{"id":34026,"date":"2023-05-17T23:02:21","date_gmt":"2023-05-17T16:02:21","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=34026"},"modified":"2023-05-17T23:02:21","modified_gmt":"2023-05-17T16:02:21","slug":"cac-thanh-phan-cua-mot-khop-khuyu-nhan-tao-toan-phan-hien-dai","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/05\/17\/cac-thanh-phan-cua-mot-khop-khuyu-nhan-tao-toan-phan-hien-dai\/","title":{"rendered":"C\u00e1c th\u00e0nh ph\u1ea7n c\u1ee7a m\u1ed9t kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o to\u00e0n ph\u1ea7n hi\u1ec7n \u0111\u1ea1i"},"content":{"rendered":"

Kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o (KKNT) \u0111\u01b0\u1ee3c t\u1ea1o ra v\u1edbi s\u1ef1 ph\u00e1t tri\u1ec3n nhanh ch\u00f3ng c\u1ee7a k\u1ef9 thu\u1eadt c\u0169ng nh\u01b0 c\u00e1c v\u1eadt li\u1ec7u kh\u1edbp nh\u00e2n t\u1ea1o, c\u00e1c b\u1ec7nh nh\u00e2n b\u1ecb c\u1ee9ng kh\u1edbp, d\u00ednh kh\u1edbp khu\u1ef7u ho\u00e0n to\u00e0n, vi\u00eam kh\u1edbp d\u1ea1ng th\u1ea5p… \u0111\u00e3 c\u00f3 hy v\u1ecdng ph\u1ee5c h\u1ed3i l\u1ea1i ch\u1ee9c n\u0103ng c\u1ee7a c\u00e1c kh\u1edbp x\u01b0\u01a1ng v\u00e0 tr\u00e1nh kh\u1ecfi nguy c\u01a1 t\u00e0n ph\u1ebf. V\u1edbi s\u1ef1 ra \u0111\u1eddi c\u1ee7a \u201cth\u1ebf h\u1ec7 kh\u1edbp khu\u1ef7u th\u1ee9 hai\u201d (kh\u1edbp b\u1ea3n l\u1ec1 b\u00e1n r\u00e0ng bu\u1ed9c) v\u00e0 \u201cth\u1ebf h\u1ec7 kh\u1edbp khu\u1ef7u th\u1ee9 ba\u201d (kh\u1edbp lai), tu\u1ed5i th\u1ecd c\u1ee7a kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o \u0111\u00e3 c\u00f3 c\u1ea3i thi\u1ec7n r\u00f5 r\u1ec7t trong su\u1ed1t 4 th\u1eadp k\u1ef7 qua v\u1edbi t\u1ec9 l\u1ec7 t\u1ed3n t\u1ea1i tr\u00ean 5 n\u0103m \u0111\u1ea1t tr\u00ean 90%.<\/strong><\/p>\n

1. C\u00e1c lo\u1ea1i kh\u1edbp c\u1ee7a kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o to\u00e0n ph\u1ea7n hi\u1ec7n \u0111\u1ea1i<\/strong><\/h2>\n

D\u1ef1a tr\u00ean \u0111\u1eb7c \u0111i\u1ec3m thi\u1ebft k\u1ebf b\u1ed9 ph\u1eadn li\u00ean k\u1ebft c\u00e1c c\u1ea5u ph\u1ea7n kh\u1edbp, kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o hi\u1ec7n \u0111\u1ea1i c\u00f3 th\u1ec3 chia l\u00e0m ba lo\u1ea1i ch\u00ednh bao g\u1ed3m: kh\u1edbp li\u1ec1n, kh\u1edbp r\u1eddi v\u00e0 kh\u1edbp lai.<\/span><\/p>\n

\u00a0<\/span>–<\/span> \u00a0 <\/span>Kh\u1edbp li\u1ec1n, l\u00e0 b\u1ed9 KKNT c\u00f3 th\u00eam m\u1ed9t c\u1ea5u ph\u1ea7n ri\u00eang \u0111\u1ec3 \u0111\u1ea3m nhi\u1ec7m vai tr\u00f2 li\u00ean k\u1ebft c\u1ea5u ph\u1ea7n tr\u1ee5 v\u00e0 c\u1ea5u ph\u1ea7n c\u00e1nh tay, nh\u01b0 v\u1eady m\u1ed9t thi\u1ebft k\u1ebf b\u1ed9 kh\u1edbp li\u1ec1n \u0111i\u1ec3n h\u00ecnh bao g\u1ed3m 3 c\u1ea5u ph\u1ea7n ch\u00ednh ; trong \u0111\u00f3 c\u1ea5u ph\u1ea7n c\u00e1nh tay v\u00e0 c\u1ea5u ph\u1ea7n tr\u1ee5 th\u01b0\u1eddng \u0111\u01b0\u1ee3c l\u00e0m t\u1eeb h\u1ee3p kim Titan ho\u1eb7c Coban, ph\u1ea7n chu\u00f4i c\u1ee7a ch\u00fang s\u1ebd \u0111\u01b0\u1ee3c c\u1ed1 \u0111\u1ecbnh v\u00e0o trong l\u00f2ng \u1ed1ng t\u1ee7y b\u1eb1ng xi c\u1ea5u ph\u1ea7n n\u00e0y ti\u1ebfp kh\u1edbp th\u00f4ng qua b\u1ed9 ph\u1eadn li\u00ean k\u1ebft th\u01b0\u1eddng \u0111\u01b0\u1ee3c l\u00e0m t\u1eeb nh\u1ef1a Polyethylene, ngo\u00e0i ra c\u00f2n c\u00f3 th\u1ec3 g\u1ed3m c\u00e1c th\u00e0nh ph\u1ea7n ph\u1ee5 kh\u00e1c nh\u01b0 \u0111inh ch\u1ed1t, m\u1eb7t b\u00edch \u0111\u1ec7m.<\/span><\/p>\n

\"Khop-khuyu-nhan-tao\"
H\u00ecnh: Thi\u1ebft k\u1ebf b\u1ed9 kh\u1edbp li\u1ec1n Discovery c\u1ee7a DJO A. C\u1ea5u ph\u1ea7n c\u00e1nh tay B. c\u1ea5u ph\u1ea7n tr\u1ee5 c. Ph\u1ea7n li\u00ean k\u1ebft<\/figcaption><\/figure>\n

–<\/span> \u00a0 <\/span>\u0110\u1ed1i v\u1edbi b\u1ed9 kh\u1edbp r\u1eddi: Th\u00e0nh ph\u1ea7n b\u1ed9 kh\u1edbp ch\u1ec9 g\u1ed3m c\u1ea5u ph\u1ea7n c\u00e1nh tay v\u00e0 c\u1ea5u ph\u1ea7n tr\u1ee5; ph\u1ea7n \u0111\u1ea7u c\u1ee7a c\u00e1c c\u1ea7u ph\u1ea7n n\u00e0y \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1eb7c bi\u1ec7t \u0111\u1ebf c\u00f3 th\u1ec3 ti\u1ebfp kh\u1edbp v\u1edbi nhau m\u00e0 kh\u00f4ng c\u1ea7n th\u00eam c\u00e1c b\u1ed9 ph\u1eadn li\u00ean k\u1ebft.<\/span><\/p>\n

2. Thi\u1ebft k\u1ebf c\u1ea5u ph\u1ea7n c\u00e1nh tay kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o<\/strong><\/h2>\n

C\u1ea5u ph\u1ea7n c\u00e1nh tay th\u01b0\u1eddng \u0111\u01b0\u1ee3c l\u00e0m t\u1eeb h\u1ee3p kim Titanium ho\u1eb7c h\u1ee3p kim Cobalt-Chromium, nhi\u1ec1u v\u1ecb tr\u00ed \u0111\u01b0\u1ee3c phun ph\u1ee7 plasma l\u00e0m t\u0103ng \u0111\u1ed9 nh\u00e1m \u0111\u1ebf gi\u00fap c\u1ea3i thi\u1ec7n kh\u1ea3 n\u0103ng c\u1ed1 \u0111\u1ecbnh v\u00e0o xi m\u0103ng v\u00e0 x\u01b0\u01a1ng. Tr\u01b0\u1edbc \u0111\u00e2y, m\u1ed9t s\u1ed1 thi\u1ebft k\u1ebf KKNT lo\u1ea1i r\u1eddi, nh\u01b0 th\u1ebf h\u1ec7 ban \u0111\u1ea7u c\u1ee7a b\u1ed9 kh\u1edbp Souter kh\u00f4ng c\u00f3 th\u00eam ph\u1ea7n chu\u00f4i d\u00e0i \u0111\u1eb7t trong l\u00f2ng \u1ed1ng tu\u1ef7 x\u01b0\u01a1ng c\u00e1nh<\/span><\/p>\n

tay, tuy nhi\u00ean ki\u1ec3u thi\u1ebft k\u1ebf n\u00e0y c\u00f3 t\u1ec9 l\u1ec7 b\u1ecb l\u1ecfng s\u1edbm sau mo cao. Sau n\u00e0y, c\u00e1c c\u1ea5u ph\u1ea7n c\u00e1nh tay c\u1ee7a c\u1ea3 b\u1ed9 kh\u1edbp li\u1ec1n l\u1eabn b\u1ed9 kh\u1edbp r\u1eddi \u0111\u1ec1u s\u1eed d\u1ee5ng chu\u00f4i \u1ed1ng tu\u1ef7. Th\u00f4ng th\u01b0\u1eddng, chi\u1ec1u d\u00e0i chu\u1ed7i t\u1eeb kho\u1ea3ng 7 – 10cm l\u00e0 \u0111\u1ee7 \u0111\u1ec3 c\u1ed1 \u0111\u1ecbnh cho h\u1ea7u h\u1ebft c\u00e1c tr\u01b0\u1eddng h\u1ee3p. Thi\u1ebft k\u1ebf h\u00ecnh d\u1ea1ng c\u1ee7a chu\u00f4i ng\u00e0y c\u00e0ng \u0111\u01b0\u1ee3c c\u1ea3i ti\u1ebfn \u0111\u1ec3 t\u01b0\u01a1ng th\u00edch nh\u1ea5t v\u1edbi gi\u1ea3i ph\u1eabu \u1ed1ng t\u1ee7y x\u01b0\u01a1ng c\u00e1nh tay. Ph\u1ea7n chu\u00f4i kh\u1edbp th\u01b0\u1eddng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf v\u1edbi m\u1eb7t c\u1eaft d\u1ea1ng tam gi\u00e1c ho\u1eb7c l\u0103ng tr\u1ee5 c\u00f3 th\u00eam c\u00e1c kh\u00eda \u0111\u1ec3 ch\u1ed1ng xoay t\u1ed1t h\u01a1n. Ph\u1ea7n chuy\u1ec3n ti\u1ebfp gi\u1eefa chu\u00f4i v\u00e0 \u0111\u1ea7u d\u01b0\u1edbi c\u0169ng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf b\u00e8 r\u1ed9ng 2 b\u00ean \u0111\u1ec3 ch\u1ed1ng xoay.<\/span><\/p>\n

D\u1ef1a tr\u00ean c\u00e1c ch\u1ec9 s\u1ed1 gi\u1ea3i ph\u1eabu x\u01b0\u01a1ng c\u00e1nh tay, ph\u1ea7n chu\u00f4i th\u01b0\u1eddng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf \u0111\u1ec3 t\u1ea1o m\u1ed9t g\u00f3c m\u1edf ra ngo\u00e0i (valgus) kho\u1ea3ng 3-8 \u0111\u1ed9 so v\u1edbi tr\u1ee5c g\u1ea5p du\u1ed7i, \u0111\u1ed3ng th\u1eddi chu\u00f4i c\u0169ng xoay trong kho\u1ea3ng 4-8 \u0111\u1ed9 so v\u1edbi \u0111\u1ea7u d\u01b0\u1edbi (H\u00ecnh 1.3 B). \u0110\u1ea7u tr\u00ean c\u1ee7a chu\u00f4i \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf h\u01a1i cong ra tr\u01b0\u1edbc (H\u00ecnh 1.4) \u0111\u1ec3 ph\u00f9 h\u1ee3p v\u1edbi \u1ed1ng tu\u1ef7 x\u01b0\u01a1ng c\u00e1nh tay v\u00e0 gi\u1ea3m hi\u1ec7n t\u01b0\u1ee3ng l\u1ecfng xi m\u0103ng hay g\u1eb7p ph\u00eda sau \u0111\u1ea7u tr\u00ean c\u1ee7a chu\u00f4i.<\/span><\/p>\n

C\u00e1c thi\u1ebft k\u1ebf c\u1ea5u ph\u1ea7n c\u00e1nh tay hi\u1ec7n \u0111\u1ea1i th\u01b0\u1eddng b\u1ed5 sung th\u00eam ng\u00e0m tr\u01b0\u1edbc, ph\u1eabu thu\u1eadt vi\u00ean c\u00f3 th\u1ec3 gh\u00e9p th\u00eam x\u01b0\u01a1ng \u1edf d\u01b0\u1edbi ng\u00e0m n\u00e0y (H\u00ecnh 1.4). Vai tr\u00f2 c\u1ee7a ng\u00e0m tr\u01b0\u1edbc l\u00e0 gi\u00fap<\/span><\/p>\n

gi\u1ea3m l\u1ef1c b\u1ebb ng\u01b0\u1ee3c \u0111\u1ea7u tr\u00ean chu\u00f4i v\u1ec1 h\u01b0\u1edbng sau tr\u00ean v\u00e0 ch\u1ed1ng xoay, nhi\u1ec1u nghi\u00ean c\u1ee9u theo d\u00f5i xa cho th\u1ea5y ng\u00e0m tr\u01b0\u1edbc th\u1ef1c s\u1ef1 h\u1eefu \u00edch v\u00ec c\u00f3 th\u1ec3 gi\u00fap duy tr\u00ec v\u1eefng kh\u1edbp \u1edf d\u00e0i h\u1ea1n.<\/span><\/p>\n

M\u1ed9t s\u1ed1 \u0111\u1ea7u d\u01b0\u1edbi c\u1ea5u ph\u1ea7n c\u00e1nh tay c\u1ee7a kh\u1edbp r\u1eddi hay kh\u1edbp lai th\u01b0\u1eddng thi\u1ebft k\u1ebf th\u00eam di\u1ec7n ch\u1ecfm con \u0111\u1ec3 c\u00f3 th\u1ec3 thay kh\u1edbp quay- ch\u1ecfm con; vi\u1ec7c thay ch\u1ecfm quay k\u00e8m theo \u0111\u01b0\u1ee3c cho r\u1eb1ng c\u00f3 th\u1ec3 gi\u00fap kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o v\u1eefng ch\u1eafc h\u01a1n v\u00e0 b\u1ec1n h\u01a1n.<\/span><\/p>\n

3. Thi\u1ebft k\u1ebf c\u1ea5u ph\u1ea7n x\u01b0\u01a1ng tr\u1ee5<\/strong><\/h2>\n

C\u1ea5u ph\u1ea7n x\u01b0\u01a1ng tr\u1ee5 c\u0169ng \u0111\u01b0\u1ee3c l\u00e0m t\u1eeb h\u1ee3p kim v\u00e0 phun ph\u1ee7 plasma t\u01b0\u01a1ng t\u1ef1 \u1edf x\u01b0\u01a1ng c\u00e1nh tay, \u1edf’ \u0111\u1ea7u tr\u00ean c\u00f3 khuy\u1ebft tr\u00f2n m\u00f4 ph\u1ecfng h\u00f5m sigma ch\u1ee9a l\u1edbp \u0111\u1ec7m b\u1eb1ng nh\u1ef1a Polyethylen (PE). Tr\u01b0\u1edbc \u0111\u00e2y m\u1ed9t s\u1ed1 nh\u00e0 s\u1ea3n xu\u1ea5t ch\u1ebf t\u1ea1o c\u1ea5u ph\u1ea7n tr\u1ee5-ho\u00e0n to\u00e0n t\u1eeb polyethylen nh\u1eb1m gi\u1ea3m gi\u00e1 th\u00e0nh s\u1ea3n xu\u1ea5t. V\u1eadt li\u1ec7u PE ch\u1ecbu m\u00e0i m\u00f2n t\u1ed1t nh\u01b0ng k\u00e9m h\u01a1n h\u1ee3p kim v\u1ec1 kh\u1ea3 n\u0103ng ch\u1ecbu l\u1ef1c b\u1ebb v\u00e0 xo\u1eafn c\u0169ng nh\u01b0 kh\u1ea3 n\u0103ng li\u00ean k\u1ebft v\u1edbi xi m\u0103ng, c\u00f3 m\u1ed9t s\u1ed1 t\u00e1c gi\u1ea3 b\u00e1o c\u00e1o t\u1ec9 l\u1ec7 g\u00e3y c\u1ea5u ph\u1ea7n tr\u1ee5 ho\u00e0n to\u00e0n t\u1eeb PE cao do \u0111\u00f3 v\u1ec1 sau lo\u1ea1i c\u1ea5u ph\u1ea7n tr\u1ee5 to\u00e0n b\u1ed9 b\u1eb1ng PE kh\u00f4ng c\u00f2n \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng n\u1eefa.<\/span><\/p>\n

\u00a0<\/span>C\u1ea5u ph\u1ea7n tr\u1ee5 c\u0169ng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf theo c\u00e1c ch\u1ec9 s\u1ed1 gi\u1ea3i ph\u1eabu v\u1ec1 g\u00f3c ng\u1ea3 tr\u01b0\u1edbc, g\u00f3c m\u1edf trong c\u1ee7a \u0111\u1ea7u tr\u00ean x\u01b0\u01a1ng tr\u1ee5: g\u00f3c c\u1ed5 tr\u01b0\u1edbc c\u1ee7a c\u1ea5u ph\u1ea7n tr\u1ee5 v\u00e0o kho\u1ea3ng 20-25 \u0111\u1ed9 (H\u00ecnh 1.5), \u0111\u1ea7u tr\u00ean c\u1ea5u ph\u1ea7n tr\u1ee5 c\u0169ng m\u1edf v\u00e0o trong (varus) kho\u1ea3ng 11-23 \u0111\u1ed9 (H\u00ecnh 1.6)<\/span><\/p>\n

4.\u00a0 Thi\u1ebft k\u1ebf c\u1ea5u ph\u1ea7n li\u00ean k\u1ebft<\/strong><\/h2>\n

C\u1ea5u ph\u1ea7n li\u00ean k\u1ebft c\u1ee7a b\u1ed9 kh\u1edbp li\u1ec1n \u0111\u01b0\u1ee3c th\u01b0\u1eddng \u0111\u01b0\u1ee3c thi\u1ebft k\u1ebf c\u00f3 thanh ch\u1ed1t kho\u00e1. Ph\u1ea7n ti\u1ebfp kh\u1edbp n\u00e0y c\u00f3 l\u1edbp \u0111\u1ec7m PE \u0111\u1ec3 c\u00f3 th\u1ec3 gi\u1ea3m m\u1ee9c \u0111\u1ed9 r\u00e0ng bu\u1ed9c c\u0169ng nh\u01b0 \u0111\u1ec3 tr\u00e1nh va ch\u1ea1m gi\u1eefa c\u00e1c th\u00e0nh ph\u1ea7n kim lo\u1ea1i khi kh\u1edbp chuy\u00ean \u0111\u1ed9ng (H\u00ecnh 1.7).<\/span><\/p>\n

B\u1ed9 kh\u1edbp r\u1eddi kh\u00f4ng c\u00f3 b\u1ed9 ph\u1eadn li\u00ean k\u1ebft ri\u00eang, hai c\u1ea5u ph\u1ea7n s\u1ebd g\u1eafn v\u1edbi nhau nh\u1edd di\u1ec7n ti\u1ebfp x\u00fac kh\u1edbp v\u1edbi nhau; h\u00ecnh d\u1ea1ng ph\u1ea7n ti\u1ebfp x\u00fac c\u1ee7a kh\u1edbp r\u1eddi \u0111\u01b0\u1ee3c c\u00e1c h\u00e3ng thi\u1ebft k\u1ebf kh\u00e1c nhau, tr\u00ean nguy\u00ean t\u1eafc v\u1eadn \u0111\u1ed9ng d\u1ea1ng b\u1ea3n l\u1ec1 c\u1ee7a kh\u1edbp c\u00e1nh tay-tr\u1ee5 (H\u00ecnh 1.8). C\u00e1c ki\u1ec3u thi\u1ebft k\u1ebf kh\u00e1c nhau s\u1ebd c\u00f3 m\u1ee9c \u0111\u1ed9 r\u00e0ng bu\u1ed9c c\u1ee7a c\u00e1c c\u1ea5u ph\u1ea7n \u1edf m\u1ee9c \u0111\u1ed9 kh\u00e1c nhau.<\/span><\/p>\n

\u00a0<\/span>Ph\u1ea7n li\u00ean k\u1ebft c\u1ee7a kh\u1edbp l\u1ea1i \u0111\u01b0\u1ee3c l\u1eafp v\u00e0o c\u1ea5u ph\u1ea7n tr\u1ee5 \u0111\u1ebf chuy\u1ec3n th\u00e0nh thi\u1ebft k\u1ebf t\u01b0\u01a1ng t\u1ef1 nh\u01b0 kh\u1edbp r\u1eddi, tuy nhi\u00ean c\u00f3 th\u00eam m\u1ed9t ph\u1ea7n m\u0169 c\u00f3 th\u1ec3 <\/span>l\u1eafp v\u00e0o c\u1ea5u ph\u1ea7n tr\u1ee5 \u0111\u1ec3 chuy\u1ec3n th\u00e0nh kh\u1edbp li\u1ec1n. <\/span>\u00a0<\/span><\/p>\n

Nh\u00f3m t\u00e1c gi\u1ea3:\u00a0<\/b><\/p>\n

Ch\u1ee7 bi\u00ean: <\/b>GS.TS. Tr\u1ea7n Trung D\u0169ng<\/span><\/p>\n

Bi\u00ean so\u1ea1n:<\/b><\/p>\n

ThS.BS. <\/span>Tr\u1ea7n Quy\u1ebft, BSCKII. Ph\u1ea1m Trung Hi\u1ebfu, ThS.BS. Nguy\u1ec5n Tr\u1ea7n Quang S\u00e1ng, BSCKII. V\u0169<\/span><\/p>\n

T\u00fa Nam, ThS.BSNT. V\u00f5 S\u0129 Quy\u1ec1n N\u0103ng,ThS.BSNT. Tr\u1ea7n \u0110\u1ee9c Thanh, ThS.BSNT. Phan Khoa<\/span><\/p>\n

Nguy\u00ean, BSCKII. Nguy\u1ec5n V\u0103n V\u1ef9.<\/span><\/p>\n

Th\u01b0 k\u00fd: <\/b>ThS.BS. Tr\u1ea7n Quy\u1ebft<\/span><\/p>\n

Xem th\u00eam:<\/span> L\u1ecbch s\u1eed ph\u00e1t tri\u1ec3n v\u00e0 c\u00e1c thu\u1eadt ng\u1eef v\u1ec1 kh\u1edbp khu\u1ef7u nh\u00e2n t\u1ea1o<\/b><\/a><\/p>\n

\u00a0<\/span><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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