Kuva Sculco n'abandi batanga raporo ku nshuro ya mbere ku ndwara ya THA (small-incision total hip arthroplasty). Muri iki gihe, hagaragaye impinduka nshya nyinshi zagiye zigaragara. Muri iki gihe, igitekerezo cya THA cyagiye gikwirakwizwa cyane kandi cyemerwa buhoro buhoro n'abaganga. Ariko, nta cyemezo kiraboneka ku bijyanye no kumenya niba uburyo bwa THA bugomba gukoreshwa cyangwa busanzwe.
Ibyiza byo kubagwa mu buryo budakabije birimo gucikamo uduce duto, kuva amaraso make, ububabare buke, no gukira vuba; icyakora, ingaruka mbi zirimo kubaga mu buryo budahagije, koroshya gutera imvune mu mitsi, imiterere mibi y’inzobere, ndetse n’ibyago byinshi byo kubagwa mu buryo bushya.
Mu gusinzira kw'imitsi mu kibuno (MIS - THA) mu buryo buciriritse, kubura imbaraga z'imitsi nyuma yo kubagwa ni impamvu ikomeye igira ingaruka ku gukira, kandi uburyo bwo kubaga ni ikintu cy'ingenzi bigira ingaruka ku mbaraga z'imitsi. Urugero, uburyo bwo kuvura imbere n'imbere bushobora kwangiza imitsi ya abductor, bigatuma igenda buhoro buhoro (Trendelenburg limp).
Mu rwego rwo gushaka uburyo bwo kugabanya kwangirika kw'imitsi, Dr. Amanatullah n'abandi bo muri Mayo Clinic muri Leta Zunze Ubumwe za Amerika bagereranije uburyo bubiri bwa MIS-THA, uburyo bwo kuvura imbere (DA) n'uburyo bwo kuvura imbere (DS), ku bipimo by'imirambo kugira ngo hamenyekane ibyangiritse ku mitsi n'imitsi. Ibisubizo by'ubu bushakashatsi byagaragaje ko uburyo bwa DS butangiza imitsi n'imitsi cyane kurusha uburyo bwa DA kandi bushobora kuba ari bwo buryo bwiza bwo kuvura MIS-THA.
Igishushanyo mbonera cy'igerageza
Ubushakashatsi bwakorewe ku nyamaswa umunani zari zimaze gukonjeshwa zifite amagufwa umunani y’amagufwa 16 zidafite amateka yo kubagwa mu kibuno. Igufwa rimwe ryatoranijwe ku buryo butunguranye kugira ngo rikorerwe MIS-THA binyuze mu buryo bwa DA n’irindi binyuze mu buryo bwa DS muri kimwe mu bice by’umubiri, kandi ubuvuzi bwose bwakozwe n’abaganga b’inararibonye. Ingano ya nyuma y’imvune y’imitsi n’imitsi yapimwe n’umuganga w’amagufwa utari muri icyo gikorwa.
Imiterere y'umubiri yasuzumwe irimo: gluteus maximus, gluteus medius n'imitsi yayo, gluteus minimus n'imitsi yayo, vastus tensor fasciae latae, quadriceps femoris, upper trapezius, piatto, lower trapezius, obturator internus, na obturator externus (Ishusho ya 1). Imitsi yasuzumwe kugira ngo irebe niba imitsi yacitse kandi ikagira ububabare bugaragara ku maso.
Ishusho ya 1 Ishusho y'imiterere ya buri mutsi
Ibisubizo
1. Kwangirika kw'imitsi: Nta tandukaniro ry'imibare ryagaragaye mu rugero rw'ibyangiritse ku gice cy'ubuso cya gluteus medius hagati y'uburyo bwa DA na DS. Ariko, ku mitsi ya gluteus minimus, igipimo cy'ibyangiritse ku gice cya DA cyari hejuru cyane ugereranyije n'ibyatewe n'uburyo bwa DS, kandi nta tandukaniro rigaragara hagati y'uburyo bubiri bw'imitsi ya quadriceps. Nta tandukaniro rigaragara hagati y'uburyo bubiri bw'ibyangiritse ku mitsi ya quadriceps, kandi igipimo cy'ibyangiritse ku gice cya vastus tensor fasciae latae na rectus femoris cyari kinini ugereranyije n'uburyo bwa DA ugereranyije n'uburyo bwa DS.
2. Ibikomere by'imitsi: Nta na kimwe cyagize ingaruka zikomeye ku gukomereka k'umutsi.
3. Gufata imitsi: Uburebure bw'ugufata imitsi ya gluteus minimus bwari hejuru cyane mu itsinda rya DA ugereranyije n'itsinda rya DS, kandi igipimo cy'imvune cyari kinini cyane mu itsinda rya DS. Nta tandukaniro rigaragara mu gukomereka kw'imitsi hagati y'amatsinda abiri ya pyriformis na obturator internus. Ishusho yo kubaga igaragara ku Ishusho ya 2, Ishusho ya 3 yerekana uburyo gakondo bwo ku ruhande, naho Ishusho ya 4 igaragaza uburyo gakondo bwo ku ruhande.
Igishushanyo cya 2 1a. Guca burundu umutsi wa gluteus minimus mu gihe cyo kubagwa kwa DA bitewe n'uko bikenewe ko ufata igitsina cy'umugore; 1b. Guca igice cy'umutsi wa gluteus minimus bigaragaza urwego rw'imvune ku mutsi wayo no ku nda yayo. gt. greater trochanter; * gluteus minimus.
Ishusho ya 3 Ishusho y'uburyo gakondo bwo gufata icyuma gifata ...
Ishusho ya 4 Kugaragara k'imitsi migufi yo hanze ya rotator mu buryo busanzwe bwa THA posterior
Umwanzuro n'ingaruka z'ubuvuzi
Ubushakashatsi bwinshi bwakozwe mbere ntibwagaragaje itandukaniro rigaragara mu gihe cyo kubagwa, kugenzura ububabare, igipimo cyo guterwa amaraso, gutakaza amaraso, igihe umuntu amara mu bitaro, n'inzira iyo agereranije THA isanzwe na MIS-THA. Ubushakashatsi bwakozwe kuri THA hamwe n'uburyo busanzwe bwo kwinjira no kudatera THA yakozwe na Repantis et al. nta tandukaniro rigaragara bwagaragaje hagati y'ibyo byombi, uretse kugabanuka gukomeye k'ububabare, kandi nta tandukaniro rigaragara mu kuva amaraso, kwihanganira kugenda, cyangwa gusubiranamo nyuma yo kubagwa. Ubushakashatsi bwakozwe na Goosen et al.
Isuzuma ryakozwe na Goosen n'abandi ryagaragaje ko amanota ya HHS yiyongereye nyuma yo kubagwa mu buryo budakabije (bigaragaza ko umuntu ashobora gukira neza), ariko igihe cyo kubagwa kikaba kirekire ndetse n'ingorane nyinshi nyuma yo kubagwa. Mu myaka ya vuba aha, hakozwe ubushakashatsi bwinshi busuzuma kwangirika kw'imitsi n'igihe cyo gukira nyuma yo kubagwa bitewe no kubagwa mu buryo budakabije, ariko ibi bibazo ntibirakemurwa neza. Ubu bushakashatsi kandi bwakozwe bushingiye kuri ibyo bibazo.
Muri ubu bushakashatsi, byagaragaye ko uburyo bwa DS bwangizaga imitsi buhoro cyane ugereranyije n’uburyo bwa DA, nk’uko bigaragazwa n’uko imitsi ya gluteus minimus n’imitsi yayo yangiritse cyane, imitsi ya vastus tensor fasciae latae, n’imitsi ya rectus femoris yangiritse cyane. Izi mvune zagenwe n’uburyo bwa DA ubwabwo kandi byari bigoye gusana nyuma yo kubagwa. Bitewe n’uko ubu bushakashatsi ari icyuma, hakenewe ubushakashatsi ku buvuzi kugira ngo hamenyekane akamaro k’ubu bushakashatsi mu buryo bwimbitse.
Igihe cyo kohereza: Ugushyingo-01-2023
