Joint Lavage No Longer Among the Recommended Treatments for Gne Osteoarthritis
N'ihe dị n'afo 1970, a na-anụkarị onye nwere ọrịa ogbu na nkwonkwo nke na-eji nkwonkwo arthroscopic eme ihe. Ọtụtụ iri afọ ka e mesịrị, ijikọ ụgbọ mmiri abụghị ihe nkịtị. Dịka eziokwu, ejikọtaghị aka na nkwonkwo ndị a na- atụ aro maka ọrịa ogbu na nkwonkwo .
Kedu ihe jikọrọ ọnụ?
N'ọrịa ogbu na nkwonkwo, dị ka cartilage na- agbaji, akụkụ nke anụ ahụ, mkpịsị na-arụkwa cartilage na mmeze enzymes nwere ike ịhapụ n'ime nkwonkwo.
Enwere ike ịnwe kristal na nkwonkwo ma ọ bụ na nkwonkwo njikọ . Ngwakọta nkwonkwo bụ usoro nke na-ehichapụ anụ ahụ ma ọ bụ irighiri ihe site na nkwonkwo njikọ.
Usoro gụnyere ịtinye obere akpa n'ime nkwonkwo na otu ma ọ bụ karịa isi ntinye. E nwere ụdị ihe atọ dị iche iche:
- Ogwurugwu ikuku nke ogbugba mmiri - na-eji otu isi nke abanye n'ime nkwonkwo iji gbanye mmiri ma mee ka mmiri pụta.
- Ejikọta na-enweghị arthroscopic - ejiri ihe abụọ abanye na nkwonkwo, onye ịgbanye mmiri na nke ọzọ iji dọpụta mmiri. Enyochaghị anya nke njikọ ahụ ga-apụta.
- Arthroscopic na-ejikọta ya na nkwonkwo - ijikọta ya na nlele anya nke nkwonkwo (arthroscopy) .
Mgbe a na-ehicha ya, a na-ejikọta nkwonkwo ya na nnu nnu na mmiri (ntụgharị, saline), a na-ehichapụkwa mmiri dị na nkwonkwo. A na-emegharị usoro ịgbanye na igbapu ugboro ugboro. Nzuzo, ikpochapu nkwonkwo nke irighiri ihe na-ebelata mmetụ na nkwonkwo mgbu.
Ma, a jụọla ma ọ bụ mụọ ihe dị irè nke ikuku mmiri.
Nnyocha ndị e mere banyere arụmọrụ nke Joint Lavage
Dika nnyocha nlekọta Cochrane banyere ule asa nwere nsogbu ndi mmadu 567, ndi oru nyocha choputara na ikpochapu ndi mmadu enweghi uru bara uru nye ndi nwere oria ogbugbu ikpere banyere ihe mgbu ma obu mmekorita nke oru.
Atọ n'ime ule asaa ahụ gụnyere arthroscopic nkwonkwo nkwonkwo. Abụọ n'ime ihe ọmụmụ ndị ahụ na-ejikọtaghị aka na-abụghị nke arthroscopic, ndị fọdụrụ n'ime ha bụ mmiri mmiri.
Ihe nyocha nke Cochrane na-emegide nkwubi nke ọmụmụ nke e bipụtara na Arthritis & Rheumatism na 1999. N'akwụkwọ a, 98 ndị nwere ọrịa ogwu na-eme ka ọkpụkpụ tibiofemoral debara aha na nyocha isii nke ọnwa ma nyefee otu n'ime ọgwụ anọ: ebe a na-etinye intraarticular , corticosteroids intraarticular, nkwonkwo ikuku na placebo intraarticular, na nkwonkwo akwara na corticosteroids intraarticular. Nsonaazụ gosiri na, ma e jiri ya tụnyere placebo, ma corticosteroid na intraarticular na nkwonkwo ikuku wepụrụ ihe mgbu - ma ọ bụghị ọrụ dị mma. Corticosteroid nke na-ahụkarị na-enye ihe mgbochi ihe mgbu oge, ma uru nke nkwonkwo nkwonkwo dị ruo izu iri abụọ na anọ.
N'afọ 2008, Ụlọ Ọrụ American Academy of Orthopedic Surgeons (AAOS) bipụtara 22 aro maka ọgwụgwọ ọrịa ikiri ụkwụ na-egbuke egbuke . Arthroscopy na nkedo ma ọ bụ nkwonkwo akwara adịghị atụ aro ka a na-emeso ikuku ogbu na nkwonkwo ikpere. Dị ka AAOS si kwuo, ọ dịghị ihe akaebe nke uru bara uru.
Otu nkuzi ọzọ, nke e bipụtara na Annals of Diseases Rheumatic in 2004, kwuru na ọ bụghị nanị na enweghi uru bara uru na nkwonkwo aka, nsogbu ndị metụtara usoro ahụ ga-ekwe omume.
Pseudogout bụ ngosipụta nke arthroscopic na-asa ndị ọrịa na chondrocalcinosis . Ihe ize ndụ nke pseudogout na ndị nwere chondrocalcinosis, na / ma ọ bụ kristal, tupu ịkwacha bụ ugboro ise nke ndị na-enweghị nsogbu ọ bụla.
Dị ka ihe ọ bụla ogbugba, enwere ike ibute ọrịa na-esochi ikuku. Soro dọkịta gị kwurịta ihe niile gbasara ọgwụgwọ gị. Jikọta ọnụ, bara uru na ihe ize ndụ, ma mee mkpebi doro anya.
Isi mmalite:
Mmekọrịta nkwonkwo maka ọrịa ogbu na nkwonkwo. Reichenbach S. et al. Cochrane Database System Review. 2010 May 12; (5): CD007320.
Mmetụta nke ikpo mmiri na steroid injection na ndị ọrịa na osteoarthritis nke ikpere: nsonaazụ nke ọtụtụ usoro, randomized, na-achịkwa ikpe. Ravaud P. Arthritis & Rheumatism 42 (3): 475-82. 03/01/1999.
Ọgwụgwọ Osteoarthritis nke Knee (Nonarthroplasty). Richmond, John MD. Akwụkwọ nke American Academy of Orthopedic Surgeons 17 (9): 591-600. September 2009.
Mkponye aka na pseudogout. Pasquetti P. et al. Akwụkwọ nke Ọrịa Rheumatic. 2004; 63: 1529-1530