Maye gurbin gwiwa mara siminti yana nufin ƙasa ko lokaci

Maye gurbin gwiwa mara siminti, madadin hanyar yin tiyatar maye gurbin gwiwar siminti na gargajiya, yana samun sha'awa a fagen aikin tiyatar kashi. Masu bincike a asibitin tiyata na musamman (HSS) sun ƙaddamar da wani bincike don kwatanta sakamakon zamani maras siminti dasa gwiwa zuwa daidaitaccen kafa gwiwa wanda ke buƙatar simintin kashi don gyarawa.              

HSS hip da gwiwa likitan tiyata Geoffrey H. Westrich, MD, da abokan aikinsa ba su sami wani bambanci a tsawon zaman asibiti ba, rikice-rikice, sake dawowa asibiti a cikin kwanaki 90 na tiyata, ko adadin aikin tiyata na bita a cikin shekaru biyu na marasa lafiya. An gabatar da binciken a yau a Cibiyar Nazarin Orthopedic Surgeons 2022 na shekara-shekara a Chicago.

Dangane da lokacin da ake amfani da shi a cikin dakin tiyata (OR), masu bincike sun gano cewa yin amfani da dasa shuki maras siminti ya rage OR lokaci da 25%, yana adana matsakaicin mintuna 27. "A cikin jimlar maye gurbin gwiwa ba tare da siminti ba, ba dole ba ne ku jira ciminti ya taurare kuma ya bushe kamar yadda kuke yi a cikin maye gurbin gwiwa na siminti," in ji Brian P. Chalmers, MD, likitan tiyata na hip da gwiwa a HSS da marubucin marubucin. .

"Ragewar lokaci a cikin OR a karkashin maganin sa barci yana da amfani ga marasa lafiya, amma wannan ba shine kawai damar da za a iya amfani da su na simintin gyaran kafa ba," in ji Dokta Westrich, wanda kuma shi ne darektan bincike na Cibiyar Gyaran Ma'aikata da Ma'aikatar Matsala ta Haɗin gwiwa a HSS. "Tare da maye gurbin gwiwa mara siminti, abubuwan da aka gyara suna latsa su dace da wuri don 'gyaran halittu,' wanda ke nufin kashi zai girma zuwa cikin dasawa. Idan akwai gyaran ilimin halitta na farko, sassautawa dasa shuki akan lokaci yakamata ya zama ƙasa da yuwuwar kuma jimlar maye gurbin gwiwa na iya yuwuwa dadewa sosai."

A cikin maye gurbin gwiwa na al'ada, ana kiyaye abubuwan da aka sanyawa a cikin haɗin gwiwa ta amfani da simintin kashi. Dabarar gwadawa ce ta gaskiya wacce ta yi aiki da kyau shekaru da yawa. Amma a ƙarshe, bayan lokaci, siminti yana farawa daga kashi da/ko dasa. Lokacin da ya ƙare ko ya ɓace, marasa lafiya gabaɗaya suna buƙatar maye gurbin gwiwa na biyu, wanda aka sani da tiyatar bita.

Dokta Westrich ya yi imanin cewa dasa shuki maras siminti da kyau zai sa sassautawa a kan lokaci kaɗan, yana ba da damar maye gurbin gwiwa gabaɗaya ya daɗe. Tsawon dasawa shine muhimmin abin la'akari, musamman ga ƙananan marasa lafiya da cututtukan arthritis waɗanda suka zaɓi maye gurbin haɗin gwiwa don kula da salon rayuwarsu. Gabaɗaya suna ƙara ƙarin buƙatu akan haɗin gwiwa, yana haifar da ƙarin lalacewa da yuwuwar sassautawa. Tushen gwiwar da aka yi da siminti da ake amfani da shi wajen maye gurbin haɗin gwiwa na gargajiya yawanci yana ɗaukar shekaru 15 zuwa 20.

“An yi amfani da na’urar da ba ta da siminti cikin nasara a cikin jimillar tiyatar maye gurbin hip na tsawon shekaru da yawa. Ya kasance mafi ƙalubale wajen samar da na'urar da ba ta da siminti wacce za ta yi aiki da kyau a gwiwa saboda yanayin jikin gwiwa na musamman," Dr. Westrich ya bayyana.

Ya kara da cewa, "A baya, an nuna wasu nau'ikan da aka sanya a gwiwa ba tare da siminti ba suna da lahani na zane, tare da sassautawa daga tibia," in ji shi. “Sabuwar siminti maras siminti da aka yi amfani da shi a cikin bincikenmu bai nuna irin wannan sassautawa ba kamar yadda aka buga a cikin binciken da aka buga a baya. Mun tashi don ganin yadda dashen da aka yi wa majinyatan HSS.”

Masu bincike sun sake nazarin 598 na farko unilateral jimlar maye gurbin gwiwa a HSS (170 cementless da 428 cemented) na wannan zane daga 2016 zuwa 2018. Bayanan alƙaluma, bayanan aiki da duk wani rikitarwa an samu daga bayanan likita na marasa lafiya. Marasa lafiya da ke yin aikin rashin siminti sun kasance ƙanana gaba ɗaya, tare da matsakaicin shekaru 63, da 68 ga waɗanda ke da maye gurbin siminti na gargajiya. Kyakkyawan ƙashi mai kyau yana da mahimmanci a cikin nasarar gyaran gwiwa maras ciment. Don haka, likitocin kashin baya sun gwammace su zaɓi ƙananan marasa lafiya don aikin da babu siminti, Dr. Chalmers ya lura.

Babu wani bambanci mai mahimmanci a cikin tsawon zaman asibiti, rikitarwa, ko sake dawowa asibiti don matsala a cikin kwanaki 90 na farko bayan tiyata. Kashi casa'in da shida cikin dari na marasa lafiya maye gurbin siminti da kashi 95% na waɗanda ke da maye gurbin gwiwar siminti sun ci gaba da dasa su ba tare da buƙatar yin tiyatar bita ba a bin shekaru biyu.

"Babban tambaya a yanzu shine ko ko a'a ba tare da siminti ba duka maye gurbin gwiwa zai sami kyakkyawan tsayin daka da gyare-gyare na dogon lokaci fiye da maye gurbin gwiwa," in ji Dokta Chalmers. "Biyan waɗannan marasa lafiya don tantance sakamakon dogon lokaci shine mataki na gaba."