Ibhodi yesiqingatha senyanga yi-fibrous cartilage efumaneka ngaphakathi nangaphandle kwamalungu eqonga le-tibial.Iindidi ezahlukeneyo zesini esahlukileyo kunye nokungalingani kwe-biomechanics zinokuhlangabezana neemfuno zoomatshini bomdibaniso wamadolo, njengokuthwala umthwalo, ukugcina ulungelelwaniso lwamadolo, umthambo ozinzile, kunye nokufunxa ukothuka.Ukuba ukwenzakala kweplate yesiqingatha senyanga ayinakunyangwa ngexesha, kuya kuhlala kubangele i-osteoarthritis, kwaye eyona nto iphambili yokubonisana nesigulane kukuba intlungu iyancipha kwaye ingasebenzi kakuhle.Ibhodi yesiqingatha senyanga inokwahlulwa kwezi ndawo zintathu zilandelayo, ezizezi, indawo emhlophe, indawo ebomvu kunye nomda obomvu nomhlophe.Akukho ukuhanjiswa kwemithambo yegazi kwindawo emhlophe, kwaye ukunikezelwa kwegazi kwendawo akubonelelwanga.Emva kokuba umonakalo kunzima ukugqiba ukulungiswa kwezicubu.Ngoko ke, kunzima ukulungisa emva kokulimala kwebhodi yenyanga, kwaye izigulane ezininzi zine-prognosis embi.Kwiminyaka yakutshanje, kunye nophuhliso oluqhubekayo lobuchwepheshe bezonyango, iindlela ze-biochemical ezikhuthaza ukulungiswa kwesiqingatha senyanga ye-dispenation ziye zasetyenziswa ngokubanzi kwiklinikhi kwaye zibonise iingenelo ezinokubakho.I-Plateau plasma plasma (PRP) inokuphucula amandla e-semi-moon plate fibrocytocytes kunye neendawo ezimhlophe zeeseli ze-cartilage ukukhuthaza ukuphulukiswa kwezicubu kunye nokufezekisa iziphumo ezibalulekileyo.
Iimpawu zomonakalo webhodi yesiqingatha senyanga
1) I-anatomy kunye nomsebenzi webhodi lenyanga yedolo
Njengeplate ye-fiber cartilage, ibhodi yesiqingatha senyanga iphakathi kweqonga le-tibial kunye neqakamba le-femoral kwi-joint joint.Iimpawu zembonakalo yebhodi yesiqingatha senyanga zimi ngolu hlobo lulandelayo: Icala elingaphakathi le-C elinemilo kunye no-O-shaped ngaphandle;umphezulu ongaphezulu uyatshona, indawo esezantsi ithe tyaba;Qhagamshela.Ukongezelela, ibhodi yenyanga yesiqingatha inokudibaniswa kumda weplatifomu ye-tibial ngoncedo lwe-coronary ligament yangaphandle kwaye idibanise kwi-capsule ejikelezayo yamadolo, ngelixa i-tendon ye-router ingadlula kwii-capsules zangaphandle kunye nezidibeneyo ze-half-moon plate. .Ngenxa yokuba i-half-moon plate blood supply inikezelwa kuphela yi-tissue ejikelezileyo, emva kokuba izicubu ezijikelezayo zonakaliswe, i-half-moon plate ixhomekeke kwi-necrosis, eya kuchaphazela umsebenzi wamadolo.
2) Inkqubo yokulimala kwebhodi yenyanga yesiqingatha sedolo
Idolo elihlangeneyo labantu abadala ibhodi yesiqingatha senyanga inokubangela umonakalo ngenxa yezinto ezininzi zangaphandle ezifana nobudala, umsebenzi kunye nokuqina komsebenzi.Izigulana ezinabantu abancinci zihlala zikrazulwa, ngelixa izigulana ezibuthathaka zihlala zizalana ngokusondeleyo notshintsho oluwohlokayo.Ukutshatyalaliswa kweplate yesiqingatha senyanga kunokukhokelela ekunciphiseni amandla ayo, okukhokelela ekwandeni kwamathuba omonakalo.Ke ngoko, ukuzivocavoca ngokungazinzanga kunokubangela umonakalo webhodi yesiqingatha senyanga.Xa umsebenzi ohlangeneyo wamadolo, i-half-moon plate yokulimala ihambelana nokuhamba kwesalamane sayo kwidolo.Xa idolo elihlangeneyo lithe tye, ibhodi yesiqingatha senyanga ihamba phambili;xa idolo elihlangeneyo liguquguquka, i-half-moon plate ibuyela ngasemva;kwaye xa idolo elidibeneyo liguquguqukayo, ngaphandle, okanye ukujikeleza kwangaphakathi kwangaphakathi, Ukunyakaza kamva.Ukuba idolo elidibeneyo lijika ngokukhawuleza kwaye lijikeleze, iiplate zesiqingatha zenyanga kumacala omabini ziya kuba nemisebenzi ephikisanayo, oko kukuthi, "i-half moon board contradiction movement".
3) Ukuxilongwa kunye nokuhlelwa kokulimala kwebhodi yesiqingatha senyanga
Uninzi lwezigulane ezinokulimala kwesiqingatha senyanga zinembali yokulimala kwamadolo.Iklinikhi ihlala ikhalaza ngeempawu zeentlungu zedolo, ukudumba, kunye nokuqina.Okokuqala, i-periphery ye-semi-moon plate iqulethe inani elikhulu lee-peripherals ze-nerve ezibandakanya umongo ongenazo ii-fibers ze-nerve kunye ne-medullary nerve fibers, ngoko ke umonakalo weplate yenyanga ungabangela intlungu ngokulula;okwesibini, imisebenzi edibeneyo yamadolo iya kutsalwa kwaye ikhuthazwe yi-meniscus, eya kubangela intlungu ngakumbi.Ubuhlungu buya kwenzeka phakathi koluhlu oluthile lwamadolo, kwaye ububele buqiniswe ngakumbi kwaye bukhawulelwe kuluhlu oluthile lwezithuba ezidibeneyo.Ukukhutshwa kwenyanga kunokubangela ukopha kwamalungu, ukopha, kunye nokudumba kwamalungu.Xa idolo liguquguquka, ukuvuvukala okulinganiselwe kunokufumaneka xa uchukumisa umonakalo odibeneyo.Umsebenzi odibeneyo wamadolo unokuhamba kunye neebhulethi kuluhlu oluthile.Ngeli xesha, ukutyibilika kweplate yesiqingatha senyanga kunokubangela ukulimala kwe-extrusion.Kwabo banembali ende yembali yonyango, uluhlu lwemisebenzi engentla kunye neendawo ezithile zokwaluka zinokubangelwa.
I-PRPIimpawu zebhayoloji kunye nendima
1) Iimpawu zebhayoloji
I-PRP yiplatelet egxininisiweyo ye-autologous epheleleyo.Xa kuthelekiswa neeplatelet eziqhelekileyo, ukugxila kwayo kumaxesha angama-4-5 aphezulu.Iiplatelet zoxinzelelo eziphezulu kunye ne-coordinase kunye ne-calcium ions Iigels ezijikelezayo ezenziweyo zibizwa ngokuba yi-gel platelet ecebileyo, enokuthi ithathe inxaxheba ekusekweni kwe-architecture yesebe leseli.I-PRP iqulethe ezininzi iintlobo zeprotheni kunye ne-cytokines, ezifana ne-platelet derivative growth factor (PDGF), i-vascular endothelial growth factor (VEGF), kunye ne-fibrin.Iingqungquthela ze-alpha ezikhutshwe emva kwezi zinto zingasentla zokukhula zingadlala indima yokulungisa, ngaloo ndlela zikhuthaza ukuphulukiswa kwamathambo kunye nokwakhiwa kwakhona kwe-vascular reconstruction.I-PRP iqulethe iprotheni ekhuthaza i-cartilage cell adhesion, ngaloo ndlela iqinisekisa ukulungiswa kwezicubu.I-PRP ihlukaniswe negazi le-autologous, kwaye ukhuseleko lwayo luye lwaqinisekiswa ngovavanyo lwezilwanyana kunye nezilwanyana ezinxulumene nazo.I-PRP ayikhuselekanga kuphela, kodwa ineempawu ze-biological regenerative, enempembelelo enkulu yokulungisa i-cartilage kunye nomonakalo wezicubu.
2) Indlela yokwandisa iiseli ze-cartilage
I-VEGF kunye ne-Fiber cell growth factor (FGF) inxulumene nokwakhiwa kwakhona kwe-vascular reconstruction.Ngaphantsi kwesenzo se-VEGF, ukwanda kweeseli ze-vascular endothelial kunokunceda ukubunjwa kwemithambo yegazi emitsha kunye nokuphuculwa kokuthuthwa kwegazi kwindawo echaphazelekayo, ngaloo ndlela kukhuthaze ukuphulukiswa kwezicubu.I-FGF inokulawula iiseli ukukhawulezisa ukwanda kweeseli ze-vascular endothelial ngokulawula iiseli.I-Hepatocyte factor factor (HGF) inokwenza i-nuclear factor-XB (NF-XB) isebenze, i-leukocyte (IL) -1 ukuvimbela impendulo yokuvuvukala kwee-chondrocytes.I-fiber protein ye-molecular content ye-PRP inomxholo ophezulu.Inokwenza i-fiber yegridi ye-3D phantsi kokusebenza kwe-coordinase kunye ne-calcium ion.Ngoko ke, i-PRP inokubizwa ngokuba yi-gel platelet.I-PRP ayikwazi nje ukukhuthaza ukulungiswa kwezicubu ze-cartilage, kodwa iphinde ibonelele i-bracket eqhotyoshelweyo kwiiseli ze-cartilage zangaphambili kunye nokukhuthaza ukuhlukana kwayo, okuya kunceda ukubunjwa kwe-matrix ye-cartilage ebonakalayo.Ingabonwa ukuba i-PRP ayincedi kuphela ukwakhiwa kwakhona kwe-cartilage kunye nommandla we-vascular kunye nokuhlanganiswa kwe-cartilage fiber brackets, kodwa ikhuthaza ukunamathela kunye nokufuduka kweeseli ze-cartilage ze-cartilage, kwaye emva koko zilungise umonakalo we-cartilage tissue.
I-3) Uphando lovavanyo lwe-PRP kwi-half-moon board repair
Abanye abaphengululi bakhetha imivundla njengovavanyo, kwaye emva kokuba iziphene zebhodi yesiqingatha senyanga zenziwe emadolweni omabini, imivundla yabulawa kwiiveki ezi-4 kunye neeveki ezi-8, kwaye ukusebenza kwabo kwe-pathological kuhlalutywe.Uphononongo lufumene ukuba kwiiveki ze-4, iqela lokulawula i-half-moon plate lihlanganiswe nezicubu ezidibeneyo, ezinokubonakaliswa njenge-fibrosis enzima;kunye neqela le-PRP lonyango lwe-half-moon plate structure libonise ngokuqhelekileyo, kwaye i-junction tissue yayinokulungiswa okucacileyo.Ukuqulunqwa kombutho.Kwiiveki ze-8, iqela lokulawula laligcwele izicubu ze-fibrous, kwaye i-cartilage ye-half-moon plate ayizange yenziwe.Iqela le-PRP lonyango lalicebile kwifiber kwi-half-moon plate, eyanda kakhulu.Kwangaxeshanye, izicubu zeplate yesiqingatha senyanga zibonakalisa i-fibrosis ephakathi, kwaye nokuphiliswa kancinci kukho.Olunye uphando lufumene ukuba i-fibrin kwi-PRP yokulungisa kwangaphambili inokwenza i-mesh stent equkethe i-polystumin-hydroxylcetic acid cluster.Ukuba i-PRP i-centrifuged, kwaye i-half moon cartilage chondrocyte idibaniswe ukuhlakulela i-7D kwiigundane ezinqunu zeqela lokulinga, ukuhlolwa kwe-microscope ye-fluorescent: Iiseli ze-cartilage emva kokuba izithole zihlwayelwe ziyakwazi ukunamathela kwaye zisasazeke kulo lonke i-bracket.Emva kokuba i-PRP iphathwe, inani leeseli ze-cartilage liye landa kakhulu.Iziphumo zokuskena i-electron microscopy zibonisa ukuba kwiibrakethi ze-PRP ezicwangcisiweyo, iiseli ze-cartilage zinokudibaniswa kwinethiwekhi yeprotheni yefiber emva kwe-24H kunye ne-7D.Phakathi kweemeko ze-16 zokucubungula iigundane zeqela le-bracket ye-PRP, iimeko ze-6 zaphiliswa ngokupheleleyo, iimeko ze-9 aziphelelanga, kwaye ityala le-1 alizange liphilise, ngelixa iigundane zeqela lokulawula azizange ziphilise.Ingabonwa ukuba emva kokuba i-PRP icutshungulwe, iiseli ze-cartilage ezihlangeneyo zabantu zinezakhono ezithile zokubambelela kwiseli, ezinokuphucula amandla okuphulukisa ibhodi yesiqingatha senyanga.Uphando lovavanyo lwe-in vitro kunye ne-vitro, xa kuthelekiswa neqela le-gel ye-PRP elula, iqela le-PRP-osteoma matrix yonyango ye-gel gel inezinga eliphezulu lokuhlukana.ithambo.Kukho izifundo kwi-processing ye-PRP edibeneyo ye-Jackie Daping imodeli ye-cartilage yomvundla, kwaye ugcine indawo ye-cartilage enesiphako intshukumo yokuhamba.Iziphumo ze-immunohistochemistry kunye novavanyo lwe-fault scanning luqinisekisile ukuba amanqaku ayo okulungisa izicubu eziphezulu.Isiphumo sibonisa ukuba i-PRP idlala indima ebalulekileyo ekulungiseni i-cartilage, kunye nesicelo esidibeneyo sokusetyenziswa okudibeneyo kwe-bone marrow mesenchymal stem cells kunye ne-bracket material ingcono.
(Imixholo yeli nqaku ishicilelwe, kwaye asiboneleli nasiphi na isiqinisekiso esicacileyo okanye esichaziweyo sokuchaneka, ukuthembeka okanye ukugqibelela kokuqulathwe kweli nqaku, kwaye abanaxanduva ngezimvo zeli nqaku, nceda uqonde.)
Ixesha lokuposa: May-11-2023