Osteonecrosis

I-Osteonecrosis kukufa kwethambo okubangelwa kukungabikho kwegazi. Ixhaphake kakhulu esinqeni nasemagxeni, kodwa inokuchaphazela amanye amalungu amakhulu afana nedolo, ingqiniba, isihlahla kunye namaqatha.

I-Osteonecrosis yenzeka xa inxalenye yethambo ingafumani gazi kwaye iswelekileyo. Emva kwethutyana, ithambo linokuwa. Ukuba i-osteonecrosis ayinyangwa, idibeneyo iya isiba mbi, ekhokelela kwisifo samathambo esiqatha.

I-Osteonecrosis inokubangelwa sisifo okanye ukwenzakala okukhulu, njengokuqhekeka okanye ukususwa, okuchaphazela ukuhanjiswa kwegazi kwithambo. I-Osteonecrosis nayo inokwenzeka ngaphandle konzakalo okanye isifo. Oku kubizwa ngokuba yi-idiopathic-ethetha ukuba iyenzeka ngaphandle kwesizathu esaziwayo.

Oku kulandelayo kungunobangela:

• Sebenzisa i-steroids yomlomo okanye efakwa ngaphakathi
• Ukusetyenziswa gwenxa kotywala
• Isifo seSickle cell
• Ukususwa okanye ukuqhekeka ejikeleze indibaniselwano
• Ukuphazamiseka kokuvala
• Intsholongwane kaGawulayo okanye ukuthatha iziyobisi ze-HIV
• Unyango ngemitha okanye ichemotherapy
• Isifo seGaucher (isifo apho izinto eziyingozi zakha khona kumalungu athile nakwithambo)
• Isystemic lupus erythematosus (isifo esizenzekelayo apho amajoni omzimba ahlasela ngempazamo izicwili ezinjengethambo)
• Isifo seLegg-Calve-Perthes (isifo sobuntwana apho ithambo lethanga elisesinqeni alifumani gazi laneleyo, libangela ukuba ithambo life)
• Ukudodobala kokugula kuninzi lokuntywila elwandle

Xa i-osteonecrosis ivela kumdibaniso wamagxa, ihlala ibangelwa kunyango lwexesha elide nge-steroids, imbali yokwenzakala egxalabeni, okanye umntu unesifo se-sickle cell.

Akukho zimpawu kumanqanaba okuqala. Njengoko ukonakala kwamathambo kusiba nzima, unokuba nezi mpawu zilandelayo:

• Ubuhlungu kwilungu elinokunyuka ngokuhamba kwexesha kwaye buba nzima ukuba ithambo liyawa
• Intlungu eyenzekayo nokuba uphumle
• Uluhlu olunomda lokuhamba
• Intlungu ye-Groin, ukuba idibeneyo ye-hip ichaphazelekayo
• Ukuqhwalela, ukuba imeko yenzeka emlenzeni
• Ubunzima ngokuhamba ngaphezulu, ukuba ukudityaniswa kwegxalaba kuyachaphazeleka

Umboneleli wakho wezempilo uya kwenza uvavanyo lomzimba ukufumanisa ukuba unazo naziphi na izifo okanye iimeko ezinokuchaphazela amathambo akho. Uya kubuzwa malunga neempawu zakho kunye nembali yonyango.

Qiniseka ukuba wazisa umboneleli wakho malunga nawaphi na amayeza okanye izongezo zeevithamini ozithathayo, nokuba ungathengisa amayeza.

Emva koviwo, umboneleli wakho uya kuyala enye okanye nangaphezulu kwezi mvavanyo zilandelayo:

• X-reyi
• IMRI
• Ukuskena amathambo
• Ukuskena i-CT

Ukuba umboneleli wakho uyazi unobangela we-osteonecrosis, inxenye yonyango iya kujolisa kwimeko engaphantsi. Umzekelo, ukuba ukuphazamiseka kwegazi ekunqandeni kungunobangela, unyango luya kubandakanya, ngokuyinxenye, iyeza lokunyibilika kwegazi.

Ukuba imeko ibanjwe kwangoko, uya kuthatha ukuthomalalisa iintlungu kunye nokunciphisa ukusetyenziswa kwendawo echaphazelekayo. Oku kunokubandakanya ukusebenzisa iintonga ukuba isinqe sakho, idolo, okanye iqatha lichaphazelekile. Kuya kufuneka ukuba wenze uluhlu lweentshukumo zokuhamba. Unyango lwe-Nonsurgical lungahlala lucothisa ukuqhubela phambili kwe-osteonecrosis, kodwa uninzi lwabantu luya kufuna utyando.

Iinketho zotyando zibandakanya:

• Ukumiliselwa kwethambo
• Igrafti yethambo kunye negazi lalo (i-vascularized bone graft)
• Ukususa inxenye yangaphakathi kwethambo (eyona nto ingxamisekileyo) ukunciphisa uxinzelelo kunye nokuvumela imithambo yegazi emitsha ukuba yenze
• Ukusika ithambo kunye nokutshintsha ulungelelwaniso lwayo ukunciphisa uxinzelelo kwithambo okanye ngokudibeneyo (osteotomy)
• Iyonke indawo edibeneyo

Unokufumana ulwazi ngakumbi kunye nezixhobo zenkxaso kulo mbutho ulandelayo:

• IZiko leSizwe leArthritis kunye neMisculoskeletal kunye nezifo zolusu- www.niams.nih.gov/health-topics/osteonecrosis
• Isiseko seArthritis - www.arthritis.org

Uqhuba kakuhle kangakanani kuxhomekeke koku kulandelayo:

• Unobangela we-osteonecrosis
• Isifo siqatha kangakanani xa sifunyaniswa
• Inani lethambo elibandakanyekayo
• Ubudala bakho kunye nempilo yonke

Iziphumo zinokwahluka kunyango olupheleleyo ukuya kumonakalo osisigxina kwithambo elichaphazelekayo.

I-osteonecrosis ephezulu inokukhokelela kwi-osteoarthritis kunye nokwehla okusisigxina kokuhamba. Iimeko ezinzima zingadinga ukutshintshwa ngokudibeneyo.

Fowunela umboneleli wakho ukuba uneempawu.

Uninzi lweziganeko ze-osteonecrosis azinaso isizathu esaziwayo, ke kuthintelo akunakwenzeka. Ngamanye amaxesha ungawunciphisa umngcipheko ngokwenza oku kulandelayo:

• Kuphephe ukusela utywala kakhulu.
• Xa kunokwenzeka, thintela iidosi eziphezulu kunye nokusetyenziswa kwexesha elide kwe-corticosteroids.
• Landela amanyathelo okhuseleko xa udilika emanzini ukunqanda ukugula okudakisayo.

I-avascular necrosis; Ukuthanjiswa kwethambo; Ischemic ithambo necrosis; I-AVN; Aseptic necrosis

• I-Aseptic necrosis

UMcAlindon T, kwiWadi RJ. Osteonecrosis. Ku: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, ii-eds. Rheumatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; I-2019: isahluko 206.

ILungu lePalamente le-Whyte. I-Osteonecrosis, i-osteosclerosis / hyperostosis, kunye nezinye iingxaki zethambo. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Umhla wama-25. IPhiladelphia, PA: Elsevier Saunders; I-2016: isahluko 248.