Igice cyukwezi cyakabiri ni fibrous karitsiye iherereye imbere ninyuma yumutwe wa tibial platform.Ibitsina bitandukanye bitandukanye ndetse nuburinganire bwibinyabuzima birashobora kuzuza ibisabwa bitandukanye byubukanishi bwikivi, nko kwikorera imitwaro, gukomeza guhuza ivi, imyitozo ihamye, no gukurura ihungabana.Niba igikomere cy'igice cy'ukwezi kidashobora kuvurwa mugihe gikwiye, akenshi bizatera osteoarthritis, kandi impamvu nyamukuru itera inama umurwayi nuko ububabare bwiyongera kandi bukora nabi.Ikibaho cy'ukwezi gishobora kugabanywamo ibice bitatu bikurikira, aribyo byera, agace gatukura hamwe n'umupaka utukura n'umweru.Nta miyoboro y'amaraso ikwirakwizwa muri zone yera, kandi amaraso yaho ntatangwa.Iyo ibyangiritse bigoye kurangiza gusana imyenda.Kubwibyo, biragoye gusana nyuma yimvune yimbeho yukwezi, kandi abarwayi benshi bafite prognoz mbi.Mu myaka yashize, hamwe n’iterambere rikomeje ry’ikoranabuhanga mu buvuzi, uburyo bwa biohimiki buteza imbere gusana igice cya kabiri cyo gutangwa bwakoreshejwe henshi mu ivuriro kandi bugaragaza ibyiza bishoboka.Plasma plasma plasma (PRP) irashobora kongera ubushobozi bwa kimwe cya kabiri cyameza fibrocytocytes hamwe nu gice cyera cyingirabuzimafatizo kugirango biteze imbere gukira no kugera kubisubizo byingenzi.
Ibiranga igice cyakwezi kwangirika
1) Anatomy n'imikorere y'amavi igice cy'ukwezi
Nka plaque ya fibre karibasi, igice cyukwezi cyakwezi kiri hagati ya tibial platform na cricket ya femorale mu ivi.Ibigaragara biranga igice cyukwezi kwakabiri nuburyo bukurikira: C -imiterere yimbere imbere na O-ishusho hanze;hejuru yo hejuru yararohamye, ubuso bwo hasi burasa;Ihuze.Byongeye kandi, igice cyakwezi cyakabiri gishobora kwomekwa kumpande ya tibial platifike hifashishijwe imitsi yinyuma ya coronary ligament hanyuma igahuza na capsule ikikije ivi, mugihe inzira ya router ishobora kunyura hanze na capsules ya plaque yukwezi. .Kuberako igice cyamezi yamaraso gitangwa gusa ninyama ziyikikije, iyo tissue ikikije yangiritse, isahani yukwezi ikunze kwibasirwa na nérosose, bizagira ingaruka kumikorere yivi.
2) Uburyo bwo gukomeretsa kumavi igice cyakwezi
Abakuze bapfukamye igice cya kabiri cyukwezi barashobora kwangiza bitewe nibintu byinshi byo hanze nkimyaka, akazi hamwe nimbaraga zakazi.Abarwayi bafite urubyiruko bakunze gutanyagurwa, mugihe abarwayi bageze mu za bukuru usanga akenshi bafitanye isano nimpinduka zangirika.Iyangirika rya kimwe cya kabiri cy'isahani irashobora gutuma imbaraga zayo zigabanuka, ibyo bigatuma kwiyongera kwinshi kwangirika.Kubwibyo, imyitozo utabishaka irashobora kwangiza igice cyukwezi kwangirika.Iyo ivi rifatanije, igice cyakwezi cyakomeretse kijyanye no kugenda kwacyo ugereranije n ivi.Iyo ivi rifatanye rigororotse, igice cyakwezi kigenda imbere;iyo ivi ifatanye ihindagurika, isahani yukwezi igenda isubira inyuma;kandi iyo ivi rihindagurika, hanze, cyangwa imbere imbere kuzenguruka, Nyuma kugenda.Niba ifi ifatanye ihindutse itunguranye, isahani yukwezi kumpande zombi izaba ifite ibikorwa bivuguruzanya, ni ukuvuga, "igice cyukwezi kwivuguruza".
3) Gupima no gutondekanya igice cyakomeretse cyakwezi
Benshi mu barwayi bafite ibikomere by'igice cy'ukwezi bafite amateka yo guhahamuka.Ivuriro rikunze kwinubira ibimenyetso byububabare bwivi, kubyimba, na elastique.Mbere ya byose, impande zose zisahani yukwezi zirimo umubare munini wimyanya ndangagitsina igizwe nudusimba twinshi twitwa ner fibre ner fibre medullary, bityo kwangirika kwicyapa cyakwezi birashobora gutera ububabare byoroshye;icya kabiri, ibikorwa byamavi bizakururwa kandi bikangurwe na menisk, bizatera uburibwe.Ububabare buzabaho murwego runaka rwikivi, kandi ubwuzu burashimangirwa kandi bugarukira kumurongo runaka wu icyuho.Ukwezi kurashobora kandi gutera kuva amaraso, kuva amaraso, no kubyimba ingingo.Iyo ivi ryoroshye, kubyimba kugufi birashobora kuboneka mugihe ukoze kwangirika.Igikorwa cyo guhuza amavi kirashobora kandi guherekezwa namasasu kurwego runaka.Muri iki gihe, kunyerera kwa kimwe cya kabiri cy'isahani birashobora gutera ibikomere.Kubafite amateka maremare ugereranije namateka yubuvuzi, ibikorwa byavuzwe haruguru hamwe nibice byihariye bya elastique birashobora guterwa.
PRP'Ibinyabuzima biranga ninshingano
1) Ibiranga ibinyabuzima
PRP ni platologiya yibanze.Ugereranije na platine isanzwe, ubunini bwayo bukubye inshuro 4-5.Umuvuduko mwinshi wa platine hamwe na coorase na calcium ion Geles ya flocculent yakozwe yitwa gelles ikungahaye cyane, ishobora kugira uruhare mugushinga amashami yububiko.PRP ikubiyemo ubwoko bwinshi bwa poroteyine na cytokine, nkibintu bisanzwe bikura bikomoka kuri platine (PDGF), imikurire yimitsi iva mu mitsi (VEGF), na fibrin.Ibice bya alfa byasohotse nyuma yibintu byavuzwe haruguru bishobora kugira uruhare mu gusana, bityo bigatera gukira amagufwa no kwiyubaka kwimitsi.PRP irimo poroteyine iteza imbere ingirabuzimafatizo ya selile, bityo igahindura ingirabuzimafatizo.PRP itandukanijwe namaraso ya autologique, kandi umutekano wacyo wemejwe nubushakashatsi bwibikoko bifitanye isano.PRP ntabwo ifite umutekano gusa, ahubwo ifite n'ibiranga ibiranga ibinyabuzima bishya, bigira ingaruka zikomeye zo gusana kwangirika kwa karitsiye.
2) Uburyo bwo gukwirakwiza ingirabuzimafatizo
VEGF na Fibre selile yo gukura (FGF) bifitanye isano no kwiyubaka kwubaka imitsi.Igikorwa cya VEGF, ikwirakwizwa ry'uturemangingo twa endoteliyale y'amaraso birashobora gufasha imiyoboro mishya y'amaraso no guteza imbere ubwikorezi bw'amaraso bwaho bwanduye, bityo bigatera gukira ingirangingo.FGF irashobora kandi kugenzura ingirabuzimafatizo kugirango yihutishe ikwirakwizwa ry'uturemangingo twa endoteliyale du selile.Imikurire ya Hepatocyte (HGF) irashobora gukora ibintu bya kirimbuzi-XB (NF-XB), leukocyte (IL) -1 kugirango ibuze igisubizo cya chondrocytes.Imbere ya fibre protein imbere muri PRP ifite ibintu byinshi.Irashobora gukora fibre ya 3D ya fibre munsi ya activation ya coordinase na calcium ion.Kubwibyo, PRP irashobora kandi kwitwa platel gel.PRP ntishobora guteza imbere gusa gusana ingirangingo, ahubwo inatanga igitereko gifatanye na selile yimbere ya selile kandi igateza imbere itandukaniro ryayo, bizafasha gushiraho matrise ya karitsiye ibonerana.Birashobora kugaragara ko PRP idafasha gusa kwiyubaka mukarere ka karitsiye hamwe nimiyoboro y'amaraso hamwe no guhuza fibre fibre ya karitsiye, ariko kandi iteza imbere guhuza no kwimuka kwingirabuzimafatizo za karitsiye, hanyuma igasana ibyangiritse byumubiri.
3) PRP ubushakashatsi bwubushakashatsi kuri kimwe cya kabiri cyukwezi gusana
Intiti zimwe zahisemo inkwavu nkubushakashatsi, hanyuma nyuma yukwezi kwa kabiri inenge yibibaho byakozwe mumavi yombi, inkwavu ziciwe mubyumweru 4 nibyumweru 8, hanyuma hasesengurwa imikorere yabyo.Ubushakashatsi bwerekanye ko mu byumweru 4, itsinda rishinzwe kugenzura igice cya kabiri cy’isahani cyari kigizwe nuduce duhuza, dushobora kugaragara nka fiboside ikabije;hamwe na PRP yo kuvura itsinda ryigice cyakabiri cyerekana isahani yerekanaga bisanzwe, kandi tissue ihuza yari ifite gusana bigaragara.Abagize umuryango.Mugihe cibyumweru 8, itsinda ryigenzura ryuzuyemo fibrous fibrous, kandi karitsiye yisahani y-ukwezi ntiyakozwe.Itsinda rya PRP rivura ryari rikungahaye kuri fibre mu gice cya kabiri cy'ukwezi, cyiyongereye ku buryo bugaragara.Muri icyo gihe, igice cya kabiri cy'isahani yerekana ukwezi kugaragara muri fibrosis iringaniye, ndetse no gukira igice birahari.Ubundi bushakashatsi bwerekanye ko fibrin mbere yo gutunganya PRP ishobora gukora mesh igizwe na polystumin-hydroxylcetic acide.Niba PRP yashizwemo, hanyuma igice cya kabiri cyitwa cartilage chondrocyte ikomatanyirijwe hamwe kugirango ihinge 7D mu mbeba zambaye ubusa zitsinda ryikigereranyo, isuzuma rya microscope ya fluorescent: Uturemangingo twa karitsiye nyuma yingemwe zimaze kubiba zirashobora gufatanwa neza kandi zigakwirakwira hose.PRP imaze kuvurwa, umubare w'utugingo ngengabuzima twiyongereye cyane.Ibisubizo byo gusikana microscopi ya electron yerekana ko kumurongo wa PRP yatunganijwe, selile ya karitsiye irashobora guhuzwa numuyoboro wa fibre protein nyuma ya 24H na 7D.Mu manza 16 zo gutunganya imbeba zo mu itsinda rya PRP, imanza 6 zarakize burundu, imanza 9 ntizuzuye, naho urubanza 1 ntirwakize, mu gihe imbeba zo mu itsinda zagenzuye ntizakize.Birashobora kugaragara ko PRP imaze gutunganywa, ingirabuzimafatizo zabantu zifata ingirabuzimafatizo zifite ubushobozi bwihariye bwo gufatira hamwe, zishobora kongera ubushobozi bwokwezi kwakabiri.Muri vitro no mubushakashatsi bwibizamini bya vitro, ugereranije nitsinda ryoroheje rya PRP gel, itsinda rya PRP-osteoma matrix selile selile rifite urwego rwo hejuru rwo gutandukana.igufwa.Hariho ubushakashatsi kubijyanye no gutunganya PRP yuburyo bwa Jackie Daping ya moderi yinkwavu, kandi igakomeza agace ka karitsiye.Ibisubizo bya immunohistochemie hamwe nikizamini cyo gusikana amakosa byemeje ko amanota yacyo yo gusana ari menshi.Igisubizo cyerekana ko PRP igira uruhare runini mugusana karitsiye, hamwe no gushyira hamwe mugukoresha hamwe hamwe gushira hamwe guhuza amagufwa ya mesenchymal stem selile hamwe nibikoresho bya bracket nibyiza.
Ibiri muri iyi ngingo byongeye gusubirwamo, kandi ntidutanga ingwate iyo ari yo yose cyangwa yerekana ko ari ukuri, kwiringirwa cyangwa kuzuza ibikubiye muri iyi ngingo, kandi ntabwo dushinzwe ibitekerezo by'iyi ngingo, nyamuneka ubyumve.）
Igihe cyo kohereza: Gicurasi-11-2023