Kima hiki ke hoʻohana ʻia i loko o ke kino kanaka - iwi sima

He inoa maʻamau no ka iwi sima a he lāʻau lapaʻau i hoʻohana ʻia i nā orthopedic. Ma muli o kona helehelena a me nā waiwai kino e like me ka sima keʻokeʻo i hoʻohana ʻia i ke kūkulu ʻana a me ka hoʻonaninani ma hope o ka paʻa ʻana, he inoa kaulana kona. I ka makahiki 1970, ua hoʻohana mua ʻia ka sima iwi no ka hoʻopaʻa ʻana i ka prosthesis hui, a hiki ke hoʻohana ʻia ma ke ʻano he mea hoʻopiha a me ka hoʻoponopono ʻana i ka ʻiʻo i nā orthopedic a me nā niho.

ʻO ka pōmaikaʻi nui loa o ka iwi sima ʻo ia ka hoʻopaʻa paʻa wikiwiki ʻana, e ʻae ai i nā hana hoʻoponopono hou ma hope o ka hana. ʻO kaʻoiaʻiʻo, loaʻa kekahi mau hemahema o ka iwi sima, e like me ke kaomi kiʻekiʻe o ka iwi iwi i ka wā o ka hoʻopiha ʻana, hiki ke hoʻokomo i nā kulu momona i loko o nā kīʻaha koko a hoʻoulu i ka embolism. Eia kekahi, ʻokoʻa ia me nā iwi kanaka, a i ka wā lōʻihi, hiki ke wehe ʻia nā ami hana. No laila, ʻo ka noiʻi ʻana e pili ana i nā biomaterials sima iwi he kumuhana wela no ka poʻe noiʻi.

I kēia manawa, ʻo nā sima iwi i hoʻohana nui ʻia a noiʻi ʻia, ʻo ia ka polymethyl methacrylate (PMMA) iwi sima, calcium phosphate iwi sima, a me ka calcium sulfate iwi sima.
ʻO ka sima iwi PMMA he polymer acrylic i hana ʻia e ka hui ʻana i ka methyl methacrylate monomer a me ka dynamic methyl methacrylate styrene copolymer, me ke koena monomer haʻahaʻa, haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa haʻahaʻa a me ke koʻikoʻi māwae, a me ka ikaika tensile kiʻekiʻe a me ka plasticity. Ua hoʻohana nui ʻia ʻo PMMA iwi sima ma ke kahua o ka lāʻau lapaʻau ʻokiʻoki, a ua hoʻohana ʻia i ka lāʻau lapaʻau niho, iwi poʻo, a me nā māla hoʻoponopono iwi ʻē aʻe i ka makahiki 1940. Ua hoʻohana ʻia ʻo Acrylate iwi cement i ka ʻoki kino kanaka a ua hoʻohana ʻia i nā haneli kaukani o nā hihia lapaʻau ma ka home a me ka honua.

ʻO ka māhele paʻa o ka sima iwi PMMA he ʻāpana polymerized prepolymer PMMA, a ʻo ka māhele wai ʻo MMA monomer, me kekahi mau mea hoʻomaka polymerization a me nā stabilizers i hoʻohui ʻia. Ke hui ʻia ka PMMA prepolymer solid-phase me ka monomer MMA-phase wai, hiki koke mai ka hopena copolymerization polymer e hoʻokō i ka paʻa o ka iwi sima. Eia naʻe, i loko o kēia kaʻina hana paʻa, hoʻokuʻu ʻia ka nui o ka wela, hiki ke hōʻino i ka wela i nā ʻiʻo a puni, e alakaʻi ana i ka mumū a hiki i ka necrosis kiko. No laila, makemake nui ʻia ka noiʻi hou e hoʻomaikaʻi i ka maikaʻi o ka iwi sima polymethyl methacrylate a hōʻemi a hoʻopau paha i nā hopena ʻaoʻao o ka iwi iwi PMMA.

Hoʻohana ʻia ka calcium phosphate i ka hoʻoponopono ʻana i ka iwi ma muli o kona biocompatibility maikaʻi loa a me ka hiki ke hoʻoponopono hou i ka iwi. ʻO ka maʻi maʻi, hoʻohana pinepine ʻia e like me kahi mea injectable e hoʻopiha ai i nā ʻāpana iwi a hoʻomaikaʻi i ka hoʻoponopono ʻana i ka mīkini i ka ʻoki ʻoki. ʻO ka hui ʻana o ka iwi calcium phosphate cement ua like ia me nā minerala o nā iwi kanaka, hiki ke hoʻihoʻi hou ʻia a hoʻoikaika i ka ulu ʻana a me ka hoʻoponopono hou ʻana o nā iwi maoli. ʻO ka mīkini paʻa o ka iwi calcium phosphate cement he hopena hoʻoheheʻe hydration precipitation. Ma ka mālama ʻana i ka waiwai pH o ke kaʻina hana, hiki i ka hydroxyapatite (HA) ke kahe i loko o ka pae pH o 4.2-11. I ka pae mua, hoʻomalu nui ʻia ka hanauna o HA e nā hopena o ka ʻili, a ʻo ka HA i hana ʻia ma waena o nā ʻāpana a ma luna o ka ʻili o nā ʻāpana e hoʻoikaika i nā pilina ma waena o nā ʻāpana. ʻOi aku ka kiʻekiʻe o ka ʻike o nā kristal HA, ʻoi aku ka nui o nā wahi pili, a piʻi pū ka ikaika compressive e like me ia. I ka hopena hope o ka hydration reaction, ua uhi ʻia ka ʻili o ka ʻili me kahi papa o HA, a lilo ka hopena hydration o ka iwi calcium phosphate cement i hoʻopuehu ʻia ma o ka hopena hydration. Me ka hopena hydration mau, hoʻonui ʻia nā ʻāpana HA, a ke ulu nei nā kristal HA i hana ʻia. Hoʻopiha mālie nā huahana hydration i ka hakahaka o ka wai e komo ana i ka hopena, no laila ua māhele ʻia ka wahi i noho mua ʻia e ka wai i nā pores capillary irregular e nā kristal HA.

Hoʻonuiʻia nā pores gel, a hoʻemi mauʻia ka nui o ka pore. Hoʻopili ʻia nā kristal HA a hoʻopaʻa ʻia, a ke piʻi nei ka ikaika paʻa ma waena o nā ʻāpana. Hoʻopaʻa ʻia ka mea sima iwi i kahi ʻano porous paʻa me ka nui o nā pores, no laila e hōʻike ana i ka ikaika hoʻōla macro.

Ma ka hoʻomaʻamaʻa hoʻomaʻamaʻa, loaʻa kahi ʻano hana hōʻeha kūikawā i ka ʻeha vertebral burst traumatic a maʻamau i ka poʻe ʻōpio i ʻoi aku ka ikaika o ke kūkulu hou ʻana i ka iwi. Hiki ke hoʻohana maikaʻi ʻia ka sima iwi calcium phosphate no ka mālama ʻana i ia mau haki. I kēia manawa, ʻo ka sima iwi calcium phosphate kekahi mea e pani ai i ka iwi no ka ʻoki ʻoki ʻana i ka iwi ʻōpū. Eia naʻe, ma muli o ka lōʻihi o ka paʻa ʻana a me ka haʻahaʻa haʻahaʻa o ka hoʻokuʻu ʻana i ka wela i ka wā o ke kaʻina hana paʻa, ʻaʻole maikaʻi ka hoʻopili ʻana a me ka ikaika o ka iwi calcium phosphate, a hiki i ka hemo ʻana mai ka iwi. No laila, ke hoʻomau nei ka noiʻi ʻana no ka iwi calcium phosphate cement.

ʻO ka calcium sulfate ka mea maʻalahi loa no ka hoʻoponopono iwi a ua hoʻohana ʻia i nā mea hoʻoponopono iwi no nā makahiki he 100, me ka mōʻaukala noiʻi lapaʻau lōʻihi loa. Loaʻa i ka calcium sulfate ka hoʻomanawanui kanaka, biodegradability, a me nā waiwai conduction iwi, e lilo ia i mea waiwai ʻē aʻe no ka hoʻololi ʻana i ka iwi autologous i ka noiʻi mua. ʻO ka māhele paʻa o ka calcium sulfate iwi sima he calcium sulfate pauka anhydrous, a ʻo ka wai wai he paʻakai physiological a me nā ʻano wai ʻē aʻe. Ke hui pū ʻia nā ʻāpana paʻa a me ka wai, e loaʻa ana ka calcium sulfate i kahi hopena hydration, e hoʻohua ana i nā ʻūhā calcium sulfate dihydrate i hoʻohālikelike ʻia i ke alahaka a hoʻopaʻa pū kekahi me kekahi, a laila paʻa i loko o kahi puʻu me kekahi ʻano a me ka ikaika. Eia nō naʻe, ma muli o ka maikaʻi ʻole o ka hana olaola, ʻaʻole hiki i ke kinikini iwi calcium ke hana i nā paʻa kemika ma waena o nā grafts calcium sulfate a me ka ʻiʻo iwi, a e hoʻohaʻahaʻa koke. Hiki ke hoʻopaʻa piha ʻia ka sima iwi calcium sulfate i loko o ʻeono pule ma hope o ka hoʻokomo ʻia ʻana, a ʻaʻole kūlike kēia hōʻino wikiwiki i ke kaʻina hana o ka iwi. No laila, i ka hoʻohālikelike ʻia me ka calcium phosphate iwi sima, ʻo ka hoʻomohala ʻana a me ka hoʻohana ʻana i ka lāʻau lapaʻau o ka calcium sulfate iwi sima he mea liʻiliʻi.

Eia kekahi, ua hōʻike ʻia nā haʻawina he nui e hiki ke hoʻomaikaʻi maikaʻi i ka hana ʻana o ka iwi sima, e hāʻawi ana i nā manaʻo noʻonoʻo no nā ʻano hou o ka iwi sima.
I ka hōʻuluʻulu manaʻo, hiki i ka iwi sima ke pāʻani i ka hana koʻikoʻi i ka lāʻau lapaʻau niho a me nā orthopedic, a ua manaʻo ʻia e lilo i mea lawe lāʻau kūpono a me nā mea pani iwi no ka ʻōnaehana iwi.

Me ka hoʻomau mau ʻana a me ka hoʻomohala ʻana o ka ʻepekema, ʻenehana, a me nā mea waiwai, ua manaʻo ʻia e hoʻomohala ʻia nā mea kiʻekiʻe kiʻekiʻe o nā mea sima iwi i ka wā e hiki mai ana, e like me nā ʻano ikaika kiʻekiʻe, injectable, wai kūpaʻa, a me nā ʻano hoʻonohonoho wikiwiki. E hoʻolaha nui ʻia ka hoʻohana ʻana i ka iwi sima i ka hana lapaʻau, a e piʻi aʻe ka waiwai.