I-Osteonecrosis

I-Osteonecrosis ukufa kwamathambo okubangelwa ukungatholakali kahle kwegazi. Kuvame kakhulu okhalweni nasemahlombe, kepha kungathinta amanye amalunga amakhulu afana nedolo, indololwane, isihlakala neqakala.

I-Osteonecrosis yenzeka lapho ingxenye yethambo ingatholi igazi futhi ifa. Ngemuva kwesikhashana, ithambo lingawa. Uma i-osteonecrosis ingelashwa, ilunga liyawohloka, okuholela ekuguleni kwamathambo okukhulu.

I-Osteonecrosis ingabangelwa izifo noma ukuhlukumezeka okukhulu, njengokuqhekeka noma ukuhlukaniswa, okuthinta ukunikezwa kwegazi ethanjeni. I-Osteonecrosis nayo ingenzeka ngaphandle kokuhlukumezeka noma isifo. Lokhu kubizwa nge-idiopathic - okusho ukuthi kwenzeka ngaphandle kwesizathu esaziwayo.

Izimbangela ezilandelayo zingenzeka:

• Kusetshenziswa i-steroids yomlomo noma efakwa emithanjeni
• Ukuphuza ngokweqile
• Isifo se-Sickle cell
• Ukwehlukaniswa noma ukuphuka okuzungeze ilunga
• Izinkinga zokuvala
• I-HIV noma ukuthatha imishanguzo ye-HIV
• Ukwelashwa ngemisebe noma i-chemotherapy
• Isifo se-Gaucher (isifo lapho izinto eziyingozi zakha khona ezithweni ezithile nasethanjeni)
• Isystemic lupus erythematosus (isifo esizimele lapho amasosha omzimba ahlasela ngephutha izicubu ezinempilo ezifana nethambo)
• Isifo iLegg-Calve-Perthes (isifo sobuntwana lapho ithambo lethanga elisesinqeni lingatholi khona igazi elanele, okwenza ukuthi ithambo life)
• Ukugula ngokweqile kusuka ekujuleni kolwandle okuningi okujulile

Lapho i-osteonecrosis ivela ekuhlanganeni kwehlombe, imvamisa kungenxa yokwelashwa kwesikhathi eside ngama-steroids, umlando wokuhlukumezeka ehlombe, noma umuntu unesifo se-sickle cell.

Azikho izimpawu ezigabeni zokuqala. Njengoba ukulimala kwamathambo kukhula, ungaba nalezi zimpawu ezilandelayo:

• Ubuhlungu ejoyinini obungakhuphuka ngokuhamba kwesikhathi futhi buba bukhulu uma ithambo liwa
• Ubuhlungu obenzeka ngisho nokuphumula
• Ububanzi obunomkhawulo bokunyakaza
• Ubuhlungu besisu, uma ilunga le-hip lithintekile
• Ukuxhuga, uma isimo senzeka emlenzeni
• Kunzima ukunyakaza okuphezulu, uma ukuhlangana kwehlombe kuthintekile

Umhlinzeki wakho wezokunakekelwa kwempilo uzokwenza ukuhlolwa komzimba ukuthola ukuthi unazo yini izifo noma izimo ezingathinta amathambo akho. Uzobuzwa ngezimpawu zakho nomlando wezokwelapha.

Qiniseka ukuthi wazisa umhlinzeki wakho nganoma yimiphi imithi noma izithasiselo zamavithamini owathathayo, ngisho nemithi ethengiswayo.

Ngemuva kokuhlolwa, umhlinzeki wakho uzo-oda olunye noma eziningi zalezi zivivinyo ezilandelayo:

• I-X-ray
• I-MRI
• Ukuskena kwamathambo
• Iskena se-CT

Uma umhlinzeki wakho eyazi imbangela ye-osteonecrosis, ingxenye yokwelashwa izobhekiswa kwisimo esingaphansi. Isibonelo, uma ukugula okuvala igazi kuyimbangela, ukwelashwa kuzoba, ngokwengxenye, kwemithi yokuqothula amahlule.

Uma isimo sibanjwa kusenesikhathi, uzothatha ukudambisa izinhlungu futhi unqande ukusetshenziswa kwendawo ethintekile. Lokhu kungabandakanya ukusebenzisa izinduku uma kuthinteka isinqe sakho, idolo noma iqakala. Ungadinga ukwenza izivivinyo zokuhamba-hamba. Ukwelashwa ngokuhlinzwa kungavimbela ukukhula kwe-osteonecrosis, kepha abantu abaningi bazodinga ukuhlinzwa.

Izinketho zokuhlinzwa zifaka:

• Ukuxhunyelelwa kwamathambo
• Ukuxhunyaniswa kwamathambo kanye nokunikezwa kwegazi (i-vascularized bone graft)
• Ukususa ingxenye engaphakathi kwethambo (ukucindezela okuyisisekelo) ukukhulula ingcindezi futhi kuvumele imithambo yegazi emisha yakheke
• Ukusika ithambo nokushintsha ukuqondanisa kwalo ukuze unciphise ukucindezelwa kwethambo noma ilunga (i-osteotomy)
• Inani lokufakwa esikhundleni ngokuhlanganyela

Ungathola imininingwane ethe xaxa nezinsizakusebenza kule nhlangano elandelayo:

• Isikhungo Sikazwelonke Se-Arthritis neMisculoskeletal kanye Nezifo Zesikhumba - www.niams.nih.gov/health-topics/osteonecrosis
• Isisekelo se-Arthritis - www.arthritis.org

Wenza kahle kangakanani kuncike kokulandelayo:

• Imbangela ye-osteonecrosis
• Siba sibi kangakanani lesi sifo lapho sitholakala
• Inani lamathambo ahilelekile
• Iminyaka yakho nempilo yonke

Umphumela ungahluka kusukela ekuphulukisweni okuphelele kuye ekulimaleni unomphela ethanjeni elithintekile.

I-osteonecrosis esezingeni eliphakeme ingaholela ku-osteoarthritis nokuhamba unomphela kokuncipha. Amacala abucayi angadinga ukushintshwa okuhlanganyelwe.

Shayela umhlinzeki wakho uma unezimpawu.

Izimo eziningi ze-osteonecrosis azinayo imbangela eyaziwayo, ngakho-ke ukuvimbela kungenzeka kungenzeki. Kwezinye izimo, unganciphisa ubungozi ngokwenza okulandelayo:

• Gwema ukuphuza utshwala obuningi ngokweqile.
• Uma kunokwenzeka, gwema imithamo ephezulu kanye nokusetshenziswa kwesikhathi eside kwama-corticosteroids.
• Landela izinyathelo zokuphepha lapho udilika emanzini ukuze ugweme ukugula okubangelwa ukucindezela.

I-avascular necrosis; I-infarction yamathambo; Ischemic ithambo necrosis; I-AVN; I-necrosis ye-septic

• I-necrosis ye-septic

UMcAlindon T, iWadi RJ. I-Osteonecrosis. Ku: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, abahleli. I-Rheumatology. Umhla wesi-7. IPhiladelphia, PA: Elsevier; 2019: isahluko 206.

ILungu lePhalamende lase-Whyte. I-Osteonecrosis, i-osteosclerosis / hyperostosis, nezinye izifo zethambo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-25. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 248.