I-Avascular Necrosis ye-Hip: Izimbangela, Izimpawu, Ukuxilongwa, Ukwelashwa nokuningi

I-avascular necrosis ye-hip ingaba buhlungu kakhulu. Kuwukuwohloka okuqhubekayo kwezicubu zamathambo okubangelwa ukuncipha kokujikeleza kwegazi esakhiweni samathambo esingaphansi, okuholela ekufeni kwamangqamuzana amathambo.

Iyini i-Avascular Necrosis of Hip (AVN) noma i-Osteonecrosis?

I-AVN noma i-Avascular necrosis ye-hip, igama elisetshenziselwa ukuchaza ukulahlekelwa kwezicubu zethambo okubangelwa ukuncipha kokunikezwa kwegazi. Eyaziwa nangokuthi i-osteonecrosis, ingaholela emifantwini emincane ethanjeni, ibangele ukuthi ibhidlike. Lesi simo singathinta noma yiliphi ithambo, kodwa ngokuvamile sivela ekugcineni kwamathambo amade. Kungathinta ithambo elilodwa ngesikhathi, amathambo amaningi ngesikhathi esisodwa, noma amathambo amaningi ngezikhathi ezahlukene. Ukugeleza kwegazi engxenyeni yethambo kungaphazamiseka ngenxa yethambo eliqhekekile noma ilunga eliphukile.

Nakuba lesi simo sezokwelapha singathinta noma ubani, sivame ukwenzeka kubantu abaphakathi kweminyaka engu-30 no-50. Ngaphezu kwalokho, ukuphuza utshwala ngokweqile kanye nokusetshenziswa isikhathi eside kwemithi ye-steroid ephezulu kuhlotshaniswa ne-avascular necrosis ye-hip joint. Ezimweni eziningi, lesi simo sithatha izinyanga noma ngisho neminyaka ukukhula.

Yini ebangela i-Avascular Necrosis?

I-avascular necrosis yethambo le-hip yenzeka ngokuphuka kwamathambo noma izifo ezinqamula ukunikezwa kwegazi ezicutshini zethambo. Lapho ukunikezwa kwegazi ekhanda lesifazane kunqunywa, izicubu zethambo ziyafa, okuholela ku-necrosis ye-avascular of the hip.

Izimbangela ze-avascular necrosis in the hip zimi kanje:

• I-traumatic avascular necrosis - Lokhu kungase kwenzeke ngemva kokuphuka kwethambo noma ukuhlukana kwamalunga.
• I-Nontraumatic avascular necrosis - Lokhu kwenzeka lapho umuntu enesifo noma isimo sezokwelapha esivimbela ukugeleza kwegazi emathanjeni. I-Nontraumatic avascular necrosis ngokuvamile ithinta amathambo afanayo nhlangothi zombili zomzimba.
• Ukuphuka kwe-Hip kanye nokuhlukaniswa - I-avascular necrosis yamalunga e-hip yenzeka kubantu abane-hip dislocation.

Ezinye izimbangela ze-avascular necrosis hip kungaba:

• Ukwelashwa kwamafutha
• Izinto zokufakelwa
• Isifo sokucindezeleka kwabatshuzi be-scuba
• Diabetes
• HIV
• Ukuphazamiseka kwegazi, njenge-sickle cell anemia

Izinketho ezithile zendlela yokuphila nazo zandisa ingozi ye-avascular necrosis ye-hip joint:

• Ukuphuza ngokweqile nokubhema
• Ukusetshenziswa isikhathi eside komthamo omkhulu we-corticosteroid

Izimpawu ze-Avascular Necrosis

Ukuqhubekela phambili kwe-avascular necrosis kuhamba kancane. Isibonakaliso sokuqala esivame kakhulu ubuhlungu be-hip. Lokhu kungase kubangele ubuhlungu obuncane noma obuhlabayo endaweni ye-groin noma ye-buttock. Njengoba isimo siba sibi kakhulu, i-hip joint iba nzima ukunyakaza, okwenza kube nzima ukuma nokuthwala isisindo esinqeni esithintekile. Ukuqhubeka kwalesi simo sezempilo kungase kuthathe izinyanga ezimbalwa kuya ngaphezu konyaka. Ngenxa yokuthi ezinye izifundo zibonisa ukuthi ukwelashwa kusenesikhathi kuxhumene nemiphumela ethuthukisiwe, kubalulekile ukuhlonza i-avascular necrosis kusenesikhathi.

Izimpawu ze-avascular necrosis zingahluka kuye ngokuthi ilunga elithintekile kanye nesiteji sesimo. Izimpawu ezijwayelekile zihlanganisa:

• Ubuhlungu obuhlangene: Ubuhlungu belunga elithintekile luwuphawu oluvamile lwasekuqaleni. Ubuhlungu bungase bube mnene ekuqaleni futhi buqhubeke kancane kancane njengoba isimo siqhubeka.
• Ibanga Lokunyakaza Elinomkhawulo: I-Avascular necrosis ingabangela ukuqina kanye nohla oluncishisiwe lokunyakaza endaweni ehlangene ethintekile. Lo mkhawulo ungase uthinte imisebenzi yansuku zonke nokuhamba.
• Ukuvuvukala Kwamalunga: Ukuvuvukala eduze kwelunga elithintekile kungase kwenzeke, kube nomthelela ekuphathekeni nasekunciphiseni umsebenzi.
• Ukungaqini Okuhlangene: Njengoba isimo siqhubeka, ithambo elithintekile lingase liwe, okuholela ekungaqini kahle kwamalunga nokukhubazeka.
• I-Crepitus: Kwezinye izimo, kungase kube nokuzwa kwe-grating noma ukuqhekeka (crepitus) lapho uhambisa ilunga elithintekile.

Izinqubo zokuxilonga

Ukuhlola okukodwa noma ngaphezulu kwalokhu okulandelayo kungenziwa ngaphezu komlando wezokwelapha ophelele kanye nokuhlolwa ngokomzimba kumuntu ngamunye:

• I-X-ray ukuze ubheke ukuphuka kanye nezimpawu ze-arthritic
• Icwecwe le-computer tomography (CT)
• I-Avascular Necrosis MRI hip
• I-Radionuclide scan scan
• Ukuhlolwa okusebenzayo kwethambo
• Biopsy 

Yiziphi izindlela zokwelapha ze-Avascular Necrosis of the Hip (AVN)?

Iminyaka yesiguli, impilo ejwayelekile, izimpawu ze-avascular necrosis hip, kanye nesimo sekhanda lesifazane sidlala indima ekunqumeni inkambo engcono kakhulu ye-avascular necrosis yokwelashwa kwe-hip.

• Ukwelashwa Okungahlinzeki: I-AVN yesigaba sangaphambi kwesikhathi ingase yelashwe ngezinketho ezingezona ezokuhlinzwa. Nakuba lezi zindlela zingadambisa izimpawu, ngokuvamile azikumisi ukuqhubeka kwe-AVN. Izinqubo ezingahlinzeki zihlanganisa:
  • Ukuqinisa imisipha ye-hip ngokwelashwa ngokomzimba.
  • Imithi yobuhlungu, njengezidakamizwa ezingezona ukuvuvukala (ama-NSAID) zokudambisa izinhlungu.
  • Ukusebenzisa ama-walkers, izinduku, nezinduku ukunciphisa isisindo enqulwini elimele.
  • Ukuphumula.
• Ukwelashwa kwe-hyperbaric oxygen (HBO): Ukwelashwa kwe-HBO, enye indlela engeyona yokuhlinzwa, iyindlela ephephile nephumelelayo yabantu abane-AVN ye-hip yesigaba sasekuqaleni. Iseshini ngayinye yokwelapha ngokuvamile ithatha imizuzu engama-90, namaseshini amahlanu ngeviki okungenani amaseshini angama-30.
• Ukwelapha Okuhlinzekwayo: Imigomo yokwelashwa kokuhlinzwa ukunciphisa izimpawu, ukumisa noma ukunciphisa ukuqhubeka kwesifo, nokubuyisela ukusebenza kwelunga le-hip.
  • I-Core decompression: Inqubo ehlasela kancane eyaziwa ngokuthi i-core decompression ihlanganisa ukubhoboza endaweni yekhanda lesifazane elihlaselwe yi-AVN. Kuyasiza ukunciphisa ukucindezeleka ngaphakathi kwethambo, ukuthuthukisa ukugeleza kwegazi, nokunciphisa ukungakhululeki ku-AVN yasekuqaleni.
  • Ukuxhunyelelwa kwethambo: Kuyinqubo yokushintsha ithambo elithintekile ufake izicubu zamathambo ezinempilo ezitholwe emzimbeni wesiguli noma enye indawo yokwenziwa.  
  • I-Osteotomy: Ngesikhathi se-osteotomy, udokotela ohlinzayo usika futhi ubeka kabusha i-femur ukuze isisindo sesiguli sidluliselwe ezindaweni ezinempilo, ezinesisindo zethambo.
  • Ukushintshwa kwe-hip okuphelele: Uma i-acetabulum, i-hip joint, noma ikhanda lesifazane liye lagcina umonakalo omkhulu, ukushintshwa okuphelele kwe-hip kungase kudingeke.

Ubona nini udokotela?

Ubuhlungu be-Avascular necrosis hip yisimo sezokwelapha esiqhubeka siba sibi ngokuhamba kwesikhathi. Iziguli ezine-avascular necrosis kufanele ziqaphe izimpawu zazo, kuhlanganise nobuhlungu nokuhamba.

Isiguli kufanele sithinte umhlinzeki wezempilo uma sihlangabezana:

• Ubuhlungu obungaba ngcono ngokuphumula noma ngamaphilisi ezinhlungu.
• Ubuhlungu obenza ukuhamba noma ukuhamba kube nzima.
• Limp ngaphandle kwesizathu.

Yiziphi Izingozi ze-Avascular Necrosis of the Hip (AVN)?

Nakuba isizathu esiqondile sokungabikho kokugeleza kwegazi singacacile ngaso sonke isikhathi, ochwepheshe bezokwelapha baye bathola izici eziningi eziyingozi ezingase zandise amathuba omuntu okuba ne-osteonecrosis:

• Ukuphuka kwe-Hip, ukuhlukana, nokunye ukulimala kwe-hip kungalimaza imithambo yegazi futhi kunciphise ukugeleza kwegazi ekhanda lesifazane.
• Izidakamizwa ze-Steroid, ezisetshenziselwa ukwelapha izifo ezihlukahlukene ezifana ne-rheumatoid arthritis kanye ne-asthma, zingaholela ku-osteonecrosis njengomphumela omubi.
• Ukusebenzisa kabi utshwala ngokuhamba kwesikhathi kungase kubangele ukunqwabelana kwamafutha emithanjeni yegazi futhi kukhuphule amazinga e-cortisol, kunciphise ukugeleza kwegazi ethanjeni.
• Ezinye izifo ze-thrombotic, njenge-thrombophilia, nazo zingaba nomthelela ekuthuthukisweni kwe-osteonecrosis.

Prevention

Ngisho noma i-avascular necrosis ingenakugwenywa ngokuphelele, kunezinqubo ezingase zithathwe ukuze kuncishiswe ingozi:

• Yehlisa ukuphuza utshwala futhi uyeke ukubhema.
• Bheka amazinga e-cholesterol.
• Xhumana nodokotela mayelana nokunciphisa umthamo uma i-corticosteroids ithathelwa isimo sezempilo esiqhubekayo.

Isimo esibuhlungu esaziwa ngokuthi i-avascular necrosis sinomthelela omkhulu eqophelweni lempilo yomuntu. Uma umuntu enezimo zezokwelapha noma esebenzisa imithi eyandisa ingozi yokuthuthukisa i-avascular necrosis, kufanele abonane nochwepheshe bezokwelapha. Ukuqhubekela phambili kwesifo kungase kwehliswe ngokutholakala kusenesikhathi nokwelashwa.