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Abubuwan da ke faruwa na aikin tiyata na arthroscopic ya karu a cikin shekaru ashirin da suka gabata, kuma tsarin shaver na arthroscopic ya zama kayan aiki na orthopedic da aka yi amfani da su sosai.Duk da haka, yawancin reza gabaɗaya ba su da kaifi, sauƙin sawa, da sauransu.Makasudin wannan labarin shine don bincika halayen tsarin sabon nau'in serrated na BJKMC (Bojin◊ Kinetic Medical) reza arthroscopic.Yana ba da bayyani na ƙirar samfuri da tsarin tabbatarwa.Reza arthroscopic na BJKMC yana da ƙirar bututu-in-tube, wanda ya ƙunshi hannun bakin karfe na waje da bututun ciki mai juyawa.Harsashi na waje da harsashi na ciki suna da madaidaicin tsotsawa da yanke tashar jiragen ruwa, kuma akwai ƙima akan harsashi na ciki da na waje.Don tabbatar da ƙira, an kwatanta shi da abin saka Dyonics◊ Incisor◊ Plus.An duba bayyanar, taurin kayan aiki, ƙaƙƙarfan bututun ƙarfe, kauri bangon kayan aiki, bayanin martabar haƙori, kusurwa, tsarin gabaɗaya, girma mai mahimmanci, da sauransu.saman aiki da tukwici mai ƙarfi da bakin ciki.Don haka, samfuran BJKMC na iya yin aiki mai gamsarwa a cikin aikin tiyata.
Haɗin gwiwa a jikin ɗan adam wani nau'i ne na haɗin kai kai tsaye tsakanin ƙasusuwa.Tsari ne mai rikitarwa da kwanciyar hankali wanda ke taka muhimmiyar rawa a rayuwarmu ta yau da kullun.Wasu cututtuka suna canza rarraba kaya a cikin haɗin gwiwa, yana haifar da iyakancewar aiki da asarar aiki1.Yin tiyata na gargajiya na gargajiya yana da wahala a yi daidai da ƙarancin ɓarna, kuma lokacin dawowa bayan jiyya yana da tsawo.Tiyatar arthroscopic hanya ce mai saurin kamuwa da cuta wacce ke buƙatar ƙaramin yanki kawai, yana haifar da ƙarancin rauni da tabo, yana da saurin dawowa, da ƙarancin rikitarwa.Tare da haɓaka na'urorin likitanci, ƙananan dabarun tiyata a hankali sun zama hanya na yau da kullun don ganewar asali da magani.Ba da daɗewa ba bayan tiyatar arthroscopic gwiwa na farko, Kenji Takagi da Masaki Watanabe sun karɓe shi a hukumance azaman dabarar tiyata ta Japan2,3.Arthroscopy da endoprosthetics sune biyu mafi mahimmancin ci gaba a cikin orthopedics4.A yau, ana amfani da aikin tiyata na arthroscopic kadan don magance yanayi daban-daban da raunin da ya faru, ciki har da osteoarthritis, raunin meniscal, raunuka na baya da na baya, synovitis, intra-articular fractures, patellar subluxation, guringuntsi da sako-sako da raunuka na jiki.
Abubuwan da ke faruwa na aikin tiyata na arthroscopic ya karu a cikin shekaru ashirin da suka gabata, kuma tsarin shaver na arthroscopic ya zama kayan aiki na orthopedic da aka yi amfani da su sosai.A halin yanzu, likitocin suna da zaɓuɓɓuka iri-iri da ake da su ga likitocin, ciki har da sake gina ligament na cruciate, gyaran meniscus, grafting osteochondral, hip arthroscopy, da facet haɗin gwiwa arthroscopy, dangane da fifiko na likitan tiyata1.Yayin da hanyoyin aikin tiyata na arthroscopic ke fadada zuwa ƙarin haɗin gwiwa, likitoci na iya bincikar haɗin gwiwar synovial da kuma yin aikin tiyata a cikin hanyoyin da ba a iya tunanin su a baya.A lokaci guda kuma, an samar da wasu kayan aikin.Yawanci sun ƙunshi na'ura mai sarrafawa, kayan hannu tare da mota mai ƙarfi da kayan aiki na yanke.Kayan aikin rarrabawa yana ba da izinin lokaci guda da ci gaba da tsotsawa da lalata6.
Saboda rikitarwa na aikin tiyata na arthroscopic, ana buƙatar kayan aiki da yawa.Manyan kayan aikin tiyata da ake amfani da su wajen tiyatar arthroscopic sun hada da arthroscopes, almakashi na bincike, naushi, karfi, wukake arthroscopic, ruwan wukake da reza, kayan aikin tiyata na lantarki, lasers, kayan mitar rediyo da sauran kayan aikin 7.
Reza kayan aiki ne mai mahimmanci a cikin tiyata.Akwai manyan ka'idoji guda biyu na ƙwanƙwasa aikin tiyata na arthroscopic.Na farko shi ne a cire ragowar gurɓataccen guringuntsi, gami da raƙuman jikin jiki da ƙashin ƙugu mai iyo, ta hanyar tsotsa da kuma zubar da haɗin gwiwa tare da saline mai ɗanɗano don kawar da raunuka na cikin articular da masu shiga tsakani.Sauran shine don cire guntun guntun da aka rabu da kashi na subchondral da kuma gyara lahani na guringuntsi da aka sawa.An cire tsagewar meniscus kuma an kafa meniscus da aka sawa da karye.Har ila yau, ana amfani da reza don cire wasu ko duk abin da ke haifar da kumburi na synovial, irin su hyperplasia da thickening1.
Mafi ƙarancin ɓangarorin ɓarna suna da yanki mai yankewa tare da rami mara kyau na waje da bututun ciki.Ba kasafai suke da hakora 8 masu ɗorewa don yankewa ba.Daban-daban na tukwici na samar da matakan yanke wuta daban-daban ga reza.Haƙoran reza na al'ada na al'ada sun faɗi cikin rukuni uku (Hoto na 1): (a) bututun ciki da na waje masu santsi;(b) bututu na waje masu santsi da bututun ciki masu serrated;(c) serrated (wanda zai iya zama reza ruwa)) bututu na ciki da na waje.9. Kaifinsu zuwa ga laushi yana ƙaruwa.Matsakaicin ƙarfin kololuwar ƙarfi da ingancin yankan zato na ƙayyadaddun ƙayyadaddun abubuwa iri ɗaya ya fi mashaya lebur 10 kyau.
Duk da haka, akwai matsaloli masu yawa tare da masu sharar arthroscopic a halin yanzu.Na farko, ruwa ba shi da kaifi sosai, kuma yana da sauƙi don toshe lokacin yankan nama mai laushi.Na biyu, reza na iya yanke kawai ta cikin nama mai laushi na synovial - dole ne likita ya yi amfani da burar don goge kashi.Sabili da haka, ana buƙatar canza ruwan wukake akai-akai yayin aiki, wanda ke ƙara lokacin aiki.Yanke lalacewa da sawar reza suma matsalolin gama gari ne.Mashin daidaici da sarrafa daidaito da gaske sun samar da fihirisar kimantawa guda.
Matsala ta farko ita ce, reza ba ta da kyau sosai saboda yawan gibin da ke tsakanin ciki da waje.Maganin matsala na biyu na iya zama ƙara girman kusurwar reza da ƙara ƙarfin kayan aikin gini.
Sabuwar reza ta arthroscopic na BJKMC tare da ɓangarorin serrated biyu na iya magance matsalolin ɓangarorin yankan ɓangarorin, sauƙin toshewa da saurin kayan aiki.Don gwada ingancin sabon ƙirar reza na BJKMC, an kwatanta shi da takwarar Dyonics◊, Incisor◊ Plus Blade.
Sabuwar reza ta arthroscopic tana da ƙirar tube-in-tube, gami da hannun rigar bakin karfe na waje da bututu mai jujjuyawar ciki tare da tsotsa mai dacewa da yanke tashar jiragen ruwa a hannun rigar waje da bututun ciki.Kambun ciki da na waje suna da kyau.Lokacin aiki, tsarin wutar lantarki yana haifar da bututun ciki don juyawa, kuma bututu na waje yana cizon hakora, yana hulɗa tare da yanke.Ana cire ɓangarorin nama da sassaukarwa daga haɗin gwiwa ta cikin bututu mai zurfi.Don inganta aikin yankewa da inganci, an zaɓi tsarin haƙori mai maƙarƙashiya.Ana amfani da waldawar Laser don sassa masu haɗaka.Ana nuna tsarin aske kan haƙori na al'ada biyu a hoto na 2.
A cikin ƙira na gaba ɗaya, diamita na waje na ƙarshen ƙarshen arthroscopic shaver ya ɗan ƙarami kaɗan fiye da ƙarshen baya.Bai kamata a tilasta reza a cikin sararin haɗin gwiwa ba, saboda duka tip da gefen taga mai yankan an wanke su kuma suna lalata farfajiyar articular.Bugu da ƙari, nisa na taga mai aski ya kamata ya zama babban isa.Fadin tagar, da tsari mai askewa yana yankewa yana tsotsa, kuma yana da kyau ya hana rufe taga.
Tattauna tasirin bayanin martabar haƙori akan yanke ƙarfi.An ƙirƙiri ƙirar 3D na reza ta amfani da software na SolidWorks (SolidWorks 2016, SolidWorks Corp., Massachusetts, Amurka).An shigo da samfuran harsashi na waje tare da bayanan bayanan haƙori daban-daban zuwa cikin ƙayyadaddun tsarin ƙayyadaddun abubuwa (ANSYS Workbench 16.0, ANSYS Inc., Amurka) don tantancewa da tantance damuwa.Kaddarorin injina (modulus na elasticity da rabon Poisson) na kayan ana bayar da su a cikin Tebur.1. Ƙaƙƙarfan raƙuman da aka yi amfani da shi don kyallen takarda mai laushi shine 0.05 mm, kuma mun tsaftace fuska 11 na planer a cikin hulɗa da kyallen takarda mai laushi (Fig. 3a).Duk samfurin yana da nodes 40,522 da 45,449 meshes.A cikin saitunan yanayin iyaka, mun cika cika matakan 6 na 'yanci da aka ba wa ɓangarorin 4 na kyallen takarda mai laushi kuma an juya reza 20 ° a kusa da x-axis (Fig. 3b).
Wani bincike na nau'in reza guda uku (Fig. 4) ya nuna cewa ma'anar matsananciyar damuwa yana faruwa a wani canji na gaggawa, wanda ya dace da kayan aikin injiniya.Reza kayan aiki ne da ake iya zubarwa4 kuma akwai ɗan haɗarin karyewar ruwa yayin amfani guda ɗaya.Saboda haka, mun fi mai da hankali kan iyawar sa na yankewa.Matsakaicin daidaitaccen danniya da ke aiki akan nama mai laushi na iya nuna wannan sifa.A ƙarƙashin yanayin aiki iri ɗaya, lokacin da matsakaicin matsakaicin matsakaicin damuwa ya fi girma, an riga an yi la'akari da cewa yanke kaddarorinsa sune mafi kyau.Dangane da danniya mai laushi, reza bayanin martabar haƙori na 60° ya samar da matsakaicin matsakaicin ƙarfi mai ƙarfi (39.213 MPa).
Shaver da taushi nama rarraba damuwa lokacin da reza sheaths tare da daban-daban hakora profiles yanke taushi kyallen takarda: (a) 50° bayanin martaba haƙori, (b) 60° bayanin martaba, (c) 70° profile hakori.
Don tabbatar da ƙirar sabon ruwan BJKMC, an kwatanta shi da daidaitaccen Dyonics◊ Incisor◊ Plus ruwa (Fig. 5) wanda ke da irin wannan aikin.An yi amfani da nau'ikan iri guda uku na kowane samfur a duk gwaje-gwaje.Duk reza da aka yi amfani da su sababbi ne kuma ba su lalace ba.
Abubuwan da ke shafar aikin reza sun haɗa da taurin ruwa da kauri, da ƙaƙƙarfan bututun ƙarfe, da bayanin martaba da kusurwar hakori.Don auna ma'auni da kusurwoyi na hakora, an zaɓi na'ura mai kwakwalwa tare da ƙuduri na 0.001 mm (Starrett 400 series, Fig. 6).A cikin gwaje-gwajen, an sanya gashin kai a kan benci na aiki.Auna bayanin martabar haƙori da kusurwar da ke kusa da giciye akan allon tsinkaya kuma yi amfani da micrometer azaman bambanci tsakanin layi biyu don tantance ma'auni.Ana samun ainihin girman bayanin martabar haƙori ta hanyar rarraba shi ta hanyar haɓaka maƙasudin da aka zaɓa.Don auna kusurwar haƙori, daidaita ƙayyadaddun maki a kowane gefen kusurwar da aka auna tare da madaidaicin layin layi akan allon ƙyanƙyashe kuma yi amfani da siginan kusurwa a cikin tebur don ɗaukar karatu.
Ta hanyar maimaita wannan gwaji, an auna manyan ma'auni na tsawon aiki (bututu na ciki da na waje), diamita na gaba da na baya, tsayin taga da faɗin, da tsayin haƙori.
Bincika rashin ƙarfi na saman tare da fitillu.An motsa tip na kayan aiki a kwance sama da samfurin, daidai da jagorancin hatsin da aka sarrafa.Ana samun matsakaicin matsakaicin rashin ƙarfi Ra kai tsaye daga kayan aiki.A kan fig.7 yana nuna kayan aiki tare da allura (Mitutoyo SJ-310).
Ana auna taurin reza bisa ga gwajin taurin Vickers ISO 6507-1: 20055.Ana danna maƙallan lu'u-lu'u a saman samfurin na wani ɗan lokaci a ƙarƙashin wani ƙarfin gwaji.Sa'an nan kuma an auna tsayin diagonal na ciki bayan an cire mai shiga.Vickers taurin ya yi daidai da rabon ƙarfin gwajin zuwa farfajiyar abin da ake gani.
Ana auna kaurin bangon kan aski ta hanyar saka kan ƙwallon siliki tare da daidaiton 0.01 mm da kewayon auna kusan 0-200 mm.An bayyana kaurin bango a matsayin bambanci tsakanin diamita na waje da ciki na kayan aiki.Ana nuna hanyar gwaji don auna kauri a cikin siffa 8.
An kwatanta aikin tsarin reza na BJKMC da na Dyonics◊ reza na ƙayyadaddun bayanai.Ana auna da kwatanta bayanan aikin kowane ɓangaren samfurin.Dangane da bayanan ƙima, iyawar yankan samfuran biyu ana iya faɗi.Duk samfuran biyu suna da ingantattun kaddarorin tsari, ana buƙatar kwatancen bincike na ƙarfin lantarki daga kowane bangare har yanzu.
Bisa ga gwajin kusurwa, an nuna sakamakon a cikin Table 2 da Table 3. Ma'anar ma'anar ma'auni da daidaitattun bayanan bayanan martaba na samfurori guda biyu ba su bambanta da ƙididdiga ba.
Ana nuna kwatancen wasu maɓalli na maɓalli na samfuran biyu a cikin Hoto na 9. Dangane da faɗin bututu na ciki da na waje da tsayi, Dyonics◊ windows bututu na ciki da na waje sun ɗan fi tsayi fiye da na BJKMC.Wannan yana nufin Dyonics◊ na iya samun ƙarin ɗaki don yanke kuma bututun ba zai yuwu ya toshe ba.Kayayyakin biyu ba su bambanta ba a kididdiga ta wasu fannoni.
An haɗa sassan reza na BJKMC ta hanyar walƙiya ta Laser.Saboda haka, babu wani waje matsa lamba a kan weld.Bangaren da za a yi masa walda ba ya ƙarƙashin matsin zafi ko nakasar zafi.Bangaren walda yana da kunkuntar, shigarwar yana da girma, ƙarfin injin na ɓangaren walda yana da girma, girgiza yana da ƙarfi, juriya mai tasiri yana da girma.Abubuwan da aka welded Laser suna da aminci sosai a cikin taro14,15.
Ƙunƙarar saman ma'auni ne na rubutun saman.An yi la'akari da manyan mita da gajerun raƙuman ruwa na saman da aka auna, waɗanda ke ƙayyade hulɗar da ke tsakanin abu da yanayinsa.Hannun hannun wuka na ciki da kuma saman bututun ciki sune manyan wuraren aiki na reza.Rage rashin ƙarfi na saman biyu na iya rage lalacewa a kan reza da inganta aikinta yadda ya kamata.
An yi gwajin yanayin yanayin harsashi na waje, da kuma na ciki da na waje na cikin ciki na bututun ƙarfe guda biyu.Matsakaicin ƙimar su ana nuna su a cikin Hoto 10. Tsarin ciki na ciki na waje da wuka na ciki shine babban kayan aiki.Ƙunƙarar saman ciki na scabard da saman saman wuka na ciki na BJKMC ya yi ƙasa da samfuran Dyonics ◊ iri ɗaya (bayani ɗaya).Wannan yana nufin cewa samfuran BJKMC na iya samun sakamako mai gamsarwa dangane da yanke aikin.
Bisa ga gwajin taurin ruwa, an nuna bayanan gwaji na ƙungiyoyi biyu na reza a cikin Hoto na 11. Yawancin ɓangarorin arthroscopic ana yin su ne da bakin karfe na austenitic saboda ƙarfin ƙarfi, ƙarfi da ductility da ake buƙata don reza ruwan wukake.Koyaya, BJKMC aski an yi shi daga bakin karfe 1RK91 martensitic.Bakin Karfe na Martensitic yana da ƙarfi da ƙarfi fiye da bakin ƙarfe austenitic17.Abubuwan sinadaran da ke cikin samfuran BJKMC sun cika buƙatun S46910 (ASTM-F899 Kayan aikin tiyata) yayin aikin ƙirƙira.An gwada kayan don cytotoxicity kuma ana amfani dashi sosai a cikin na'urorin likita.
Ana iya gani daga sakamakon bincike mai iyaka cewa yawan damuwa na reza ya fi mayar da hankali kan bayanin martabar hakori.IRK91 babban ƙarfi supermartensitic bakin karfe ne tare da babban tauri da kyakkyawan ƙarfi mai ƙarfi a duka zafin ɗaki da zafin jiki mai tsayi.Ƙarfin ƙira a cikin zafin jiki na ɗakin zai iya kaiwa fiye da 2000 MPa, kuma matsakaicin ƙimar damuwa bisa ga ƙididdigar ƙayyadaddun ƙayyadaddun abu shine kusan 130 MPa, wanda yake da nisa daga iyakar raguwa na kayan.Mun yi imanin cewa hadarin karayar ruwa kadan ne.
Kauri daga cikin ruwa kai tsaye yana rinjayar ikon yanke reza.Mafi ƙarancin kauri na bango, mafi kyawun aikin yankan.Sabuwar reza ta BJKMC tana rage kaurin bangon sanduna masu juyawa biyu masu adawa da juna, kuma kai yana da bangon sirara fiye da takwarorinsa na Dyonics◊.Wukake na bakin ciki na iya ƙara ƙarfin yanke tip.
Bayanan da ke cikin Tebu 4 sun nuna cewa kaurin bangon reza BJKMC da aka auna ta hanyar auna kaurin bangon matsawa-juyawa ya fi na Dyonics◊ reza na ƙayyadaddun bayanai.
Dangane da gwaje-gwajen kwatankwacin, sabon reza na arthroscopic na BJKMC bai nuna bambance-bambancen ƙira ba daga irin wannan samfurin Dyonics◊.Idan aka kwatanta da Dyonics◊ Incisor◊ Plus abubuwan da aka saka cikin sharuddan kaddarorin kayan, BJKMC abubuwan saka haƙoran haƙora biyu suna da faffadan aiki mai santsi da tukwici mai ƙarfi da sirara.Don haka, samfuran BJKMC na iya yin aiki mai gamsarwa a cikin aikin tiyata.An tsara wannan binciken da wuri kuma ana buƙatar gwada takamaiman aiki a gwaje-gwaje na gaba.
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Wannan binciken bai sami takamaiman kudade daga kowace hukumomin ba da tallafi a cikin jama'a, kasuwanci, ko sassa masu zaman kansu ba.
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