The half month board ndi fibrous cartilage yomwe ili mkati ndi kunja kwa malo a tibial platform.Mitundu yosiyanasiyana yamitundu yosiyanasiyana komanso kusagwirizana kwa biomechanics kumatha kukwaniritsa zofunikira zamakina olumikizirana mawondo, monga kunyamula katundu, kusunga kulumikizana kwa mawondo, kuchita masewera olimbitsa thupi mokhazikika, komanso kugwedezeka kwamphamvu.Ngati kuvulala kwa theka la mwezi sikungathe kuchiritsidwa panthawi yake, nthawi zambiri kumayambitsa nyamakazi ya osteoarthritis, ndipo chifukwa chachikulu cha kukambirana kwa wodwalayo ndi chakuti ululuwo ukukulirakulira komanso kukanika.Gulu la theka la mwezi likhoza kugawidwa m'madera atatu otsatirawa, omwe ndi malo oyera, malo ofiira ndi malo ofiira ndi oyera.Palibe kugawa kwa mitsempha yamagazi m'dera loyera, ndipo magazi am'deralo saperekedwa.Kamodzi kuwonongeka kumakhala kovuta kumaliza kukonza minofu.Choncho, n'zovuta kukonza pambuyo pa kuvulala kwa theka la mwezi, ndipo odwala ambiri ali ndi vuto losauka.M'zaka zaposachedwa, ndikukula kosalekeza kwaukadaulo wamankhwala, njira zama biochemical zomwe zimalimbikitsa kukonzanso kwa theka la mwezi uliwonse zakhala zikugwiritsidwa ntchito kwambiri kuchipatala ndikuwonetsa zabwino zomwe zingakhalepo.Plateau plasma plasma (PRP) imatha kupititsa patsogolo luso la semi-moon plate fibrocytocytes ndi malo oyera a cell cartilage kulimbikitsa machiritso a minofu ndikupeza zotsatira zazikulu.
Makhalidwe a kuwonongeka kwa theka la mwezi
1) The anatomy ndi ntchito ya bondo theka la mwezi bolodi
Monga mbale ya fiber cartilage, theka la mwezi lili pakati pa nsanja ya tibial ndi cricket ya femoral mu bondo.Mawonekedwe a gulu la theka la mwezi ndi awa: C -oboola pakati mbali ndi O -woboola kunja;chapamwamba chamira, chapansi ndi chathyathyathya;Lumikizani.Kuonjezera apo, bolodi la theka la mwezi likhoza kumangirizidwa pamphepete mwa nsanja ya tibial mothandizidwa ndi chingwe chakunja cha coronary ligament ndikugwirizanitsa ndi kapsule ya bondo yozungulira, pamene tendon ya router imatha kudutsa makapisozi akunja ndi ophatikizana a theka la mwezi. .Chifukwa chakuti magazi a theka la mwezi amangoperekedwa ndi minofu yozungulira, minofu yozungulira ikawonongeka, theka la mwezi limakhala lokhazikika ku necrosis, zomwe zidzakhudza ntchito ya mawondo.
2) The kuvulala limagwirira wa bondo theka mwezi bolodi
Akuluakulu bondo olowa theka mwezi bolodi akhoza kuwononga chifukwa cha zinthu zambiri kunja monga zaka, ntchito ndi ntchito kwambiri.Odwala omwe ali ndi achinyamata nthawi zambiri amang'ambika, pamene odwala okalamba nthawi zambiri amakhala okhudzana kwambiri ndi kusintha kosinthika.Kuwonongeka kwa mbale ya theka la mwezi kungayambitse kuchepa kwa mphamvu zake, zomwe zimabweretsa kuwonjezeka kwa mwayi wowonongeka.Choncho, kuchita masewera olimbitsa thupi mosadziwa kungayambitse kuwonongeka kwa theka la mwezi.Pamene bondo olowa ntchito, theka la mwezi mbale kuvulala zikugwirizana ndi kayendedwe wake wachibale kwa bondo olowa.Pamene mgwirizano wa bondo uli wowongoka, gulu la theka la mwezi limapita patsogolo;bondo likamasinthasintha, theka la mwezi limayenda chammbuyo;ndipo pamene mgwirizano wa bondo umasinthasintha, kunja, kapena kusinthasintha kwa mkati, Pambuyo pake kuyenda.Ngati mawondo a bondo atembenuka mwadzidzidzi ndikuzungulira, mbale za theka la mwezi kumbali zonse zidzakhala ndi zotsutsana, ndiko kuti, "half moon board contradiction movement".
3) Kuzindikira ndi kugawa kuvulala kwa theka la mwezi
Ambiri mwa odwala omwe amavulala ndi theka la mwezi amakhala ndi mbiri ya kuvulala kwa mawondo.A chipatala nthawi zambiri amadandaula zizindikiro za ululu mawondo, kutupa, ndi elasticity.Choyamba, periphery wa theka-mwezi mbale lili ambiri mitsempha peripherals wopangidwa m`mafupa free mitsempha ulusi ndi medullary mitsempha ulusi, kotero theka mwezi mbale kuwonongeka mosavuta kupweteka;chachiwiri, ntchito zamagulu a mawondo zidzakokedwa ndikulimbikitsidwa ndi meniscus, zomwe zingayambitse kupweteka.Ululu udzachitika mkati mwamagulu ena a mawondo, ndipo kukoma mtima kumakhala kosasunthika komanso kumangokhala ndi mipata yambiri yamagulu.Kutuluka kwa mwezi kungayambitsenso magazi, kutuluka magazi, ndi kutupa kwa mafupa.Pamene bondo likugwedezeka, kutupa kochepa kungapezeke mukakhudza kuwonongeka kwa mgwirizano.Ntchito yolumikizira mawondo imathanso kutsagana ndi zipolopolo kumtundu wina.Panthawi imeneyi, kutsetsereka kwa mbale ya theka la mwezi kungayambitse kuvulala kwa extrusion.Kwa iwo omwe ali ndi mbiri yakale yachipatala, zochitika zomwe zili pamwambazi ndi zigawo zenizeni za elasticity zikhoza kuyambitsidwa.
PRP's biological makhalidwe ndi udindo
1) Makhalidwe Achilengedwe
PRP ndi gulu lokhazikika la autologous full platelet.Poyerekeza ndi mapulateleti wamba, ndende yake ndi 4-5 nthawi zambiri.Mapulateleti apamwamba kwambiri okhala ndi coordinase ndi calcium ions Ma gels oyenda omwe amapangidwa amatchedwa ma gel olemera a mapulateleti, omwe amatha kutenga nawo gawo pakukhazikitsa kamangidwe ka nthambi.PRP ili ndi mitundu yambiri ya mapuloteni ndi ma cytokines, monga ma platelet derivative growth factor (PDGF), vascular endothelial growth factor (VEGF), ndi fibrin.Ma alpha particles omwe amatulutsidwa pambuyo pa kukula kwa zinthu zomwe zili pamwambazi zimatha kugwira ntchito yokonzanso, potero kulimbikitsa machiritso a mafupa ndi kukonzanso kwa mitsempha ya mitsempha.PRP ili ndi mapuloteni omwe amalimbikitsa kuphatikizika kwa maselo a cartilage, motero kuonetsetsa kuti minofu ikukonzedwa.PRP imasiyanitsidwa ndi magazi a autologous, ndipo chitetezo chake chatsimikiziridwa ndi kuyesera kwachidziwitso ndi zokhudzana ndi zinyama.PRP sikuti ndi yotetezeka kokha, komanso imakhala ndi makhalidwe osinthika achilengedwe, omwe amakhudza kwambiri kukonzanso kwa cartilage ndi kuwonongeka kwa minofu.
2) Kuchulukitsa kwa ma cell a cartilage
VEGF ndi Fiber cell growth factor (FGF) zimagwirizana ndi kumangidwanso kwa mitsempha ya mitsempha.Pansi pa zochita za VEGF, kuchuluka kwa ma cell endothelial cell kungathandize kupanga mapangidwe atsopano a mitsempha yamagazi komanso kupititsa patsogolo kayendedwe ka magazi m'dera lomwe lakhudzidwa, potero kulimbikitsa machiritso a minofu.FGF imathanso kuwongolera ma cell kuti apititse patsogolo kuchuluka kwa ma cell endothelial cell powongolera ma cell.Hepatocyte kukula factor (HGF) ikhoza kuyambitsa zinthu za nyukiliya-XB (NF-XB), leukocyte (IL) -1 kuti alepheretse kuyankha kotupa kwa chondrocytes.Mapuloteni opangidwa ndi fiber mkati mwa PRP ali ndi zambiri.Ikhoza kupanga 3D grid fiber pansi pa kutsegulidwa kwa coordinase ndi calcium ion.Chifukwa chake, PRP imathanso kutchedwa gel platelet.PRP silingangolimbikitsa kukonzanso minofu ya cartilage, komanso kupereka cholumikizira chomangira cha cartilage anterior cell cell ndikulimbikitsa kusiyanitsa kwake, zomwe zingathandize kupanga matrix owonekera a cartilage.Zitha kuwoneka kuti PRP sikuti imangothandiza kumangidwanso kwa cartilage ndi dera la mitsempha komanso kuphatikizika kwa mabakiteriya a cartilage fiber, komanso kumalimbikitsa kumamatira ndi kusamuka kwa maselo a cartilage a cartilage, ndiyeno kukonzanso kuwonongeka kwa minofu ya cartilage.
3) Kafukufuku woyesera wa PRP pakukonzekera kwa theka la mwezi
Akatswiri ena anasankha akalulu monga zoyesera, ndipo pambuyo pa zofooka za theka la mwezi zidapangidwa m'mawondo onse, akalulu amaphedwa pa masabata 4 ndi masabata 8, ndipo machitidwe awo amatenda adawunikidwa.Phunzirolo linapeza kuti pa masabata a 4, gulu lolamulira theka la mwezi linapangidwa ndi minofu yolumikizana, yomwe imatha kuwonetsedwa ngati fibrosis yoopsa;ndipo gulu lachipatala la PRP la theka la mwezi lidawonetsa bwino, ndipo minofu yolumikizirana idakonzedwa bwino.Zolemba za bungwe.Pa masabata 8, gulu lolamulira linali lodzaza ndi minofu ya fibrous, ndipo cartilage ya theka la mwezi-mwezi sinapangidwe.Gulu la mankhwala a PRP linali lolemera mu fiber mu theka la mwezi, lomwe linakula kwambiri.Pa nthawi yomweyi, minofu ya theka la mwezi imawonekera mu fibrosis yokhazikika, ndipo ngakhale kuchiritsa pang'ono kumakhalapo.Kafukufuku wina wapeza kuti fibrin mu pre-processing PRP imatha kupanga mesh stent yokhala ndi polystumin-hydroxylcetic acid cluster.Ngati PRP ndi centrifuged, ndipo theka la mwezi cartilage chondrocyte imaphatikizidwa kuti ikhale ndi 7D mu mbewa zamaliseche za gulu loyesera, kufufuza kwa microscope ya fulorosenti: Maselo a cartilage pambuyo pa mbande kufesa akhoza kukhazikika mofanana ndikufalikira pa bulaketi lonse.Pambuyo pa chithandizo cha PRP, chiwerengero cha maselo a cartilage chawonjezeka kwambiri.Zotsatira za scanning electron microscopy zimasonyeza kuti pamabakiteriya a PRP okonzedwa, maselo a cartilage amatha kugwirizanitsidwa ndi fiber protein network pambuyo pa 24H ndi 7D.Pakati pa milandu ya 16 yokonza mbewa za gulu la PRP, milandu ya 6 inachiritsidwa kwathunthu, milandu ya 9 inali yosakwanira, ndipo mlandu wa 1 sunachiritse, pamene mbewa za gulu lolamulira sizinachiritse.Zitha kuwoneka kuti PRP ikasinthidwa, maselo amtundu wa anthu omwe ali ndi cartilage amakhala ndi mphamvu zapadera zomata maselo, zomwe zingapangitse mphamvu yochiritsa theka la mwezi.Kafukufuku wa in vitro ndi in vitro test, poyerekeza ndi gulu losavuta la PRP gel, gulu la PRP-osteoma matrix cell treatment gel lili ndi kusiyana kwakukulu.fupa.Pali maphunziro ophatikizika a PRP kachitidwe ka Jackie Daping ka cartilage ya kalulu, ndikupangitsa kuti chichereŵechereŵe chisasunthike.Zotsatira za immunohistochemistry ndi kuyesa kwa zolakwika zatsimikizira kuti kukonzanso minofu yake ndikokwera.Chotsatiracho chimasonyeza kuti PRP imakhala ndi gawo lofunika kwambiri pakukonzekera kwa cartilage, ndipo kuphatikizika kophatikizana kophatikizana kophatikizana ndi maselo a fupa a mesenchymal stem cell ndi bracket material ndi bwino.
(Zomwe zili m'nkhaniyi zidasindikizidwanso, ndipo sitikupereka chitsimikizo chotsimikizika kapena chotsimikizika pakulondola, kudalirika kapena kukwanira kwa zomwe zili m'nkhaniyi, ndipo sitili ndi udindo pamalingaliro ankhaniyi, chonde mvetsetsani.）
Nthawi yotumiza: May-11-2023