ʻO Osteonecrosis

ʻO ka Osteonecrosis ka make o ka iwi i hoʻokumu ʻia e ke koko maikaʻi ʻole. ʻO ka mea maʻamau i ka ʻūhā a me ka poʻohiwi, akā hiki ke hoʻopili i nā hono nui ʻē aʻe e like me ke kuli, kuʻe lima, lima a me ka kuʻekuʻe wāwae.

Hana ʻia ʻo Osteonecrosis ke loaʻa ʻole kahi koko o ka iwi a make. Ma hope o kekahi manawa, hiki i ka iwi ke hāʻule. Inā mālama ʻole ʻia ka osteonecrosis, e hōʻino ana ka ami, a hiki i ka maʻi kōpaʻa.

Hiki ke kumu ʻia ʻo Osteonecrosis e ka maʻi a i ʻole nā ​​ʻehaʻeha nui, e like me ka haki a dislocation paha, e pili ana i ka hāʻawi o ke koko i ka iwi. Hiki i ka Osteonecrosis ke hana me ka ʻole o ka trauma a me ka maʻi. Kāhea ʻia kēia idiopathic - ʻo ia hoʻi me ka ʻole o kekahi kumu i ʻike ʻia.

ʻO kēia nā kumu kūpono.

• Ke hoʻohana nei i nā steroid a oral a intravenous paha
• Hoʻohana nui loa i ka waiʻona
• Maʻi maʻi maʻi maʻi
• Hōʻoki a haki paha a puni kahi hono
• Nā maʻi maʻi
• HIV a i ʻole lawe i nā lāʻau HIV
• ʻO ka radiation radiation a chemotherapy paha
• ʻO ka maʻi Gaucher (maʻi i kūkulu ʻia ai nā mea ʻino i loko o nā lālā a me ka iwi)
• ʻO systemic lupus erythematosus (kahi maʻi autoimmune kahi e kuhi hewa ai ka ʻōnaehana pale kino i nā mea olakino e like me ka iwi)
• ʻO ka maʻi Legg-Calve-Perthes (ka maʻi kamaliʻi kahi i loaʻa ʻole ai ka nui o ka iwi o ka ʻūhā i ke koko, a make ka iwi)
• Maʻi maʻi decompression mai ka nui o ka luʻu kai hohonu

Ke hiki i ka osteonecrosis i ka hui o ka poʻohiwi, ʻo ia ka mea maʻamau ma muli o ka mālama lōʻihi me nā steroid, kahi moʻolelo o ka ʻeha i ka poʻohiwi, a i ʻole he maʻi maʻi ko ke kanaka.

ʻAʻohe hōʻailona i ka wā mua. Ke ʻano ʻino ka ʻino o ka iwi, loaʻa iā ʻoe kēia mau ʻōuli:

• ʻEha ma ka ami e hoʻonui ai i ka manawa a lilo i ʻino inā hāʻule ka iwi
• ʻEha e loaʻa a i ka maha
• Palena palena palena o ka noi
• ʻO kaʻeha Groin, inā pili ka hui pūhaka
• Limping, inā kū ke ʻano i ka wāwae
• ʻO ka paʻakikī me ka neʻe o luna, inā pili ka poʻohiwi

E hana ana kāu mea mālama ola i kahi hoʻokolohua kino e ʻike inā loaʻa iā ʻoe nā maʻi a i ʻole nā ​​kūlana e hoʻopili i kou mau iwi. E nīnau ʻia ʻoe e pili ana i kāu mau hōʻailona a me ka mōʻaukala olakino.

E hoʻomaopopo pono i kāu mea nāna e hāʻawi e pili ana i nā lāʻau a i ʻole nā ​​mea hoʻohiamini āu e lawe nei, ʻo ia hoʻi ka lāʻau lapaʻau.

Ma hope o ka hōʻike, e kauoha kāu mea hāʻawi i hoʻokahi a ʻoi paha o nā hōʻike aʻe:

• X-ray
• MRI
• ʻImi iwi
• CT scan

Inā ʻike kāu mea hāʻawi i ke kumu o ka osteonecrosis, e kau ʻia kahi ʻāpana o ka mālama i ke ʻano o ke kumu. ʻO kahi laʻana, inā he maʻi maʻi kōkuʻu ke kumu, e hoʻopili ʻia ka mālama ʻana, ma kahi ʻāpana, o ka lāʻau hoʻopau lāʻau.

Inā hopu koke ʻia ke ʻano, lawe ʻoe i nā mea hōʻoluʻolu ʻeha a me ka palena o ka hoʻohana ʻana i ka wahi i hoʻopilikia ʻia. Pākuʻi paha kēia i ka hoʻohana ʻana i nā koʻokoʻo inā pili kou puhaka, kuli, a kuʻekuʻe wāwae paha. Pono paha ʻoe e hana i nā kaʻina hana o ka laulā. Hiki i ka mālama Nonsurgical ke hoʻolohi pinepine i ka holomua o ka osteonecrosis, akā pono ka hapa nui o ka poʻe i ke ʻoki.

ʻO nā koho ʻoki pū kekahi:

• ʻO kahi hui iwi
• Kahi iwi hui pū me kona lako o ke koko (vascularized iwi graft)
• Ke wehe nei i kahi ʻāpana o loko o ka iwi (decompression core) e hoʻokuʻu i ke kaomi a ʻae i nā kīʻaha koko hou e hana
• Ke ʻoki ʻana i ka iwi a hoʻololi i kāna kaulike e hōʻoluʻolu i ke koʻikoʻi ma ka iwi a i ʻole ami (osteotomy)
• Huina hui paʻa

Hiki iā ʻoe ke ʻike i ka ʻike hou aku a me ke kākoʻo ʻana i nā kumuwaiwai ma ka hui aʻe:

• National Institute of Arthritis and Musculoskeletal and Skin Diseases - www.niams.nih.gov/health-topics/osteonecrosis
• ʻO ka Foundation Foundation - www.arthritis.org

Maikaʻi kāu hilinaʻi ʻana i ka mea aʻe:

• ʻO ke kumu o ka osteonecrosis
• Pehea ke koʻikoʻi o ka maʻi ke ʻike ʻia
• Ka nui o nā iwi i pili
• ʻO kou mau makahiki a me kou olakino holoʻokoʻa

Hiki ke hoʻololi i ka hopena mai ka hoʻōla piha ʻana i nā ʻino mau loa i ka iwi i hoʻopili ʻia.

Hiki i ka osteonecrosis holomua ke alakaʻi i ka osteoarthritis a me ka neʻe mau o ka neʻe. Pono nā hihia koʻikoʻi e koi i ka loli hui.

Kāhea i kāu mea hāʻawi inā loaʻa nā ʻōuli.

ʻO nā hihia he nui o ka osteonecrosis ʻaʻohe kumu i ʻike ʻia, no laila ʻaʻole hiki ke pale. I kekahi mau hihia, hiki iā ʻoe ke hōʻemi i kou makaʻu ma ka hana ʻana i kēia mau mea:

• Hōʻalo i ka inu nui ʻana i ka waiʻona.
• Ke hiki, pale i nā kiʻekiʻena a me ka hoʻohana wā lōʻihi o nā corticosteroids.
• E hāhai i nā hana palekana i ka luʻu ʻana i mea e pale aku ai i ka maʻi decompression.

Nekrosis ākea; Infarction iwi; Iwi ʻoki Ischemic; AVN; Nā nerosis aseptic

• Nā nerosis aseptic

ʻO McAlindon T, Ward RJ. ʻO Osteonecrosis. I: Hochberg MC, Gravallese EM, Silman AJ, Smolen JS, Weinblatt ME, Weisman MH, eds. Rheumatology. ʻEpekema 7 Piladelapia, PA: Elsevier; 2019: chap 206.

Nohea MP. ʻO Osteonecrosis, osteosclerosis / hyperostosis, a me nā maʻi ʻē aʻe o ka iwi. I: Goldman L, Schafer AI, eds. ʻO ka lāʻau lapaʻau Goldman-Cecil. 25th hua. Piladelapia, PA: Elsevier Saunders; 2016: chap 248.