Osisi ọkara ọnwa bụ cartilage fibrous dị n'ime na n'èzí nkwonkwo nke ikpo okwu tibial.Ndị na-abụghị nwoke ma ọ bụ nwanyị dị iche iche na enweghị isi nke biomechanics nwere ike izute ụdị ọrụ dị iche iche chọrọ maka nkwonkwo ikpere, dị ka ibu ibu, ịkwado nhazi ikpere, mmega ahụ kwụsiri ike, na ịma jijiji.Ọ bụrụ na enweghi ike ịgwọ mmerụ ahụ efere ọkara ọnwa n'oge, ọ na-ebutekarị ọrịa ogbu na nkwonkwo, na isi ihe na-akpata ndụmọdụ onye ọrịa bụ na mgbu ahụ na-akawanye njọ ma ghara ịrụ ọrụ.Enwere ike kewaa bọọdụ ọkara ọnwa na mpaghara atọ ndị a, ya bụ mpaghara ọcha, mpaghara uhie na mpaghara oke uhie na ọcha.Enweghị nkesa arịa ọbara na mpaghara ọcha, a naghị enyekwa ọbara ọbara mpaghara.Ozugbo mmebi siri ike imecha nrụzi anụ ahụ.Ya mere, ọ na-esi ike ịrụzi mgbe ọkara ọnwa bọọdụ merụrụ ahụ, na ọtụtụ ndị ọrịa na-adịghị mma prognosis.N'ime afọ ndị na-adịbeghị anya, na mmepe nke nkà na ụzụ ọgwụ na-aga n'ihu, usoro biochemical nke na-akwalite nrụzi nke ọkara nke ọnwa kwa ọnwa ejirila ọtụtụ ebe na ụlọ ọgwụ ma gosipụta uru ndị nwere ike ime.Plateau plasma plasma (PRP) nwere ike ịkwalite ikike nke ọkara ọnwa fibrocytocytes na ebe ọcha nke mkpụrụ ndụ cartilage iji kwalite ọgwụgwọ anụ ahụ ma nweta nsonaazụ dị ịrịba ama.
Njirimara nke mmebi nke ọkara ọnwa
1) Anatomi na ọrụ nke ikpere ọkara ọnwa osisi
Dị ka efere cartilage fiber, bọọdụ ọkara ọnwa dị n'etiti ikpo okwu tibial na cricket femoral na nkwonkwo ikpere.Ọdịdị ọdịdị nke bọọdụ ọkara ọnwa dị ka ndị a: C -dị n'ime akụkụ na O - n'èzí;elu elu na-agbada, ala ala dị larịị;Jikọọ.Tụkwasị na nke ahụ, a na-ejikọta bọọdụ ọkara nke ọnwa na nsọtụ ikpo okwu tibial site n'enyemaka nke eriri akwara dị n'èzí ma jikọọ na capsule ikpere gbara ya gburugburu, ebe eriri rawụta nwere ike ịgafe na mpụga na nkwonkwo capsules nke ọkara ọnwa efere. .N'ihi na ọ bụ naanị anụ ahụ gbara ya gburugburu na-enye ọbara nke ọkara ọnwa, mgbe anụ ahụ gbara ya gburugburu mebiri emebi, efere ọkara ọnwa na-enwekarị necrosis, nke ga-emetụta ọrụ ikpere.
2) Usoro mmerụ ahụ nke ikpere ọkara ọnwa osisi
Ndị okenye ikpere ụkwụ ọkara ọnwa nwere ike imebi n'ihi ọtụtụ mpụga ihe dị ka afọ, ọrụ na ike ọrụ.Ndị na-arịa ọrịa na-eto eto na-adọkakarị, ebe ndị ọrịa agadi na-enwekarị mmekọrịta chiri anya na mgbanwe mmebi.Mbelata nke efere ọkara ọnwa nwere ike ibute mbelata ike ya, nke na-eduga n'ịbawanye ohere nke mmebi.Ya mere, mmega ahụ n'amaghị ama nwere ike imebi ọkara ọnwa.Mgbe ọrụ nkwonkwo ikpere, mmerụ ahụ efere ọkara ọnwa na-emetụta mmegharị nke ikwu ya na nkwonkwo ikpere.Mgbe nkwonkwo ikpere kwụ ọtọ, bọọdụ ọkara ọnwa na-aga n'ihu;mgbe nkwonkwo ikpere na-agbagharị, efere ọkara ọnwa na-aga azụ;na mgbe nkwonkwo ikpere na-agbanwe agbanwe, n'èzí, ma ọ bụ n'ime ime ime, mmegharị ahụ mgbe e mesịrị.Ọ bụrụ na nkwonkwo ikpere na-atụgharị na mberede na-atụgharị, ọkara ọnwa efere na n'akụkụ abụọ ga-enwe ihe ndị na-emegiderịta onwe ha, ya bụ, "ọkara ọnwa osisi contradiction ije".
3) Nchọpụta na nhazi nke mmerụ ahụ ọkara ọnwa
Ọtụtụ n'ime ndị ọrịa nwere mmerụ ahụ efere ọkara ọnwa nwere akụkọ ihe mere eme nke trauma ikpere.Ụlọ ọgwụ na-emekarị mkpesa ihe mgbaàmà nke mgbu ikpere, ọzịza, na ngbanwe.Mbụ niile, mpụta nke ọkara ọnwa efere nwere ọnụ ọgụgụ buru ibu nke akwara peripherals mejupụtara ụmịka free akwara emep uta eri na medullary akwara emep uta eri, otú ọkara ọnwa efere mebiri pụrụ mfe ime ihe mgbu;nke abụọ, a ga-adọta ma na-akpali ọrụ nkwonkwo ikpere site na meniscus, nke ga-eme ka ihe mgbu pụtakwuo.Mgbu ga-eme n'ime ihe dị iche iche nke nkwonkwo ikpere, na ịdị nro na-edozi ma na-ejedebe na njedebe nke oghere nkwonkwo.Ọpụpụ ọnwa nwekwara ike ịkpata ọbara ọgbụgba, ọbara ọgbụgba, na ọzịza nke nkwonkwo.Mgbe ikpere na-atụgharị, enwere ike ịhụ ọzịza dị oke mgbe ị metụrụ mmebi nkwonkwo aka.Ọrụ nkwonkwo ikpere nwekwara ike iji mgbọ sonye na mpaghara ụfọdụ.N'oge a, mwepu nke ọkara ọnwa efere nwere ike ime ka extrusion mmerụ.Maka ndị nwere ogologo akụkọ ihe mere eme nke akụkọ ahụike ahụike, enwere ike ime ka ọrụ dị n'elu na akụkụ dị iche iche nke elasticity.
PRP's ndu agwa na ọrụ
1) Njirimara ndu
PRP bụ platelet zuru oke na-agbakọba onwe ya.E jiri ya tụnyere platelet nkịtị, itinye uche ya dị elu ugboro 4-5.Platelet dị elu nke nwere nhazi na ion calcium A na-akpọ gels flocculent e guzobere na-akpọ platelet gels bara ọgaranya, nke nwere ike isonye na nguzobe nke alaka ụlọnga.PRP nwere ọtụtụ ụdị protein na cytokines, dị ka ihe na-eto eto na-emepụta platelet nkịtị (PDGF), vascular endothelial growth factor (VEGF), na fibrin.Akụkụ alfa ndị a tọhapụrụ mgbe ihe ndị na-eto eto dị n'elu nwere ike ịrụ ọrụ nrụzi, si otú ahụ na-akwalite ọgwụgwọ ọkpụkpụ na nwughari nke vascular nwughari.PRP nwere protein nke na-akwalite adhesion cell cell cartilage, si otú ahụ na-ahụ nrụzi anụ ahụ.PRP kewapụrụ na ọbara autologous, na ekwenyela na nchekwa ya site na usoro iwu na nnwale anụmanụ metụtara ya.PRP abụghị naanị nchekwa, kamakwa ọ nwere njirimara nke njirimara ndu nke mmeghari ohuru, nke nwere mmetụta nrụzi dị ukwuu na cartilage na mmebi anụ ahụ.
2) Usoro mmụba nke mkpụrụ ndụ cartilage
VEGF na Fiber cell growth factor (FGF) metụtara nwughari nke vaskụla nwughari.N'okpuru ọrụ nke VEGF, mmụba nke mkpụrụ ndụ endothelial vaskụla nwere ike inyere aka ịmepụta arịa ọbara ọhụrụ na mmelite nke mbugharị ọbara nke mpaghara ahụ emetụtara, si otú ahụ na-akwalite ọgwụgwọ anụ ahụ.FGF nwekwara ike ịhazi sel iji mee ka mmụba nke sel endothelial vaskụla dị ngwa ngwa site na ịhazi mkpụrụ ndụ.Ihe na-akpata ịba ụba hepatocyte (HGF) nwere ike ime ka ihe nuklia rụọ ọrụ-XB (NF-XB), leukocyte (IL) -1 iji gbochie nzaghachi mkpali nke chondrocytes.Ihe dị n'ime protein protein eriri afọ nke PRP nwere nnukwu ọdịnaya.Ọ nwere ike ịmepụta eriri grid 3D n'okpuru mmalite nke nhazi na calcium ion.Ya mere, a pụkwara ịkpọ PRP gel platelet.PRP nwere ike ọ bụghị nanị na-akwalite nrụzi nke cartilage anụ ahụ, ma na-enyekwa ihe nkwado maka cartilage n'ihu cell cell na-akwalite ya dị iche iche, nke ga-enyere guzobe transperent cartilage matrix.Enwere ike ịhụ na PRP ọ bụghị nanị na-enyere aka nwughari nke cartilage na mpaghara vaskụla na njikọ nke eriri eriri cartilage, ma na-akwalite njikọ na ịkwaga nke mkpụrụ ndụ cartilage nke cartilage, wee mezie mmebi nke anụ ahụ cartilage.
3) Nchọpụta nnwale nke PRP na nrụzi bọọdụ ọkara ọnwa
Ụfọdụ ndị ọkà mmụta na-ahọrọ oke bekee dị ka nnwale, na mgbe e mechara ntụpọ ọkara nke ọnwa na ikpere abụọ ahụ, a na-egbu oke bekee na izu 4 na izu 8, na nyocha nke ọrịa ha.Nnyocha ahụ chọpụtara na n'ime izu 4, ndị na-achịkwa ọkara ọnwa efere bụ ihe jikọrọ anụ ahụ, nke nwere ike igosi dị ka fibrosis siri ike;na nhazi efere ọkara ọnwa nke ọgwụgwọ PRP gosipụtara nke ọma, na anụ ahụ njikọ ahụ nwere nrụzi doro anya.Ngwakọta nhazi.N'ime izu 8, ndị na-ahụ maka njikwa jupụtara na anụ ahụ fibrous, na cartilage nke efere ọkara ọnwa adịghị emepụta.Otu ọgwụgwọ PRP bara ụba na eriri na efere ọkara ọnwa, nke mụbara nke ukwuu.N'otu oge ahụ, ọkara ọnwa efere anụ ahụ na-egosipụta na agafeghị oke fibrosis, na ọbụna ele mmadụ anya n'ihu ọgwụgwọ dị.Nnyocha ọzọ achọpụtala na fibrin na-arụ ọrụ tupu nhazi PRP nwere ike ịmepụta stent mesh nke nwere ụyọkọ polystumin-hydroxylcetic acid.Ọ bụrụ na PRP bụ centrifuged, na ọkara ọnwa cartilage chondrocyte jikọtara ịzụlite 7D n'ime ịgba ọtọ ụmụ oke nke nnwale otu, fluorescent microscope nnyocha: The cartilage cell mgbe seedlings na-agha mkpụrụ nwere ike ọbụna rapaara na-agbasa n'elu niile nkwado.Mgbe a gwọchara PRP, ọnụ ọgụgụ nke mkpụrụ ndụ cartilage abawanyela nke ukwuu.Nsonaazụ nke nyocha microscopy eletrọn na-egosi na na brackets PRP arụpụtara, mkpụrụ ndụ cartilage nwere ike jikọọ na netwọk protein fiber mgbe 24H na 7D gasịrị.N'ime ikpe iri na isii nke nhazi nke oke ndị PRP bracket, 6 bụ ikpe zuru oke, ikpe 9 ezughị ezu, na ikpe 1 adịghị agwọta, ebe ndị na-ahụ maka njikwa ahụ adịghị agwọta.Enwere ike ịhụ na mgbe edozichara PRP, sel nkwonkwo nkwonkwo mmadụ nwere ikike adhesion cell kpọmkwem, nke nwere ike ime ka ike gwọọ ọkara ọnwa.In vitro na in vitro nyocha nyocha, ma e jiri ya tụnyere otu PRP gel dị mfe, otu PRP-osteoma matrix cell gel ọgwụgwọ nwere ogo dị elu nke ọdịiche.ọkpụkpụ.Enwere ọmụmụ banyere nhazi PRP jikọtara ọnụ nke Jackie Daping nlereanya nke cartilage oke bekee, ma mee ka cartilage nwere nkwarụ mpaghara na-agafe agafe.Nsonaazụ nke immunohistochemistry na nyocha nyocha mmejọ egosila na akara nrụzi anụ ahụ ya dị elu.Nsonaazụ na-egosi na PRP na-arụ ọrụ dị mkpa n'ịrụzi cartilage, na ngwa ngwa ngwa ngwa nke ngwa ngwa jikọtara nke ngwa ngwa nke ọkpụkpụ ọkpụkpụ mesenchymal sel na ihe nkwado dị mma.
(A na-ebipụtaghachi ọdịnaya nke isiokwu a, ma anyị anaghị enye nkwa ọ bụla ma ọ bụ nkwenye doro anya maka izi ezi, ntụkwasị obi ma ọ bụ izu oke nke ọdịnaya dị n'ime edemede a, ọ bụghịkwa maka echiche nke isiokwu a, biko ghọta.)
Oge nzipu: Mee-11-2023