I-half moon board iyi-cartilage ene-fibrous etholakala ngaphakathi nangaphandle kwamalunga e-platform ye-tibial.Ubulili obuhlukile obuhlukile kanye nokungalingani kwe-biomechanics kungahlangabezana nezidingo zemishini ehlukahlukene yejoyinti lamadolo, njengokuthwala umthwalo, ukugcina ukuhlangana kwamadolo, ukuvivinya umzimba okuzinzile, kanye nokushaqeka okumuncayo.Uma ukulimala kwepuleti lenyanga kungelashwa ngesikhathi, ngokuvamile kuzobangela i-osteoarthritis, futhi imbangela eyinhloko yokubonisana kwesiguli ukuthi ubuhlungu buyaqina futhi bungasebenzi kahle.Ibhodi lenyanga eliyingxenye lingahlukaniswa ezindaweni ezintathu ezilandelayo, okungukuthi indawo emhlophe, indawo ebomvu kanye nendawo yomngcele obomvu nomhlophe.Akukho ukusatshalaliswa kwemithambo yegazi endaweni emhlophe, futhi ukuhlinzekwa kwegazi lendawo akuhlinzekiwe.Uma umonakalo kunzima ukuqedela ukulungiswa kwezicubu.Ngakho-ke, kunzima ukulungisa ngemva kokulimala kwebhodi lenyanga, futhi iziguli eziningi zine-prognosis embi.Eminyakeni yamuva nje, ngokuthuthukiswa okuqhubekayo kobuchwepheshe bezokwelapha, izindlela ze-biochemical ezikhuthaza ukulungiswa kwesigamu senyanga yenyanga ziye zasetshenziswa kabanzi emtholampilo futhi zabonisa izinzuzo ezingaba khona.I-Plateau plasma plasma (PRP) ingathuthukisa ikhono le-semi-moon plate fibrocytocyte kanye nezindawo ezimhlophe zamangqamuzana oqwanga ukukhuthaza ukuphulukiswa kwezicubu nokuzuza imiphumela ebalulekile.
Izici zokulimala kwebhodi lenyanga
1) I-anatomy kanye nomsebenzi webhodi lenyanga yedolo
Njengepuleti le-fiber cartilage, ibhodi lenyanga elinguhhafu liphakathi kweplatifomu ye-tibial kanye nekhilikithi yesifazane ekuhlanganyeleni kwamadolo.Izici zokubukeka zebhodi lenyanga yesigamu zimi kanje: Uhlangothi lwangaphakathi olune-C -shaped kanye no-O -shaped ngaphandle;indawo engaphezulu ishonile, indawo engezansi iyisicaba;Xhuma.Ukwengeza, ibhodi lenyanga yesigamu lingaxhunywa emaphethelweni esiteji se-tibial ngosizo lwe-coronary ligament yangaphandle futhi ixhume ku-capsule yamadolo ezungezile, kuyilapho i-tendon ye-router ingadlula ama-capsules angaphandle nahlangene we-half moon plate. .Ngenxa yokuthi ukunikezwa kwegazi kwesigamu senyanga kunikezwa kuphela izicubu ezizungezile, uma izicubu ezizungezile zonakalisiwe, i-half moon plate ijwayele i-necrosis, ezothinta umsebenzi wamadolo.
2) Indlela yokulimala kwebhodi lenyanga eliyingxenye yamadolo
Ibhodi labantu abadala elihlangene nesigamu senyanga lingabangela umonakalo ngenxa yezinto eziningi zangaphandle ezifana neminyaka, umsebenzi kanye nokuqina komsebenzi.Iziguli ezinabantu abasha zivame ukudabuka, kuyilapho iziguli ezikhulile ngokuvamile zihlobene eduze nezinguquko eziwohlokayo.Ukuwohloka kwepuleti lenyanga yesigamu kungaholela ekwehleni kwamandla ayo, okuholela ekwandeni kwamathuba okulimala.Ngakho-ke, ukuzivocavoca okungaqondile kungabangela ukulimala kwebhodi lenyanga.Lapho umsebenzi ohlangene wamadolo, ukulimala kwesigamu senyanga kuhlobene nokuhamba kwesihlobo sawo ekuhlanganyeleni kwamadolo.Lapho idolo elihlangene liqondile, ibhodi lenyanga eliyisigamu liya phambili;lapho idolo elihlangene liguquguquka, i-half moon plate ihlehla emuva;futhi lapho idolo elihlangene liguquguquka, ngaphandle, noma ukujikeleza kwangaphakathi kwangaphakathi, Ukunyakaza Kamuva.Uma idolo elihlangene ngokuzumayo liphenduka futhi lijikeleza, amapuleti enyanga yesigamu ezinhlangothini zombili azoba nemisebenzi ephikisanayo, okungukuthi, "i-half moon board contradiction movement".
3) Ukuxilongwa nokuhlukaniswa kokulimala kwebhodi lenyanga
Iningi leziguli ezinokulimala kwesigamu senyanga zinomlando wokuhlukumezeka kwamadolo.Umtholampilo uvame ukukhononda ngezimpawu zobuhlungu bedolo, ukuvuvukala, nokunwebeka.Okokuqala, i-periphery ye-semi moon plate iqukethe inqwaba yezinzwa ezihlanganisa umnkantsha we-nerve fibers kanye ne-medullary nerve fibers, ngakho-ke umonakalo wepuleti lenyanga ungabangela ubuhlungu kalula;okwesibili, imisebenzi ehlangene yamadolo izodonswa futhi igqugquzelwe yi-meniscus, okuzoqhubeka kubangele ubuhlungu.Ubuhlungu buzokwenzeka phakathi kohlu oluthile lwamalunga amadolo, futhi ukuzwela kugxilile futhi kunqunyelwe uhla oluthile lwezikhala ezihlangene.Ukukhishwa kwenyanga nakho kungabangela ukopha kwamalunga, ukopha, nokuvuvukala kwamalunga.Lapho idolo liguquguquka, ukuvuvukala okulinganiselwe kungatholakala uma uthinta umonakalo ohlangene.Umsebenzi ohlangene wamadolo ungabuye uhambisane nezinhlamvu ukuya ebangeni elithile.Ngalesi sikhathi, ukushelela kwe-half moon plate kungabangela ukulimala kwe-extrusion.Kulabo abanomlando omude ngokuqhathaniswa womlando wezokwelapha, uhla lomsebenzi ongenhla kanye nezingxenye ezithile zokunwebeka kungabangelwa.
I-PRPIzici zebhayoloji nendima
1) Izimpawu Zebhayoloji
I-PRP iyiplatelet egcwele ye-autologous egxilile.Uma kuqhathaniswa namaplatelet avamile, ukugxila kwawo kuphakeme izikhathi ezingu-4-5.Ama-platelet okuhlushwa aphezulu ane-coordinase kanye ne-calcium ions Ama-gel e-flocculent akhiwe abizwa ngokuthi ama-platelet acebile, angabamba iqhaza ekusungulweni kwesakhiwo segatsha lamaseli.I-PRP iqukethe izinhlobo eziningi zamaprotheni nama-cytokines, njenge-platelet derivative growth factor (PDGF), i-vascular endothelial growth factor (VEGF), ne-fibrin.Izinhlayiya ze-alpha ezikhishwe ngemva kwezici zokukhula ezingenhla zingadlala indima yokulungisa, ngaleyo ndlela zikhuthaze ukuphulukiswa kwamathambo nokwakhiwa kabusha kwe-vascular reconstruction.I-PRP iqukethe amaprotheni akhuthaza ukunamathela kwamangqamuzana e-cartilage, ngaleyo ndlela kuqinisekiswe ukulungiswa kwezicubu.I-PRP ihlukaniswe negazi le-autologous, futhi ukuphepha kwayo kuqinisekiswe ukuhlolwa kwezilwane okucatshangelwayo nokuhlobene.I-PRP ayiphephile kuphela, kodwa futhi inezici zezinto eziphilayo ezivuselelayo, ezinomthelela omkhulu wokulungisa umonakalo we-cartilage kanye nezicubu.
2) Indlela yokwandisa amangqamuzana oqwanga
I-VEGF kanye ne-Fiber cell growth factor (FGF) ihlobene nokwakhiwa kabusha kwe-vascular reconstruction.Ngaphansi kwesenzo se-VEGF, ukwanda kwamangqamuzana e-vascular endothelial kungasiza ukwakheka kwesitsha segazi esisha kanye nokuthuthukiswa kokuhamba kwegazi endaweni ethintekile, ngaleyo ndlela kukhuthaze ukuphulukiswa kwezicubu.I-FGF ingaphinde ilawule amaseli ukusheshisa ukwanda kwamaseli e-vascular endothelial ngokulawula amaseli.I-Hepatocyte growth factor (HGF) ingenza kusebenze izici ze-nuclear-XB (NF-XB), i-leukocyte (IL) -1 ukuvimbela impendulo yokuvuvukala kwama-chondrocyte.I-fiber protein protein molecular content ye-PRP inokuqukethwe okuphezulu.Ingakha i-fiber yegridi ye-3D ngaphansi kokwenziwa kusebenze kwe-coordinase ne-calcium ion.Ngakho-ke, i-PRP ingabuye ibizwe ngokuthi ijeli yeplatelet.I-PRP ayikwazi nje ukukhuthaza ukulungiswa kwezicubu ze-cartilage, kodwa futhi inikeze ubakaki onamathiselwe we-cartilage anterior cell cell futhi ikhuthaze ukuhlukaniswa kwayo, okuzosiza ukwakheka kwe-matrix ye-cartilage ebonakalayo.Kungabonakala ukuthi i-PRP ayisizi nje kuphela ukwakhiwa kabusha kwe-cartilage kanye nesifunda se-vascular kanye nokuhlanganiswa kwe-cartilage fiber brackets, kodwa futhi ikhuthaza ukunamathela nokufuduka kwamangqamuzana e-cartilage we-cartilage, bese ulungisa umonakalo wezicubu ze-cartilage.
I-3) Ucwaningo lokuhlola lwe-PRP ekulungisweni kwebhodi lenyanga
Ezinye izazi zakhetha onogwaja njengezivivinyo, futhi ngemva kokuba amaphutha ebhodi lenyanga yesigamu senziwe kuwo womabili amadolo, onogwaja babulawa emavikini angu-4 namaviki angu-8, futhi ukusebenza kwabo kwe-pathological kwahlaziywa.Ucwaningo lwathola ukuthi emavikini e-4, iqembu lokulawula i-half moon plate lakhiwa izicubu ezixhumene, ezingabonakaliswa njenge-fibrosis enzima;kanye nesakhiwo sepuleti yenyanga yesigamu seqembu le-PRP sabonisa evamile, futhi izicubu ze-junction zazinokulungiswa okusobala.Ukwakheka kwenhlangano.Emavikini angu-8, iqembu lokulawula laligcwele izicubu ze-fibrous, futhi i-cartilage ye-half-moon plate ayizange yenziwe.Iqembu le-PRP lokwelapha lalicebile nge-fiber ku-half moon plate, eyanda kakhulu.Ngesikhathi esifanayo, izicubu ze-half-moon plate zibonakala nge-fibrosis ephakathi, futhi ngisho nokuphulukiswa okuyingxenye kukhona.Olunye ucwaningo luthole ukuthi i-fibrin ku-PRP yokucubungula ngaphambilini ingakha i-mesh stent ehlanganisa iqoqo le-polystumin-hydroxylcetic acid.Uma i-PRP i-centrifuged, futhi i-half moon cartilage chondrocyte ihlanganiswa ukuhlakulela i-7D kumagundane anqunu eqembu lokuhlola, ukuhlolwa kwe-microscope ye-fluorescent: Amaseli oqwanga ngemva kokuhlwanyela kwezithombo anganamathela ngokulinganayo futhi asakaze yonke indawo kubakaki.Ngemuva kokuthi i-PRP ilashwe, inani lamaseli e-cartilage liye landa kakhulu.Imiphumela yokuskena i-electron microscopy ibonisa ukuthi kubakaki be-PRP abacutshunguliwe, amangqamuzana oqwanga angaxhunywa kunethiwekhi ye-fiber protein ngemva kwe-24H ne-7D.Phakathi kwezimo ze-16 zokucubungula amagundane eqembu le-bracket ye-PRP, amacala e-6 aphulukisiwe ngokuphelele, amacala angu-9 ayengaphelele, futhi icala le-1 alizange liphulukise, kuyilapho amagundane eqembu lokulawula engazange aphulukise.Kungabonakala ukuthi ngemva kokucutshungulwa kwe-PRP, amangqamuzana e-cartilage ahlangene womuntu anamakhono athile okunamathela kwamaseli, angathuthukisa ikhono lokuphulukisa ibhodi lenyanga.Ucwaningo lokuhlolwa kwe-in vitro kanye ne-in vitro, uma kuqhathaniswa neqembu lejeli le-PRP elilula, iqembu lokwelapha ijeli ye-PRP-osteoma matrix cell linezinga eliphakeme lokuhlukanisa.ithambo.Kukhona izifundo zokucutshungulwa kwe-PRP okuhlanganisiwe kwemodeli ka-Jackie Daping yoqwanga onogwaja, nokugcina uqwanga olunesici ukunyakaza kokungenzi lutho.Imiphumela ye-immunohistochemistry kanye nokuhlolwa kokuskena iphutha kuqinisekisile ukuthi amaphuzu ayo okulungisa izicubu aphezulu.Umphumela ubonisa ukuthi i-PRP idlala indima ebalulekile ekulungiseni i-cartilage, futhi ukusetshenziswa okuhlangene kokusetshenziswa okuhlangene kokusetshenziswa okuhlangene kwamaseli we-bone marrow mesenchymal stem kanye ne-bracket material kungcono.
(Okuqukethwe yile ndatshana kuphrintwe kabusha, futhi asinikezeli nganoma yisiphi isiqinisekiso esicacile noma esishiwoyo sokunemba, ukwethembeka noma ukuphelela kokuqukethwe okuqukethwe kulesi sihloko, futhi asinasibopho ngemibono yalesi sihloko, sicela uqonde.)
Isikhathi sokuthumela: May-11-2023