Kuva Sculco n'abandi.bwa mbere bwatangaje raporo ntoya ya hip arthroplasty (THA) hamwe nuburyo bwa posterolateral mu 1996, hahinduwe byinshi bishya byibasiwe.Muri iki gihe, igitekerezo cyo kwibasirwa nacyo cyandujwe cyane kandi cyemerwa buhoro buhoro n'abaganga.Nubwo bimeze bityo ariko, haracyari umwanzuro ufatika wo kumenya niba hakoreshwa inzira zisanzwe cyangwa izisanzwe.
Ibyiza byo kubaga byibuze byibasiye harimo uduce duto, kuva amaraso make, kubabara gake, no gukira vuba;icyakora, ibibi birimo umwanya muto wo kureba, byoroshye kubyara ibikomere byubuvuzi bwamaraso, imyanya mibi ya prostothèse, hamwe n’ibyago byo kongera kubagwa.
Mugihe gito cyibasiwe na hip arthroplasty (MIS - THA), gutakaza imitsi nyuma yo kubagwa ni impamvu yingenzi igira ingaruka ku gukira, kandi uburyo bwo kubaga ni ikintu cyingenzi kigira ingaruka kumitsi.Kurugero, inzira zinyuranye kandi zitaziguye zishobora kwangiza imitsi yabashimusi, biganisha ku kugenda (Trendelenburg limp).
Mu rwego rwo gushakisha uburyo bworoshye bwo kugabanya kugabanya imitsi, Dr. Amanatullah n'abandi.kuva ku ivuriro rya Mayo muri Amerika wagereranije uburyo bubiri bwa MIS-THA, inzira y'imbere (DA) hamwe n'uburyo bwo hejuru (DS), ku ngero za cadaveric kugirango hamenyekane kwangirika kw'imitsi n'imitsi.Ibyavuye muri ubu bushakashatsi byagaragaje ko uburyo bwa DS butangiza imitsi n'imitsi kuruta uburyo bwa DA kandi bushobora kuba inzira yatoranijwe kuri MIS-THA.
Igishushanyo mbonera
Ubushakashatsi bwakorewe kuri cadaveri umunani zimaze gukonjeshwa hamwe na joriji umunani yibibuno 16 nta mateka yo kubaga ikibuno.Ikibuno kimwe cyatoranijwe ku bushake kugira ngo gikore MIS-THA binyuze mu buryo bwa DA ikindi kinyuze mu buryo bwa DS muri cadaver imwe, kandi inzira zose zakozwe n'abaganga b'inararibonye.Urwego rwa nyuma rw’imitsi n’imvune rwasuzumwe n’umuganga ubaga amagufwa utagize uruhare muri icyo gikorwa.
Imiterere ya anatomique yasuzumwe harimo: gluteus maximus, gluteus medius na tendon yayo, gluteus minimus na tendon yayo, vastus tensor fasciae latae, quadriceps femoris, trapezius yo hejuru, piatto, trapezius yo hepfo, obturator internus, na obturator externus (Ishusho 1).Imitsi yasuzumwe amarira yimitsi nubwuzu bugaragara mumaso.
Igishushanyo 1 Igishushanyo kidasanzwe cya buri mitsi
Ibisubizo
1. Kwangirika kw'imitsi: Nta tandukanyirizo ryibarurishamibare ryigeze rigaragara ku byangiritse ku buso bwa gluteus medius hagati ya DA na DS.Nyamara, kumitsi ya gluteus minimus, ijanisha ryimvune zo hejuru zatewe nuburyo bwa DA ryari hejuru cyane kurenza iyatewe nuburyo bwa DS, kandi nta tandukaniro rikomeye ryari hagati yuburyo bubiri bwimitsi ya quadriceps.Nta tandukanyirizo rishingiye ku mibare ryari hagati y’ubwo buryo bwombi mu bijyanye no gukomeretsa imitsi ya quadriceps, kandi ijanisha ry’imvune yo hejuru y’imitsi nini ya tensor fasciae latae na rectus femoris imitsi yari myinshi hamwe na DA kuruta uburyo bwa DS.
2. Gukomeretsa kwa Tendon: Nta buryo bwigeze bukomeretsa bikomeye.
3. Guhindura Tendon: Uburebure bwa gluteus minimus tendon transection bwari hejuru cyane mumatsinda ya DA kuruta mu itsinda rya DS, kandi ijanisha ryimvune ryari hejuru cyane mumatsinda ya DS.Nta tandukaniro rikomeye ryagize mu gukomeretsa kwa tendon hagati yitsinda ryombi rya pyriformis na obturator internus.Igishushanyo mbonera cyo kubaga cyerekanwe ku gishushanyo cya 2, Igishushanyo cya 3 cyerekana uburyo bwa gakondo bwo kuruhande, naho ishusho ya 4 yerekana inzira gakondo yinyuma.
Igishushanyo 2 1a.Guhindura byuzuye bya gluteus minimus tendon mugihe cya DA kubera gukenera femorale;1b.Guhindura igice cya gluteus minimus yerekana urugero rwimvune kumitsi no munda.gt.Trochanter;* gluteus minimus.
Igishushanyo cya 3 Igishushanyo cyuburyo bwa gakondo butaziguye hamwe na acetabulum igaragara iburyo hamwe no gukwega bikwiye
Igicapo 4 Kumenyekanisha imitsi ngufi yo kuzunguruka hanze muburyo busanzwe bwa THA inyuma
Umwanzuro hamwe nubuvuzi
Ubushakashatsi bwinshi bwibanze bwerekanye ko nta tandukaniro rinini rigaragara mu gihe cyo gukora, kugenzura ububabare, umuvuduko wo guterwa, gutakaza amaraso, igihe cyo kumara ibitaro, no kugenda iyo ugereranije THA isanzwe na MIS-THA.Ubushakashatsi bw’ubuvuzi bwa THA hamwe n’uburyo busanzwe kandi butera cyane THA by Repantis n'abandi.yerekanye ko nta tandukaniro rinini riri hagati yibi byombi, usibye kugabanuka cyane kububabare, kandi nta tandukaniro rikomeye ryatewe no kuva amaraso, kwihanganira kugenda, cyangwa gusubiza mu buzima busanzwe nyuma yo kubagwa.Ubushakashatsi bwubuvuzi bwakozwe na Goosen n'abandi.
RCT ya Goosen n'abandi.yerekanye ubwiyongere bw'amanota ya HHS nyuma yuburyo bworoshye bwo gutera (byerekana gukira neza), ariko igihe kinini cyo gukora kandi nikibazo gikomeye cya perioperative.Mu myaka yashize, habaye kandi ubushakashatsi bwinshi busuzuma kwangirika kwimitsi nigihe cyo gukira nyuma yo kubagwa bitewe nuburyo bworoshye bwo kubaga bworoshye, ariko ibyo bibazo ntabwo byakemuwe neza.Ubu bushakashatsi nabwo bwakozwe bushingiye kubibazo nkibi.
Muri ubu bushakashatsi, byagaragaye ko uburyo bwa DS bwangije cyane imitsi yimitsi kurusha uburyo bwa DA, nkuko bigaragazwa n’ibyangiritse cyane ku mitsi ya gluteus minimus na tendon yayo, imitsi ya tensor fasciae latae imitsi, n'imitsi ya rectus femoris .Izi nkomere zagenwe nuburyo DA ubwayo kandi byari bigoye kuyisana nyuma yo kubagwa.Urebye ko ubu bushakashatsi ari urugero rwa cadaveric, hakenewe ubushakashatsi ku mavuriro kugira ngo hakorwe ubushakashatsi ku kamaro k’ibisubizo byimbitse.
Igihe cyo kohereza: Ugushyingo-01-2023
