Usimende ongasetshenziswa emzimbeni womuntu - usimende wamathambo

I-Bone Cement yigama elivame ukusetshenziswa le-bone Cement futhi liyimpahla yezokwelapha esetshenziswa ku-orthopedics. Ngenxa yokubukeka kwayo kanye nezakhiwo ezibonakalayo ezifana nosimende omhlophe osetshenziswa ekwakheni nasekuhlobiseni ngemva kokuqina, inegama elidumile. Ngawo-1970, usimende wamathambo wawusuvele usetshenziselwe ukulungisa i-prosthesis ehlangene, futhi ungasetshenziswa njengendawo yokugcwalisa izicubu nokulungisa ku-orthopaedics kanye nodokotela wamazinyo.

Inzuzo enkulu yethambo usimende ukuqina kwayo okusheshayo, okuvumela imisebenzi yokuvuselela yangemva kokuhlinzwa. Yiqiniso, usimende wamathambo nawo unezinye izithiyo, njengokucindezela okuphezulu ngezikhathi ezithile emgodini womnkantsha ngesikhathi sokugcwalisa, okungabangela amaconsi amafutha ukuba angene emithanjeni yegazi futhi abangele i-embolism. Ngaphezu kwalokho, ihlukile emathanjeni abantu, futhi ngokuhamba kwesikhathi, amalunga okwenziwa angase aqhubeke exega. Ngakho-ke, ucwaningo lwe-bonecement biomaterials bekulokhu kuyisihloko esishisayo sokukhathazeka kubacwaningi.

Njengamanje, osimende bamathambo abasetshenziswa kakhulu futhi abacwaningwayo yi-polymethyl methacrylate (PMMA) usimende wamathambo, usimende wamathambo we-calcium phosphate, nosimende wamathambo we-calcium sulfate.
I-PMMA bone Cement iyi-polymer ye-acrylic eyakhiwe ngokuxuba i-monomer ye-methyl methacrylate ewuketshezi kanye ne-dynamic methyl methacrylate styrene copolymer, enensalela ephansi ye-monomer, ukumelana nokukhathala okuphansi kanye nokumelana nokuqhekeka kwengcindezi, kanye namandla aqine kakhulu kanye nepulasitiki. I-PMMA bone Cement isetshenziswe kabanzi emkhakheni wokuhlinzwa kwepulasitiki yezokwelapha, futhi isetshenziswe kudokotela wamazinyo, ugebhezi, nezinye izinkambu zokulungisa amathambo ekuqaleni kwawo-1940. I-Acrylate bone Cement isetshenziswe ekuhlinzeni izicubu zomuntu futhi isetshenziswe kumakhulu ezinkulungwane zezigameko zomtholampilo kokubili ngaphakathi nangaphandle.

Isigaba esiqinile sikasimende wethambo le-PMMA ngokuvamile i-polymerized prepolymer PMMA, futhi isigaba soketshezi yi-MMA monomer, okuneziqalisi ze-polymerization kanye neziqinisi. Uma i-prepolymer yesigaba esiqinile i-PMMA ixutshwa ne-MMA monomer yesigaba se-liquid, ukusabela kwe-polymer copolymerization kwenzeka ngokushesha ukuze kuzuzwe ukuqina kukasimende wethambo. Kodwa-ke, phakathi nale nqubo yokuqinisa, kukhishwa inani elikhulu lokushisa, elingabangela ukulimala okushisayo kwezicubu ezizungezile, okuholela ekuvuvukeni ngisho ne-necrosis yezicubu. Ngakho-ke, ucwaningo olwengeziwe luyadingeka ngokushesha ukuze kuthuthukiswe ikhwalithi ye-polymethyl methacrylate bone usimende futhi kuncishiswe noma kuqedwe imiphumela emibi ye-PMMA bone samente.

I-calcium phosphate isetshenziswa ekulungiseni amathambo ngenxa ye-biocompatibility yayo enhle kakhulu nekhono lokuvuselela amathambo. Ngokomtholampilo, ivame ukusetshenziswa njengento ejovwayo ukuze igcwalise izikhala zamathambo futhi ithuthukise ukulungiswa kwe-hardware ekuhlinzeni ukuphuka. Ukwakheka kukasimende wethambo le-calcium phosphate kufana namaminerali amathambo abantu, angaphinde afakwe futhi akhuthaze ukukhula kwangaphakathi nokulungiswa kabusha kwamathambo emvelo. I-solication mechanism ye-calcium phosphate bone simende iwukusabela kwe-dissolution hydration precipitation. Ngokulawula inani le-pH lenqubo yokusabela, i-hydroxyapatite (HA) ingangena ngaphakathi kwebanga le-pH lika-4.2-11. Esigabeni sokuqala, ukukhiqizwa kwe-HA kulawulwa ngokuyinhloko ukusabela kwendawo, kanti i-HA ekhiqizwa phakathi kwezinhlayiya nangaphezulu kwezinhlayiya iqinisa ukuxhumana phakathi kwezinhlayiya. Ukuphakama kokuqukethwe kwamakristalu e-HA, amaphuzu okuxhumana amaningi akhona, namandla okucindezela nawo akhuphuka ngokufanele. Esigabeni sakamuva sokusabela kwe-hydration, ingaphezulu lezinhlayiyana limbozwa ungqimba lwe-HA, futhi ukusabela kwe-hydration kasimende wethambo le-calcium phosphate kuba ukusabalalisa okulawulwa ngokusabela kwe-hydration. Ngokusabela okuqhubekayo kwe-hydration, izinhlayiya eziningi ze-HA ziyakhiqizwa, futhi amakristalu e-HA akhiqizwayo ayakhula. Imikhiqizo ye-hydration kancane kancane igcwalisa isikhala samanzi abambe iqhaza ekuphenduleni, ukuze isikhala esithathwe amanzi ngaphambili sihlukaniswe ngama-capillary pores angavamile ngamakristalu e-HA.

Ama-gel pores anda, futhi ubukhulu be-pore buyancipha njalo. Amakristalu e-HA ayanyakaziswa futhi ahlanganiswe, futhi amandla okubopha phakathi kwezinhlayiya ayakhula. Impahla ye-samente yethambo iqiniswa ibe isakhiwo esiqinile esinezimbotshana ezinenani elikhulu lama-pores, ngaleyo ndlela sibonisa amandla okuphulukisa ama-macro.

Emisebenzini yomtholampilo, ukuqhuma kwe-vertebral fractures okuhlukumezayo kunendlela ekhethekile yokulimala futhi ngokuvamile kwenzeka kubantu abasha abanekhono elinamandla lokuvuselela amathambo. I-calcium phosphate yamathambo usimende ingasetshenziswa ngokuphumelelayo ekwelapheni ukuphuka okunjalo. Ngaleso sikhathi, usimende wamathambo we-calcium phosphate ubuye ube esikhundleni sethambo esisebenzayo sokuhlinzwa kwe-benign bone tumor resection. Nokho, ngenxa yesikhathi eside sokuqina kanye nokukhishwa kokushisa okuphansi uma kuqhathaniswa nenqubo yokuqiniswa, usimende wamathambo we-calcium phosphate unokunamathela okungekuhle namandla, futhi uthambekele ekuqhekekeni ethanjeni. Ngakho-ke, ucwaningo ngosimende wethambo le-calcium phosphate lusaqhubeka.

I-calcium sulfate iyindlela elula yokulungisa amathambo futhi isisetshenziswe ezintweni zokulungisa amathambo iminyaka engaphezu kweyi-100, enomlando omude kakhulu wokusetshenziswa komtholampilo. I-calcium sulfate inokubekezelela okuhle komuntu, ukubola kwe-biodegradability, kanye nezakhiwo ze-bone conduction, okuyenza ibe enye into ebalulekile yokufakelwa kwamathambo e-autologous ocwaningweni lokuqala. Isigaba esiqinile esivamile se-calcium sulfate bone usimende i-anhydrous calcium sulfate powder, futhi isigaba se-liquid siwusawoti we-physiological kanye nezinye izixazululo ezinamanzi. Lapho izigaba eziqinile neziwuketshezi zixutshwa, i-calcium sulfate ibhekana nokusabela kwe-hydration, ikhiqize amadevu e-calcium sulfate dihydrate amise okwenaliti abhuloho futhi anqwabelene, ngaleyo ndlela aqine abe yinqwaba enomumo othile namandla. Kodwa-ke, ngenxa yokungasebenzi kahle kwezinto eziphilayo, i-calcium sulfate bone usimende ayikwazi ukwakha izibopho zamakhemikhali phakathi kwamagrafti e-calcium sulfate kanye nezicubu zamathambo, futhi zizowohloka ngokushesha. I-calcium sulfate bone usimende ingamuncwa ngokuphelele emasontweni ayisithupha ngemva kokufakelwa, futhi lokhu konakala okusheshayo akufani nenqubo yokwakheka kwamathambo. Ngakho-ke, uma kuqhathaniswa nosimende wethambo le-calcium phosphate, ukuthuthukiswa kanye nokusetshenziswa komtholampilo kwe-calcium sulfate bone usimende kulinganiselwe.

Ngaphezu kwalokho, ucwaningo oluningi luye lwabonisa ukuthi ama-molecule amancane e-organic, ama-polymers e-biodegradable, amaprotheni, ama-polysaccharides, ama-molecule e-inorganic, ama-bioceramics, ne-bioglass angathuthukisa ngokuphumelelayo ukusebenza kwe-bone samente, anikeze imibono emisha yezinhlobo ezintsha ze-samente yamathambo.
Kafushane, usimende wethambo ungadlala indima ebalulekile kudokotela wamazinyo kanye nodokotela wamathambo, futhi kulindeleke ukuthi ube umthwali wezidakamizwa okahle kanye nezinto ezithatha indawo yamathambo ohlelweni lwamathambo.

Ngokuthuthuka okuqhubekayo nokuthuthukiswa kwesayensi, ubuchwepheshe, nezinto zokwakha, kukholakala ukuthi ezinye izinto ezisezingeni eliphezulu zikasimende zizothuthukiswa esikhathini esizayo, njengamandla aphezulu, omjovo, ukumelana namanzi, kanye nezinhlobo zokumisa ngokushesha. Ukusetshenziswa kukasimende wamathambo emisebenzini yomtholampilo kuzokwanda kakhulu, futhi ukubaluleka kwawo kuzokwanda.