Ukutshintshwa kwamagxa

Ukutshintshwa kwamagxa ngotyando endaweni yamathambo egxalaba kunye neendawo zokudibanisa.

Uya kufumana i-anesthesia ngaphambi kolu tyando. Iindidi ezimbini zeanesthesia zingasetyenziswa:

• I-anesthesia ngokubanzi, okuthetha ukuba uya kuba ungazi nto kwaye ungaziva zintlungu.
• I-anesthesia yommandla ukuphazamisa ingalo kunye nendawo yegxalaba ukuze ungaziva zintlungu kule ndawo. Ukuba ufumana kuphela i-anesthesia yengingqi, uya kunikwa iyeza lokukunceda uphumle ngexesha lotyando.

Igxalaba liyibhola kunye nesocket joint. Umjikelo wethambo lengalo ulingene ekuvulekeni ekupheleni kwegxalaba, elibizwa ngokuba sisokethi. Olu hlobo lwendibaniselwano likuvumela ukuba uhambise ingalo yakho kumacala amaninzi.

Ukutshintshwa kwegxalaba lilonke, isiphelo esingqukuva sethambo lengalo yakho liyakutshintshwa ngesiqu sokufakelwa esinentloko yesinyithi (ibhola). Icandelo lesiseko (i-glenoid) legxalaba lakho liyakutshintshwa ngeplastikhi egudileyo (isokethi) eya kubanjelwa endaweni ngesamente ekhethekileyo.Ukuba kuphela i-1 kula mathambo ama-2 kufuneka atshintshwe, utyando lubizwa ngokuba luyinxalenye yamagxa, okanye i-hemiarthroplasty.

Olunye uhlobo lwenkqubo lubizwa ngokuba lilonke eliguqukayo. Kolu tyando, izithuba zebhola yentsimbi kunye neziseko zitshintshiwe. Ibhola yentsimbi iqhotyoshelwe kwigxalaba. Isiseko siqhotyoshelwe kwithambo lengalo. Olu tyando lunokwenziwa xa iirholithi zomtya ojikelezayo zonakaliswe kakhulu okanye kukho ukwaphuka kwamagxa.

Ukutshintshwa ngokudibeneyo kwamagxa, ugqirha wakho wotyando uya kwenza ukusikwa (ukusika) ngaphezulu kwegxalaba lakho ukuze uvule indawo. Emva koko ugqirha wakho uya:

• Susa intloko (phezulu) yethambo lengalo yakho ephezulu (ihumerus)
• Yenza isamente intloko yentsimbi entsha kunye nesiqu endaweni
• Gudisa umphezulu wesokethi esidala kunye nesamente endaweni entsha
• Vala ubume bakho ngesitatshi okanye ngemisonto
• Beka isinxibo (ibhandeji) ngaphezulu kwenxeba lakho

Ugqirha wakho ugqirha unokubeka ityhubhu kule ndawo ukukhupha ulwelo olunokwakha kwilungu. Idreyini iya kususwa xa ungasayifuni.

Olu tyando ngesiqhelo luthatha iiyure ezi-1 ukuya kwezi-3.

Utyando lokutshintsha kwamagxa lwenziwa rhoqo xa unentlungu ebuhlungu egxalabeni, ethintela amandla akho okuhambisa ingalo. Izizathu zentlungu egxalabeni zibandakanya:

• Osteoarthritis
• Iziphumo ezibi zoqhaqho lwangaphambili lwamagxa
• Irheumatoid Arthritis
• Ithambo elaphukileyo elibi engalweni ecaleni kwegxalaba
• Izicubu ezonakaliswe kakubi okanye ezikrazukileyo egxalabeni
• Ithumba ngaphakathi okanye ecaleni kwegxalaba

Ugqirha wakho unokungacebisi olu tyando ukuba:

• Imbali yosulelo, enokuthi isasazeke kwilungu elitshintshiweyo
• Ukungasebenzi kakuhle kwengqondo
• Ulusu olungenampilo olujikeleze indawo yegxalaba
• Ubuthathaka kakhulu (iruff cuff) izihlunu ezijikeleze igxalaba ezingenakulungiswa ngexesha lotyando

Umngcipheko we-anesthesia kunye notyando ngokubanzi zezi:

• Impendulo kumayeza okanye kwiingxaki zokuphefumla
• Ukopha, ihlwili legazi, okanye usulelo

Iingozi zotyando olwenziwa egxalabeni zezi:

• Ukuphendula ngokuchaseneyo nelungu elenziweyo
• Umonakalo wenqanawa yegazi ngexesha lotyando
• Ukuqhekeka kwamathambo ngexesha lotyando
• Umonakalo wemithambo ngexesha lotyando
• Ukususwa kwendibaniselwano eyenziweyo
• Ukukhulula ukufakelwa ngokuhamba kwexesha

Xelela umboneleli wakho wezempilo ukuba ngawaphi amayeza owasebenzisayo. Oku kubandakanya amayeza, izongezo, okanye amayeza owathengileyo ngaphandle kommiselo.

Ngexesha leeveki ezi-2 ngaphambi kotyando lwakho:

• Unokucelwa ukuba uyeke ukuthatha abacoci gazi. Oku kubandakanya i-aspirin, ibuprofen (Advil, Motrin), naproxen (Naprosyn, Aleve), warfarin (Coumadin), dabigatran (Pradaxa), rivaroxaban powder (Xarelto), apixaban (Eliquis), kunye ne-clopidogrel (Plavix).
• Buza ugqirha wakho ukuba ngawaphi amayeza ekufuneka uwathathe ngemini yotyando lwakho.
• Ukuba unesifo seswekile, isifo sentliziyo, okanye ezinye iimeko zonyango, ugqirha wakho uya kukucela ukuba ubone ugqirha wakho okunyangayo kwezi meko.
• Xelela ugqirha wakho ukuba ubusele utywala kakhulu, ngaphezulu kwesiselo esi-1 okanye esi-2 ngosuku.
• Ukuba uyatshaya, zama ukuyeka. Cela uncedo kumboneleli wakho. Ukutshaya kunokunciphisa inxeba kunye nokuphilisa amathambo.
• Vumela ugqirha wakho azi ngoko nangoko ukuba ufumana ukubanda, umkhuhlane, umkhuhlane, ukuphuma kwe-herpes, okanye esinye isifo ngaphambi koqhaqho.

Ngomhla wotyando lwakho:

• Uya kucelwa ukuba ungaseli okanye ungatyi nantoni na iiyure ezingama-6 ukuya kwezi-12 ngaphambi kwenkqubo.
• Thatha amayeza ugqirha wakho akuxelele ukuba uwathabathe ngesiphuzo esincinci samanzi.
• Qiniseka ukuba ufika esibhedlele ngexesha.

Emva kwenkqubo:

• Unokuhlala esibhedlele kangangeentsuku ezi-1 ukuya kwezi-3 emva kotyando lwakho.
• Ngelixa ulapho, unokufumana unyango ngokwasemzimbeni ukunceda ukugcina izihlunu zijikeleze igxalaba lakho ekubeni zingabi lukhuni.
• Ngaphambi kokuba uye ekhaya, ugqirha uya kukufundisa indlela yokuhambisa ingalo yakho ngokusebenzisa enye (elungileyo) ingalo ukunceda.
• Ingalo yakho iyakudinga ukurhintyela iiveki ezi-2 ukuya kwezi-6 kungekho ntshukumo isebenzayo kunye neenyanga ezi-3 phambi kokuba zomelezwe. Iya kuba malunga neenyanga ezi-4 ukuya kwezi-6 zokufumana kwakhona.
• Landela nayiphi na imiyalelo oyinikiweyo malunga nendlela yokukhathalela igxalaba lakho ekhaya. Oku kubandakanya imisebenzi ongafanelekanga ukuyenza.
• Uya kunikwa imiyalelo kwimithambo yamagxa ekufuneka uyenzile ekhaya. Landela le miyalelo ngokuchanekileyo. Ukwenza umthambo ngendlela engalunganga kunokulimaza igxalaba lakho elitsha.

Utyando olwenziwe emagxeni luthomalalisa iintlungu kunye nokuqina kwabantu abaninzi. Kuya kufuneka ukwazi ukuqhubeka nemisebenzi yakho yesiqhelo yemihla ngemihla ngaphandle kwengxaki. Abantu abaninzi bayakwazi ukubuyela kwimidlalo enjengegalufa, ukuqubha, ukwenza igadi, i-bowling, nabanye.

Umdibaniso wakho wamagxa omtsha uya kuhlala ixesha elide ukuba uxinzelelo oluncinci lubekwe kuwo. Ngokusetyenziswa kwesiqhelo, indibaniselwano yegxalaba elitsha inokuhlala iminyaka eli-10 ubuncinci.

Igxalaba elipheleleyo le-arthroplasty; Ukutshintshwa kwegxalaba endoprosthetic; Ukutshintshwa kwamagxa athile; Ububanzi begxalaba le-arthroplasty; Utshintsho - igxalaba; IArthroplasty - igxalaba

• Ukutshintshwa kwamagxa - ukukhutshwa
• Sebenzisa igxalaba lakho emva kotyando olwenziwe ngokutsha

IAmerican Academy yeOthopedic Surgeons iwebhusayithi. Buyisela umva egxalabeni lilonke. orthoinfo.aaos.org/en/treatment/reverse-total-shoulder-replacement Ukuhlaziywa ngo-Matshi 2017. Kufikeleleke ngoDisemba 10, 2018.

IMatsen FA, iLippitt SB, iRockwood CA, iWirth MA. Glenohumeral arthritis kunye nolawulo lwayo. Ku: Rockwood CA, Matsen FA, Wirth MA, Lippitt SB, Fehringer EV, Sperling JW, ii-eds. I-Rockwood kunye neMatsen Igxalaba. Umhla we-5. IPhiladelphia, PA: Elsevier; I-2017: isahluko 16.

I-Throckmorton TW. Igxalaba kunye nengqiniba ye-arthroplasty. Ku: Azar FM, Beaty JH, Kanale ST, ii-eds. Umsebenzi weCampbell's Orthopedics. Umhla we-13. IPhiladelphia, PA: Elsevier; Ngo-2017: isahluko 12.