni. Uma iguga noma ixega, iziguli ngokuvamile zidinga ukushintshwa kwamadolo okwesibili, okwaziwa ngokuthi ukuhlinzwa okubukeziwe.

UDkt. Westrich ukholelwa ukuthi isigxivizo esingenasimende esiklanywe kahle sizokwenza ukuxega ngokuhamba kwesikhathi kube mancane amathuba, okwenza ukushintshwa kwedolo okuphelele kuhlale isikhathi eside. Ukuphila isikhathi eside kokufakelwa kubalulekile, ikakhulukazi ezigulini ezincane ezinesifo samathambo ezikhetha ukushintshwa ngokuhlanganyela ukuze zilondoloze indlela yazo yokuphila esebenzayo. Ngokuvamile babeka izimfuno ezengeziwe elungeni labo, okubangela ukuguga nokudabuka okukhulu kanye nokuxega okungase kube khona. Ukufakwa kwedolo likasimende elisetshenziswa esikhundleni selunga lendabuko ngokuvamile kuthatha iminyaka eyi-15 kuye kwengama-20.

“Izinsimbi ezingenasimende zisetshenziswe ngempumelelo ekuhlinzeni ukubuyisela inqulu iminyaka eminingi. Kube yinselele enkulu ukwakha ukufakelwa okungenasimende okungasebenza kahle edolweni ngenxa yokwakheka kwedolo okukhethekile,” kuchaza uDkt. Westrich.

"Esikhathini esidlule, ukufakelwa kwamadolo angenasimende kwaboniswa ukuthi kuneziphambeko zokuklama, ngokukhululeka ku-tibia," wanezela. “I-prosthesis entsha engenasimende esetshenziswe ocwaningweni lwethu ayizange ikhombise lolu hlobo lokuxega njengoba kwenzeka ocwaningweni olushicilelwe ngaphambilini. Sizimisele ukubona ukuthi i-implant ihamba kanjani ezigulini ze-HSS.”

Abacwaningi babuyekeze ukushintshwa kwamadolo angama-598 okuyisisekelo okuyingxenye yohlangothi olulodwa ku-HSS (angama-170 angenasimende nama-428 akasimende) omklamo ofanayo kusukela ngo-2016 kuya ku-2018. Ulwazi lwezibalo zabantu, imininingwane yokusebenza kanye nanoma yiziphi izinkinga zitholwe kumarekhodi ezokwelapha eziguli. Iziguli ebezilandela inqubo engenasimende bezincane kakhulu, zineminyaka yobudala engama-63, uma ziqhathaniswa nama-68 kulabo abafakelwa usimende idolo. Ikhwalithi enhle yamathambo ibalulekile empumelelweni yokulungiswa kwamadolo angenasimende. Ngakho-ke, odokotela abahlinzayo bamathambo bakhetha ngokukhethekile iziguli ezisencane ukuze zingasisebenzisi, kuphawula uDkt. Chalmers.

Kwakungekho umehluko obalulekile ngokwezibalo kubude bokuhlala esibhedlela, izinkinga, noma ukubuyiselwa esibhedlela ngenkinga ezinsukwini zokuqala ezingu-90 ngemva kokuhlinzwa. Amaphesenti angamashumi ayisishiyagalolunye nesithupha eziguli ezishintsha amadolo angenasimende ngokumelene nama-95% alabo abanokufakwa esikhundleni samadolo aqinile bagcina ukufakwa kwabo ngaphandle kwesidingo sokuhlinzwa okubukeziwe ekulandeleni iminyaka emibili.

"Umbuzo omkhulu manje ukuthi ngabe ukushintshwa kwamadolo angenasimende kuzoba nokuqina okungcono kwesikhathi eside nokulungiswa kunokushintshwa kwamadolo," kusho uDkt. Chalmers. "Ukulandela lezi ziguli ukuhlola imiphumela yesikhathi eside kuyisinyathelo esilandelayo."

LOKHO ONGAKUTHATHE KULESI SIHLOKO:

Researchers at Hospital for Special Surgery (HSS) launched a study to compare outcomes of a modern cementless knee implant to the standard knee implant that requires bone cement for fixation.
“In a cementless total knee replacement, you do not have to wait for the cement to harden and dry like you do in a cemented knee replacement,”.
Ninety-six percent of cementless knee replacement patients versus 95% of those with a cemented knee replacement maintained their implant without the need for revision surgery at two-year follow-up.