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Umubare wo kubaga arthroscopique wiyongereye mu myaka 20 ishize, kandi sisitemu yo kogosha ya arthroscopique yabaye igikoresho gikoreshwa cyane na orthopedic.Nyamara, urwembe rwinshi ntirukarishye bihagije, byoroshye kwambara, nibindi.Intego yiyi ngingo ni ugukora iperereza ku miterere iranga icyuma gishya cya seriveri ebyiri ya BJKMC (Bojin◊ Kinetic Medical) urwembe rwa arthroscopique.Itanga incamake y'ibicuruzwa byashizweho hamwe no kwemeza inzira.Urwembe rwa arthroscopique ya BJKMC rugaragaza igishushanyo mbonera cya tube, kigizwe n'ikiganza cyo hanze kitagira ingese hamwe n'umuyoboro w'imbere uzunguruka.Igikonoshwa cyo hanze hamwe nigikonoshwa cyimbere gifite ibyokunywa no gukata ibyambu, kandi hari ibibanza hejuru yimbere ninyuma.Kugirango ushimangire igishushanyo, cyagereranijwe na Dyonics◊ Incisor◊ Plus yinjiza.Kugaragara, gukomera kw'ibikoresho, ibyuma bitobora ibyuma, uburebure bw'urukuta rw'ibikoresho, umwirondoro w'amenyo, inguni, imiterere rusange, ibipimo bikomeye, n'ibindi byagenzuwe kandi bigereranywa.ubuso bukora hamwe ninama ikomeye kandi yoroheje.Kubwibyo, ibicuruzwa bya BJKMC birashobora gukora neza muburyo bwo kubaga.
Ihuriro mu mubiri wumuntu nuburyo bwo guhuza butaziguye hagati yamagufwa.Nibintu bigoye kandi bihamye bigira uruhare runini mubuzima bwacu bwa buri munsi.Indwara zimwe zihindura ikwirakwizwa ryumutwaro mubice, bikaviramo kugabanuka kumikorere no gutakaza imikorere1.Kubaga amagufwa gakondo biragoye kuvura neza byibasiye, kandi igihe cyo gukira nyuma yo kuvurwa ni kirekire.Kubaga Arthroscopique nuburyo bworoshye butera busaba gukomeretsa gato, bitera ihahamuka no gukomeretsa, bifite igihe cyo gukira vuba, hamwe nibibazo bike.Hamwe niterambere ryibikoresho byubuvuzi, tekinike zo kubaga zoroheje zagiye ziba uburyo busanzwe bwo gusuzuma no kuvura amagufwa.Nyuma gato yo kubagwa ivi rya mbere ryitwa arthroscopique, ryemejwe nkubuhanga bwo kubaga na Kenji Takagi na Masaki Watanabe mu Buyapani2,3.Arthroscopy na endoprosthetics nibintu bibiri byingenzi byateye imbere mumikorere4.Muri iki gihe, kubaga arthroscopique byibasiwe cyane bikoreshwa mu kuvura indwara n’imvune zitandukanye, zirimo osteoarthritis, ibikomere by’imisoro, ibikomere by’imbere n’inyuma, ibikomere bya synovitis, kuvunika imbere mu nda, kuvunika kwa patellar, karitsiye no gukomeretsa umubiri.
Umubare wo kubaga arthroscopique wiyongereye mu myaka 20 ishize, kandi sisitemu yo kogosha ya arthroscopique yabaye igikoresho gikoreshwa cyane na orthopedic.Kugeza ubu, abaganga bafite amahitamo atandukanye aboneka kubaganga, harimo kwiyubaka kwa ligamenti ikomeye, gusana menisque, gushushanya osteochondral, hip arthroscopie, hamwe na arthroscopie yibice, bitewe nibyifuzo byo kubaga1.Mugihe uburyo bwo kubaga arthroscopique bwagutse bugera ku ngingo nyinshi, abaganga barashobora gusuzuma ingingo za synovial no kubaga abarwayi muburyo butatekerezwa.Muri icyo gihe, ibindi bikoresho byatejwe imbere.Mubisanzwe bigizwe nigice cyo kugenzura, intoki ifite moteri ikomeye nigikoresho cyo gutema.Igikoresho cyo gutandukanya cyemerera icyarimwe kandi gikomeza guswera no gutesha agaciro6.
Bitewe nuburyo bugoye bwo kubaga arthroscopique, akenshi ibikoresho byinshi birasabwa.Ibikoresho nyamukuru byo kubaga bikoreshwa mu kubaga arthroscopique harimo arthroscopes, imikasi ya probe, ingumi, imbaraga, ibyuma bya arthroscopique, ibyuma bya menisk na urwembe, ibikoresho bya elegitoroniki, laseri, ibikoresho bya radiyo n’ibindi bikoresho 7.
Urwembe nigikoresho cyingenzi mububiko.Hariho amahame abiri yingenzi yo kubaga arthroscopique.Iya mbere ni ugukuraho ibisigisigi bya karitsiye yangiritse, harimo imibiri irekuye hamwe na karitsiye ireremba hejuru, mukunyunyuza no guhanagura ingingo hamwe na saline nyinshi kugirango ukureho ibikomere byimbere-arctular hamwe nabunzi batera umuriro.Ikindi ni ugukuraho karitsiye ya articular yatandukanijwe namagufa ya subchondral no gusana inenge yangiritse.Meniskus yacitse iracukurwa hanyuma hakorwa menisque ishaje kandi ivunitse.Urwembe rukoreshwa kandi mugukuraho bimwe cyangwa byose mubice bya synovial inflammatory, nka hyperplasia no kubyimba1.
Hafi ya scalpels yibasiwe cyane ifite igice cyo gukata hamwe na kanseri yo hanze yimbere hamwe numuyoboro w'imbere.Ntibakunze kugira amenyo 8 asobekeranye.Inama zitandukanye zicyuma zitanga urwego rutandukanye rwo guca imbaraga urwembe.Urwembe rusanzwe rwa arthroscopique ruri mu byiciro bitatu (Ishusho 1): (a) imiyoboro y'imbere n'inyuma;(b) imiyoboro y'inyuma yoroshye hamwe n'igitereko cy'imbere;(c) ikaranze (ishobora kuba urwembe)) imiyoboro y'imbere n'inyuma.9. Ubukare bwabo kumyenda yoroshye iriyongera.Impuzandengo yingufu zo hejuru no kugabanya imikorere yibiti bimwe bisobanurwa neza kuruta umurongo wa 10.
Ariko, hariho ibibazo bitari bike hamwe na arthroscopic yogosha.Ubwa mbere, icyuma ntigikarishye bihagije, kandi biroroshye guhagarika mugihe ukata imyenda yoroshye.Icya kabiri, urwembe rushobora guca gusa inyama zoroheje-umuganga agomba gukoresha burr kugirango yonone igufwa.Kubwibyo, ibyuma bigomba guhinduka kenshi mugihe cyo gukora, byongera igihe cyo gukora.Gukata ibyangiritse no kwambara urwembe nabyo nibibazo bisanzwe.Gutunganya neza no kugenzura neza byakozwe muburyo bumwe bwo gusuzuma.
Ikibazo cya mbere nuko urwembe rutoroha bihagije kubera ikinyuranyo gikabije kiri hagati yimbere ninyuma.Igisubizo cyikibazo cya kabiri gishobora kuba ukongera inguni yicyuma cyogosha no kongera imbaraga zibikoresho byubwubatsi.
Urwembe rushya rwa BJKMC arthroscopic urwembe rufite ibyuma bibiri birashobora gukemura ibibazo byo gukata impande zombi, gufunga byoroshye no kwambara ibikoresho byihuse.Kugirango tumenye neza igishushanyo mbonera gishya cya BJKMC, cyagereranijwe na mugenzi wa Dyonics◊, Incisor◊ Plus Blade.
Urwembe rushya rwa arthroscopique rurimo igishushanyo mbonera, harimo icyuma cyo hanze cyuma kitagira umuyonga hamwe n'umuyoboro w'imbere uzengurutswe hamwe no guswera no gukata ibyambu ku ntoki zo hanze no mu muyoboro w'imbere.Imbere n'inyuma byanditseho.Mugihe cyo gukora, sisitemu yingufu itera umuyoboro wimbere kuzunguruka, kandi umuyoboro winyuma uruma amenyo, bigahuza no gukata.Ibice byuzuye byuzuye hamwe numubiri urekuye bivanwa mubice binyuze mumiyoboro yimbere.Gutezimbere gukata imikorere no gukora neza, hatoranijwe imiterere yinyo.Gusudira Laser bikoreshwa mubice bigize ibice.Imiterere yumutwe usanzwe wo kogosha amenyo yerekanwe kumashusho 2.
Mubishushanyo rusange, diameter yinyuma yimpera yimbere yimitsi ya arthroscopique ni ntoya kurenza impera yinyuma.Urwembe ntirukwiye guhatirwa mumwanya uhuriweho, kubera ko impande zombi hamwe nuruhande rwidirishya ryo gukata byogejwe kandi byangiza ubuso bwa arctular.Mubyongeyeho, ubugari bwidirishya ryogosha bigomba kuba binini bihagije.Mugari mugari ya idirishya, niko gutondekanya kogosha no gukata, kandi nibyiza birinda gufunga idirishya.
Muganire ku ngaruka zerekana amenyo ku mbaraga zo guca.Icyitegererezo cya 3D cyogosho cyakozwe hifashishijwe software ya SolidWorks (SolidWorks 2016, SolidWorks Corp., Massachusetts, USA).Moderi yo hanze yerekana imyirondoro itandukanye yinjijwe muri gahunda yanyuma (ANSYS Workbench 16.0, ANSYS Inc., USA) kugirango isesengure kandi isesengure.Ibikoresho bya mashini (modulus ya elastique na ratio ya Poisson) yibikoresho byatanzwe mumeza.1. Ubucucike bwa mesh bwakoreshwaga mu ngingo zoroheje bwari mm 0,05, kandi twanonosoye amasura 11 yindege duhura nuduce tworoshye (Ishusho 3a).Moderi yose ifite node 40,522 na meshes 45,449.Mugihe cyimiterere yimipaka, turabuza byimazeyo dogere 6 zubwisanzure zihabwa impande 4 zumubiri woroshye kandi urwembe ruzunguruka 20 ° ruzengurutse x-axis (Ishusho 3b).
Isesengura ryerekana uburyo butatu bwo kogosha (Igicapo 4) ryerekanye ko ingingo yo guhangayika cyane ibaho mugihe cyimpinduka zitunguranye, ibyo bikaba bihuye nubukanishi.Urwembe nigikoresho gishobora gukoreshwa4 kandi harikibazo gito cyo kumeneka icyuma mugihe kimwe.Kubwibyo, twibanze cyane kubushobozi bwayo bwo guca.Impagarara zingana zingana zikora kumyenda yoroshye irashobora kwerekana ibi biranga.Muburyo bumwe bwo gukora, mugihe impagarara zingana zingana nizo nini, bifatwa mbere yuko imitungo yayo yo gukata ari nziza.Kubijyanye no guhangayikishwa nuduce tworoheje, urwembe rwa 60 ° rwerekana urwembe rwabyaye impagarike ntoya yoroheje (39.213 MPa).
Gukwirakwiza no koroshya ingirabuzimafatizo mugihe urwembe rufite amenyo atandukanye agabanya imyenda yoroshye: (a) 50 ° umwirondoro w'amenyo, (b) 60 ° umwirondoro w'amenyo, (c) 70 ° umwirondoro w'amenyo.
Kugirango ushimangire igishushanyo mbonera gishya cya BJKMC, cyagereranijwe nicyuma gihwanye na Dyonics◊ Incisor◊ Plus (Igishusho 5) gifite imikorere imwe.Ubwoko butatu busa bwa buri gicuruzwa bwakoreshejwe mubushakashatsi bwose.Urwembe rwakoreshejwe ni shyashya kandi ntirwangiritse.
Ibintu bigira ingaruka kumikorere y'urwembe harimo ubukana n'ubunini bw'icyuma, ubukana bw'icyuma, hamwe n'umwirondoro hamwe n'inguni y'amenyo.Kugirango bapime impande zose z'amenyo, hatoranijwe umushinga wa kontour ufite imiterere ya mm 0.001 (Starrett 400, ishusho 6).Mu bushakashatsi, kogosha imitwe byashyizwe ku kazi.Gupima umwirondoro w amenyo nu mfuruka ugereranije na crosshair kuri ecran ya projection hanyuma ukoreshe micrometero nkitandukaniro riri hagati yimirongo yombi kugirango umenye ibipimo.Ingano yukuri yinyo yabonetse mukuyigabanya no gukuza intego yahisemo.Gupima iryinyo ryinyo, huza ingingo zifatika kumpande zombi zapimwe hamwe nu murongo uhuza umurongo kuri ecran ya ecran hanyuma ukoreshe inguni indanga kumeza kugirango usome.
Mugusubiramo ubu bushakashatsi, hapimwe ibipimo nyamukuru byuburebure bwakazi (imbere ninyuma yinyuma), imbere yinyuma ninyuma yinyuma, uburebure bwidirishya nubugari, nuburebure bw amenyo.
Reba ubuso butagaragara hamwe na pinpointer.Isonga ryigikoresho ryimurwa mu buryo butambitse hejuru yicyitegererezo, perpendicular yerekeza ku cyerekezo cy'ingano yatunganijwe.Impuzandengo yikigereranyo Ra iboneka biturutse kubikoresho.Ku mutini.7 yerekana igikoresho gifite urushinge (Mitutoyo SJ-310).
Ubukomere bwurwembe bupimirwa ukurikije ikizamini cya Vickers gikomeye ISO 6507-1: 20055.Indanganturo ya diyama ikanda hejuru yicyitegererezo mugihe runaka munsi yikizamini runaka.Noneho uburebure bwa diagonal bwa indentation bwapimwe nyuma yo gukuraho indenter.Gukomera kwa Vickers kugereranwa nikigereranyo cyimbaraga zipimisha hejuru yubuso bwibitekerezo.
Ubunini bwurukuta rwumutwe wogosha bupimwa mugushyiramo umupira wumupira wa silindrike ufite uburebure bwa mm 0.01 nuburebure bwa mm 0-200.Ubunini bwurukuta busobanurwa nkitandukaniro riri hagati yimiterere yimbere ninyuma yibikoresho.Uburyo bwo kugerageza gupima ubunini bwerekanwe ku gishushanyo cya 8.
Imikorere yimyenda y'urwembe rwa BJKMC yagereranijwe niy'icyuma cyogosha cya Dyonics◊.Imikorere yamakuru kuri buri gice cyibicuruzwa irapimwa kandi igereranijwe.Ukurikije amakuru yikigereranyo, ubushobozi bwo guca ibicuruzwa byombi birateganijwe.Ibicuruzwa byombi bifite imiterere yuburyo bwiza, isesengura rigereranya ryumuriro w'amashanyarazi impande zose riracyakenewe.
Ukurikije igeragezwa rya angle, ibisubizo byerekanwe mu mbonerahamwe ya 2 no ku mbonerahamwe ya 3. Gutandukanya uburyo no gutandukanya amakuru yerekana imiterere y’ibicuruzwa byombi ntabwo byari bitandukanye mu mibare.
Kugereranya ibintu bimwe byingenzi byibicuruzwa byombi byerekanwe ku gishushanyo cya 9. Kubireba ubugari bwimbere ninyuma yubugari n'uburebure, Dyonics◊ idirishya ryimbere ninyuma ni ndende gato kandi yagutse kuruta iya BJKMC.Ibi bivuze ko Dyonics◊ ishobora kugira ibyumba byinshi byo gukata kandi igituba ntigishobora gufunga.Ibicuruzwa byombi ntabwo bitandukanye mu mibare mubindi bice.
Ibice byurwembe rwa BJKMC bihujwe no gusudira laser.Kubwibyo, nta gitutu cyo hanze gisudira.Igice cyo gusudira ntigishobora guhangayikishwa nubushyuhe cyangwa guhindagurika.Igice cyo gusudira ni gito, kwinjira ni binini, imbaraga za mashini zigice cyo gusudira ni nyinshi, kunyeganyega birakomeye, kurwanya ingaruka ni byinshi.Ibikoresho byo gusudira bya Laser byizewe cyane muguterana14,15.
Ubuso bwubuso ni igipimo cyimiterere yubuso.Ibice byinshi-bigizwe nibice bigufi byubuso bwapimwe, bigena imikoranire hagati yikintu n’ibidukikije, birasuzumwa.Ikiganza cyo hanze cyicyuma cyimbere hamwe nubuso bwimbere bwigitereko cyimbere nigice kinini cyakazi cyogosha.Kugabanya ubukana bwimiterere yombi birashobora kugabanya neza kwambara kurwembe no kunoza imikorere.
Ubuso bwubuso bwigikonoshwa cyo hanze, kimwe nimbere ninyuma yimbere yicyuma cyimbere cyibyuma bibiri, byabonetse mubigeragezo.Impuzandengo yabo igereranijwe igaragara ku gishushanyo cya 10. Ubuso bwimbere bwuruhu rwinyuma hamwe nubuso bwinyuma bwicyuma cyimbere ningenzi mubikorwa byakazi.Ubukonje bwubuso bwimbere bwikibabi nubuso bwinyuma bwicyuma cyimbere cya BJKMC buri munsi yibicuruzwa bisa na Dyonics◊ (ibisobanuro bimwe).Ibi bivuze ko ibicuruzwa bya BJKMC bishobora kugira ibisubizo bishimishije mubijyanye no kugabanya imikorere.
Ukurikije ikizamini cyo gukomera, icyuma cyubushakashatsi bwamatsinda abiri yicyuma cyerekanwe ku gishushanyo cya 11. Urwembe rwinshi rwa arthroscopique rukozwe mu byuma bya austenitike bitagira umuyonga kubera imbaraga nyinshi, ubukana n’ubudahangarwa bukenewe ku cyuma cyogosha.Ariko, BJKMC yogosha imitwe ikozwe muri 1RK91 martensitike idafite ibyuma.Ibyuma bya Martensitike bitagira ibyuma bifite imbaraga nubukomezi kuruta ibyuma bya austenitike 17.Ibikoresho bya chimique mubicuruzwa bya BJKMC byujuje ibisabwa na S46910 (ASTM-F899 Surgical Instruments) mugihe cyo guhimba.Ibikoresho byageragejwe kuri cytotoxicity kandi bikoreshwa cyane mubikoresho byubuvuzi.
Birashobora kugaragara mubisubizo by'isesengura ryibintu bitagira ingano ko guhangayikisha urwembe byibanda cyane kumiterere yinyo.IRK91 nimbaraga zikomeye za supermartensitike zidafite ibyuma bidafite ubukana bwinshi nimbaraga nziza zingana mubushyuhe bwicyumba ndetse nubushyuhe bwo hejuru.Imbaraga zingana mubushyuhe bwicyumba zishobora kugera kuri MPa zirenga 2000, kandi agaciro ntangarugero ukurikije isesengura ryibintu bitagira ingano ni MPa 130, iri kure y’imipaka y’ibikoresho.Twizera ko ibyago byo kuvunika inkeri ari bike cyane.
Ubunini bwicyuma bugira ingaruka kuburyo butaziguye bwo gukata urwembe.Ubunini bwurukuta ruto, nibyiza byo gukata.Urwembe rushya rwa BJKMC rugabanya uburebure bwurukuta rwibibari bibiri bizunguruka, kandi umutwe ufite urukuta ruto kurusha bagenzi babo bo muri Dyonics◊.Ibyuma byoroheje birashobora kongera imbaraga zo gukata.
Ibyatanzwe mu mbonerahamwe ya 4 byerekana ko uburebure bwurukuta rwurwembe rwa BJKMC rwapimwe nuburyo bwo gupima urukuta rwa compression-rotation yububiko ni buto ugereranije nubwa urwembe rwa Dyonics◊.
Ukurikije ubushakashatsi bugereranije, urwembe rushya rwa arthroscopique ya BJKMC rwerekanye ko nta tandukaniro rigaragara ryakozwe na moderi isa na Dyonics◊.Ugereranije na Dyonics◊ Incisor◊ Byongeye gushiramo ukurikije ibintu bifatika, winjizamo amenyo abiri ya BJKMC afite ubuso bukora neza kandi bworoshye kandi bworoshye.Kubwibyo, ibicuruzwa bya BJKMC birashobora gukora neza muburyo bwo kubaga.Ubu bushakashatsi bwakozwe muburyo buteganijwe kandi imikorere yihariye igomba kugeragezwa mubushakashatsi bwakurikiyeho.
Chen, Z. Chen, Z.Chen Z, Wang K, Jiang W, Na T, na Chen B. Gusubiramo ibikoresho byo kubaga kuvura ivi rya arthroscopique hamwe na arthroplastique yose. Chen, Z., Wang, C., Jiang, W., Na, T. & Chen, B. 膝关节 镜 清 创 术 和 全 髋 关节 置换 术 手术 器械 综述。 Chen, Z., Wang, C., Jiang, W., Na, T. & Chen, B.Chen Z, Wang K, Jiang W, Na T, na Chen B. Gusubiramo ibikoresho byo kubaga kuvura ivi rya arthroscopique no gusimbuza ikibuno cyose.Inzira ya sirusi.65, 291-2298 (2017).
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Tingstad, EM & Spindler, KP Ibikoresho byibanze bya arthroscopique. Tingstad, EM & Spindler, KP Ibikoresho byibanze bya arthroscopique.Tingstad, EM na Spindler, KP Ibikoresho byibanze bya arthroscopique. Tingstad, EM & Spindler, KP 基本 关节 镜 器械。 Tingstad, EM & Spindler, KPTingstad, EM na Spindler, KP Ibikoresho byibanze bya arthroscopique.akazi.ikoranabuhanga.ubuvuzi bwa siporo.12 (3), 200-203 (2004).
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Ubu bushakashatsi ntabwo bwakiriye inkunga yihariye y’inzego iyo ari yo yose itera inkunga mu nzego za Leta, iz'ubucuruzi, cyangwa idaharanira inyungu.
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