{"id":394,"date":"2026-10-11T18:15:24","date_gmt":"2026-10-11T11:15:24","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/thoai-hoa-sun-khop-goi-nguyen-nhan-trieu-chung-va-huong-dieu-tri-theo-chuan-chinh-hinh\/"},"modified":"2026-10-11T18:15:24","modified_gmt":"2026-10-11T11:15:24","slug":"thoai-hoa-sun-khop-goi-nguyen-nhan-trieu-chung-va-huong-dieu-tri-theo-chuan-chinh-hinh","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/11\/thoai-hoa-sun-khop-goi-nguyen-nhan-trieu-chung-va-huong-dieu-tri-theo-chuan-chinh-hinh\/","title":{"rendered":"Tho\u00e1i h\u00f3a s\u1ee5n kh\u1edbp g\u1ed1i: Nguy\u00ean nh\u00e2n, tri\u1ec7u ch\u1ee9ng v\u00e0 h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb theo chu\u1ea9n ch\u1ec9nh h\u00ecnh"},"content":{"rendered":"<h2>Tho\u00e1i h\u00f3a s\u1ee5n kh\u1edbp ch\u00e8 \u0111\u00f9i: B\u1ea3n ch\u1ea5t b\u1ec7nh l\u00fd<\/h2>\n<p>B\u1ec7nh <strong>tho\u00e1i h\u00f3a s\u1ee5n kh\u1edbp ch\u00e8 \u0111\u00f9i<\/strong> (chondromalacia patellae) l\u00e0 m\u1ed9t t\u00ecnh tr\u1ea1ng ph\u1ed5 bi\u1ebfn g\u00e2y \u0111au tr\u01b0\u1edbc \u0111\u1ea7u g\u1ed1i, \u0111\u1eb7c bi\u1ec7t \u1edf ng\u01b0\u1eddi tr\u1ebb v\u00e0 v\u1eadn \u0111\u1ed9ng vi\u00ean. M\u1eb7c d\u00f9 t\u00ean g\u1ecdi g\u1ee3i \u00fd s\u1ef1 suy gi\u1ea3m c\u1ee7a l\u1edbp s\u1ee5n, nh\u01b0ng c\u00e1c nghi\u00ean c\u1ee9u v\u1ec1 gi\u1ea3i ph\u1eabu h\u1ecdc cho th\u1ea5y s\u1ee5n kh\u1edbp kh\u00f4ng c\u00f3 d\u00e2y th\u1ea7n kinh tr\u1ef1c ti\u1ebfp, do \u0111\u00f3 b\u1ea3n th\u00e2n n\u00f3 kh\u00f4ng ph\u1ea3i l\u00e0 ngu\u1ed3n g\u1ed1c ch\u00ednh c\u1ee7a c\u01a1n \u0111au [1]. Thay v\u00e0o \u0111\u00f3, hai v\u00f9ng ch\u1ee7 y\u1ebfu sinh ra c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu l\u00e0 <strong>kh\u1edbp m\u00e0ng ho\u1ea1t d\u1ecbch<\/strong> (synovium) v\u00e0 <strong>x\u01b0\u01a1ng d\u01b0\u1edbi s\u1ee5n<\/strong>. S\u1ee5n kh\u1edbp b\u1ecb v\u1ee1 v\u1ee5n do tho\u00e1i h\u00f3a c\u00f3 th\u1ec3 g\u00e2y k\u00edch \u1ee9ng h\u00f3a h\u1ecdc l\u00ean m\u00e0ng ho\u1ea1t d\u1ecbch, d\u1eabn \u0111\u1ebfn s\u01b0ng n\u1ec1 v\u00e0 \u0111au \u0111\u1edbn [1]. Ngo\u00e0i ra, gi\u1ea3 thuy\u1ebft hi\u1ec7n \u0111\u1ea1i nh\u1ea5n m\u1ea1nh r\u1eb1ng s\u1ef1 th\u1ea5t b\u1ea1i c\u01a1 h\u1ecdc trong vi\u1ec7c truy\u1ec1n t\u1ea3i l\u1ef1c c\u1ee7a s\u1ee5n kh\u1edbp c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i c\u00e1ch ph\u00e2n ph\u1ed1i tr\u1ecdng l\u01b0\u1ee3ng xu\u1ed1ng x\u01b0\u01a1ng d\u01b0\u1edbi s\u1ee5n, ho\u1eb7c ch\u00ednh s\u1ef1 l\u1ec7ch l\u1ea1c v\u1ec1 m\u1eb7t sinh h\u1ecdc c\u1ee7a c\u01a1 ch\u1ebf co du\u1ed7i \u0111\u00f9i m\u1edbi l\u00e0 nguy\u00ean nh\u00e2n c\u1ed1t l\u00f5i g\u00e2y \u0111au [1].<\/p>\n<h2>D\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng v\u00e0 ch\u1ea9n \u0111o\u00e1n<\/h2>\n<p>Trong th\u1ef1c h\u00e0nh l\u00e2m s\u00e0ng, c\u00e1c d\u1ea5u hi\u1ec7u c\u1ee7a b\u1ec7nh n\u00e0y th\u01b0\u1eddng kh\u00f4ng \u0111\u1eb7c hi\u1ec7u. B\u1ec7nh nh\u00e2n th\u01b0\u1eddng m\u00f4 t\u1ea3 c\u1ea3m gi\u00e1c kh\u00f3 ch\u1ecbu \u00e2m \u1ec9, t\u1eadp trung r\u00f5 r\u1ec7t \u1edf ph\u1ea7n tr\u01b0\u1edbc \u0111\u1ea7u g\u1ed1i, n\u1ed5i b\u1eadt nh\u1ea5t sau khi ng\u1ed3i m\u1ed9t ch\u1ed7 l\u00e2u d\u00e0i trong th\u1eddi gian d\u00e0i \u2013 hi\u1ec7n t\u01b0\u1ee3ng \u0111\u01b0\u1ee3c g\u1ecdi l\u00e0 <strong>d\u1ea5u hi\u1ec7u \u0111i\u1ec7n \u1ea3nh<\/strong> (movie sign) ho\u1eb7c d\u1ea5u hi\u1ec7u nh\u00e0 h\u00e1t [2]. Ngo\u00e0i ra, b\u1ec7nh nh\u00e2n c\u00f3 th\u1ec3 m\u00f4 t\u1ea3 c\u1ea3m gi\u00e1c b\u1ecb k\u1eb9t, gi\u1eadt c\u1ee5c ho\u1eb7c m\u1ea5t th\u0103ng b\u1eb1ng khi v\u1eadn \u0111\u1ed9ng. C\u00e1c x\u00e9t nghi\u1ec7m h\u00ecnh \u1ea3nh nh\u01b0 MRI s\u1eed d\u1ee5ng k\u1ef9 thu\u1eadt T2 mapping hay PDFS c\u00f3 \u0111\u1ed9 ch\u00ednh x\u00e1c trung b\u00ecnh trong vi\u1ec7c ti\u00ean \u0111o\u00e1n tho\u00e1i h\u00f3a s\u1ee5n tr\u00ean kh\u1edbp ch\u00e8 \u0111\u00f9i so v\u1edbi k\u1ebft qu\u1ea3 soi kh\u1edbp tr\u1ef1c ti\u1ebfp [6].<\/p>\n<p>Qua qu\u00e1 tr\u00ecnh soi kh\u1edbp n\u1ed9i khoa, c\u00e1c b\u00e1c s\u0129 ch\u1ec9nh h\u00ecnh th\u01b0\u1eddng ph\u00e2n lo\u1ea1i m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng d\u1ef1a tr\u00ean \u0111\u1eb7c \u0111i\u1ec3m b\u1ec1 m\u1eb7t s\u1ee5n. M\u1ee9c \u0111\u1ed9 I bao g\u1ed3m nh\u1eefng thay \u0111\u1ed5i t\u1ed1i thi\u1ec3u nh\u01b0 m\u1ec1m h\u00f3a c\u1ee5c b\u1ed9; m\u1ee9c \u0111\u1ed9 II c\u00f3 s\u1ee3i x\u01a1 v\u00e0 b\u1ec1 m\u1eb7t kh\u00f4ng \u0111\u1ec1u; m\u1ee9c \u0111\u1ed9 III th\u1ec3 hi\u1ec7n r\u00f5 r\u1ec7t s\u1ef1 x\u01a1 s\u1ee3i v\u00e0 n\u1ee9t v\u1ee1 xu\u1ed1ng \u0111\u1ebfn x\u01b0\u01a1ng d\u01b0\u1edbi s\u1ee5n, t\u1ea1o ra h\u00ecnh \u1ea3nh m\u00f4 t\u1ea3 l\u00e0 <strong>d\u1ea1ng th\u1ecbt cua<\/strong> (crab meat appearance); c\u00f2n m\u1ee9c \u0111\u1ed9 IV l\u00e0 m\u1ea5t ho\u00e0n to\u00e0n l\u1edbp s\u1ee5n, \u0111\u1ec3 l\u1ed9 v\u00e0 x\u00f3i m\u00f2n x\u01b0\u01a1ng d\u01b0\u1edbi s\u1ee5n [7].<\/p>\n<h2>Nh\u1eefng y\u1ebfu t\u1ed1 nguy c\u01a1: C\u01a1 h\u1ecdc v\u00e0 H\u00f3a sinh<\/h2>\n<p>Nguy\u00ean nh\u00e2n g\u00e2y b\u1ec7nh \u0111\u01b0\u1ee3c chia th\u00e0nh hai nh\u00f3m ch\u00ednh: <strong>nguy\u00ean nh\u00e2n c\u01a1 h\u1ecdc<\/strong> v\u00e0 <strong>nguy\u00ean nh\u00e2n h\u00f3a sinh h\u1ecdc<\/strong>. V\u1ec1 m\u1eb7t c\u01a1 h\u1ecdc, c\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 xoay ngo\u00e0i nhi\u1ec1u c\u1ee7a x\u01b0\u01a1ng ch\u00e0y, kh\u1edbp g\u1ed1i l\u00f5m (genu valgum) n\u1eb7ng ho\u1eb7c l\u1ec7ch tr\u1ee5c \u0111\u1ec1u c\u00f3 th\u1ec3 l\u00e0m t\u0103ng \u00e1p l\u1ef1c l\u00ean s\u1ee5n ch\u00e8 \u0111\u00f9i [8]. V\u1ec1 m\u1eb7t h\u00f3a sinh, s\u1ef1 t\u1ed5n th\u01b0\u01a1ng do ch\u1ea5n th\u01b0\u01a1ng \u0111\u1eb7c tr\u01b0ng b\u1edfi vi\u1ec7c ph\u00e1 v\u1ee1 ho\u00e0n to\u00e0n c\u1ea5u tr\u00fac ma tr\u1eadn s\u1ee5n v\u00e0 ch\u1ebft h\u00e0ng lo\u1ea1t t\u1ebf b\u00e0o s\u1ee5n (chondrocytes). D\u1eef li\u1ec7u trong ph\u00f2ng th\u00ed nghi\u1ec7m cho th\u1ea5y m\u1ee9c \u0111\u1ed9 t\u1ed5n th\u01b0\u01a1ng li\u00ean quan \u0111\u1ebfn c\u1ea3 \u1ee9ng su\u1ea5t \u0111\u1ec9nh v\u00e0 t\u1ed1c \u0111\u1ed9 bi\u1ebfn d\u1ea1ng [5].<\/p>\n<p>Qu\u00e1 tr\u00ecnh n\u00e0y d\u1eabn \u0111\u1ebfn m\u1ea5t m\u00e1t proteoglycan, m\u1ed9t h\u1ec7 qu\u1ea3 c\u1ee7a ho\u1ea1i t\u1eed chondrocyte c\u1ea5p t\u00ednh, qu\u00e1 tr\u00ecnh ch\u1ebft t\u1ebf b\u00e0o theo ch\u01b0\u01a1ng tr\u00ecnh (apoptosis) v\u00e0 ho\u1ea1t h\u00f3a gia t\u0103ng c\u00e1c enzyme ph\u00e2n h\u1ee7y ma tr\u1eadn do t\u1ea3i tr\u1ecdng qu\u00e1 m\u1ee9c. S\u1ef1 gia t\u0103ng n\u00e0y k\u00edch ho\u1ea1t h\u00e0ng lo\u1ea1t suy tho\u00e1i m\u00f4, \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng trong tho\u00e1i h\u00f3a s\u1ee5n ti\u1ebfp theo [5]. Ngo\u00e0i ra, t\u00edn hi\u1ec7u vi\u00eam c\u0169ng c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i ph\u1ea3n \u1ee9ng c\u1ee7a chondrocyte \u0111\u1ed1i v\u1edbi t\u1ea3i tr\u1ecdng c\u01a1 h\u1ecdc th\u00f4ng qua c\u00e1c k\u00eanh ion nh\u1ea1y c\u1ea3m Piezo-1 v\u00e0 cytokine nh\u01b0 IL-1\u03b1 [10].<\/p>\n<h2>H\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb: T\u1eeb b\u1ea3o t\u1ed3n \u0111\u1ebfn ph\u1eabu thu\u1eadt<\/h2>\n<p>\u0110i\u1ec1u tr\u1ecb b\u1ec7nh <strong>tho\u00e1i h\u00f3a s\u1ee5n kh\u1edbp ch\u00e8 \u0111\u00f9i<\/strong> ph\u1ee5 thu\u1ed9c v\u00e0o nguy\u00ean nh\u00e2n g\u1ed1c r\u1ec5 c\u1ee7a s\u1ef1 thay \u0111\u1ed5i b\u1ec1 m\u1eb7t kh\u1edbp. Ph\u1ea7n l\u1edbn tr\u01b0\u1eddng h\u1ee3p \u0111\u01b0\u1ee3c x\u1eed l\u00fd b\u1eb1ng c\u00e1c bi\u1ec7n ph\u00e1p kh\u00f4ng ph\u1eabu thu\u1eadt, bao g\u1ed3m thu\u1ed1c ch\u1ed1ng vi\u00eam, t\u1eadp luy\u1ec7n c\u01a1 t\u1ee9 \u0111\u1ea7u \u0111\u00f9i, k\u00e9o gi\u00e3n c\u01a1 hamstring, s\u1eed d\u1ee5ng n\u1eb9p ho\u1eb7c gi\u00e0y d\u00e9p ch\u1ec9nh h\u00ecnh, v\u00e0 \u0111i\u1ec1u ch\u1ec9nh ho\u1ea1t \u0111\u1ed9ng \u0111\u1ec3 tr\u00e1nh c\u00e1c c\u1eed \u0111\u1ed9ng nh\u01b0 lunges, squats hay ch\u1ea1y tr\u00ean \u0111\u1ecba h\u00ecnh kh\u00f4ng b\u1eb1ng ph\u1eb3ng [6].<\/p>\n<p>Khi b\u1ec7nh ti\u1ebfn tri\u1ec3n n\u1eb7ng, ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c xem x\u00e9t. C\u00e1c ph\u01b0\u01a1ng ph\u00e1p can thi\u1ec7p v\u00e0o b\u1ec1 m\u1eb7t kh\u1edbp bao g\u1ed3m:<\/p>\n<ul>\n<li><strong>C\u1ea1o s\u1ee5n ch\u00e8 \u0111\u00f9i d\u01b0\u1edbi soi kh\u1edbp (arthroscopic patellar shaving):<\/strong> M\u1ee5c \u0111\u00edch ch\u00ednh l\u00e0 lo\u1ea1i b\u1ecf s\u1ee3i x\u01a1 \u0111\u1ec3 gi\u1ea3m c\u00e1c s\u1ea3n ph\u1ea9m v\u1ee1 v\u1ee5n g\u00e2y vi\u00eam kh\u1edbp d\u1ecbch, v\u00ec l\u1ee3i \u00edch c\u1ee7a vi\u1ec7c c\u1ea1o s\u1ee5n ch\u1ec9 h\u1ea1n ch\u1ebf \u1edf vi\u1ec7c n\u00e0y [9].<\/li>\n<li><strong>Ph\u1eabu thu\u1eadt c\u1eaft b\u1ecf t\u1ed5n th\u01b0\u01a1ng k\u1ebft h\u1ee3p khoan x\u01b0\u01a1ng d\u01b0\u1edbi s\u1ee5n:<\/strong> Ph\u01b0\u01a1ng ph\u00e1p ph\u1ed5 bi\u1ebfn cho tho\u00e1i h\u00f3a n\u1eb7ng. T\u1ed5n th\u01b0\u01a1ng b\u1ecb l\u00e0m s\u1ea1ch xu\u1ed1ng \u0111\u1ebfn x\u01b0\u01a1ng d\u01b0\u1edbi s\u1ee5n, sau \u0111\u00f3 x\u01b0\u01a1ng \u0111\u01b0\u1ee3c khoan ho\u1eb7c vi v\u1ee1 (microfracture) \u0111\u1ec3 t\u1ea1o \u0111\u01b0\u1eddng d\u1eabn m\u1ea1ch m\u00e1u nu\u00f4i d\u01b0\u1ee1ng b\u1ec1 m\u1eb7t m\u1edbi [9].<\/li>\n<li><strong>C\u1ea5y gh\u00e9p s\u1ee5n kh\u1edbp t\u1ef1 th\u00e2n (OATS):<\/strong> \u0110\u01b0\u1ee3c ch\u1ec9 \u0111\u1ecbnh cho t\u1ed5n th\u01b0\u01a1ng t\u1eadp trung, cao c\u1ea5p v\u00e0 b\u1ecb bao quanh b\u1edfi s\u1ee5n l\u00e0nh. K\u1ef9 thu\u1eadt n\u00e0y s\u1eed d\u1ee5ng c\u00e1c \u1ed1ng ch\u1ee9a m\u00f4 x\u01b0\u01a1ng s\u1ee5n t\u1eeb v\u00f9ng kh\u00e1c c\u1ee7a c\u00f9ng m\u1ed9t \u0111\u1ea7u g\u1ed1i \u0111\u1ec3 c\u1ea5y v\u00e0o v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng. Khi nhi\u1ec1u gh\u00e9p \u0111\u01b0\u1ee3c d\u00f9ng, kh\u1ed1i u d\u1ef1 ki\u1ebfn s\u1ebd l\u1ea5p \u0111\u1ea7y kho\u1ea3ng 60-80% v\u1edbi s\u1ee5n hyalin [4].<\/li>\n<li><strong>Ph\u1eabu thu\u1eadt gi\u1ea3i ph\u1eabu c\u01a1 h\u1ecdc:<\/strong> Bao g\u1ed3m n\u00e2ng cao x\u01b0\u01a1ng \u1ed1ng ch\u00e0y tr\u01b0\u1edbc (Maquet procedure) \u0111\u1ec3 gi\u1ea3m t\u1ea3i cho kh\u1edbp ch\u00e8 \u0111\u00f9i, ho\u1eb7c gi\u1ea3i ph\u00f3ng retinaculum b\u00ean n\u1ebfu c\u00f3 l\u1ec7ch tr\u1ee5c. Tuy nhi\u00ean, ph\u1eabu thu\u1eadt n\u00e0y c\u1ea7n th\u1eadn tr\u1ecdng v\u00ec c\u00f3 th\u1ec3 g\u00e2y m\u1ea5t \u1ed5n \u0111\u1ecbnh b\u00ean trong c\u1ee7a s\u1ee5n [8].<\/li>\n<\/ul>\n<p>Quan tr\u1ecdng c\u1ea7n l\u01b0u \u00fd l\u00e0 kh\u1ea3 n\u0103ng t\u1ef1 s\u1eeda ch\u1eefa c\u1ee7a s\u1ee5n kh\u1edbp r\u1ea5t h\u1ea1n ch\u1ebf do \u0111\u00e2y l\u00e0 m\u00f4 kh\u00f4ng c\u00f3 m\u1ea1ch m\u00e1u. C\u00e1c v\u1ebft th\u01b0\u01a1ng xuy\u00ean qua s\u1ee5n v\u00e0 v\u00e0o x\u01b0\u01a1ng d\u01b0\u1edbi s\u1ee5n s\u1ebd l\u00e0nh l\u1ea1i b\u1eb1ng m\u00f4 x\u01a1 s\u1ee3i k\u00e9m t\u1ed5 ch\u1ee9c, d\u1ec5 tho\u00e1i h\u00f3a h\u01a1n [3]. Do \u0111\u00f3, c\u00e1c th\u1ee7 thu\u1eadt li\u00ean quan \u0111\u1ebfn b\u1ec1 m\u1eb7t kh\u1edbp ph\u1ea3i c\u00e2n nh\u1eafc k\u1ef9 l\u01b0\u1ee1ng kh\u1ea3 n\u0103ng ph\u1ee5c h\u1ed3i c\u1ee7a m\u00f4.<\/p>\n<h2>K\u1ebft lu\u1eadn<\/h2>\n<p>B\u1ec7nh <strong>tho\u00e1i h\u00f3a s\u1ee5n kh\u1edbp ch\u00e8 \u0111\u00f9i<\/strong> l\u00e0 m\u1ed9t r\u1ed1i lo\u1ea1n ph\u1ee9c t\u1ea1p v\u1edbi nguy\u00ean nh\u00e2n \u0111a y\u1ebfu t\u1ed1, bao g\u1ed3m c\u1ea3 c\u01a1 h\u1ecdc v\u00e0 h\u00f3a sinh. Vi\u1ec7c ch\u1ea9n \u0111o\u00e1n ch\u00ednh x\u00e1c d\u1ef1a tr\u00ean l\u00e2m s\u00e0ng v\u00e0 h\u00ecnh \u1ea3nh k\u1ebft h\u1ee3p v\u1edbi soi kh\u1edbp gi\u00fap \u0111\u1ecbnh h\u01b0\u1edbng \u0111i\u1ec1u tr\u1ecb ph\u00f9 h\u1ee3p. M\u1eb7c d\u00f9 c\u00e1c k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt hi\u1ec7n \u0111\u1ea1i nh\u01b0 c\u1ea5y gh\u00e9p s\u1ee5n hay vi v\u1ee1 c\u00f3 th\u1ec3 mang l\u1ea1i hy v\u1ecdng, nh\u01b0ng hi\u1ec3u bi\u1ebft s\u00e2u s\u1eafc v\u1ec1 gi\u1edbi h\u1ea1n t\u1ef1 nhi\u00ean c\u1ee7a qu\u00e1 tr\u00ecnh l\u00e0nh v\u1ebft th\u01b0\u01a1ng s\u1ee5n v\u1eabn l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t \u0111\u1ec3 \u0111\u01b0a ra quy\u1ebft \u0111\u1ecbnh l\u00e2m s\u00e0ng \u0111\u00fang \u0111\u1eafn v\u00e0 qu\u1ea3n l\u00fd k\u1ef3 v\u1ecdng cho b\u1ec7nh nh\u00e2n.<\/p>\n<h2>T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n<ul>\n<li>[1] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2765<\/li>\n<li>[2] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2764<\/li>\n<li>[3] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2766<\/li>\n<li>[4] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 3082<\/li>\n<li>[5] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 83<\/li>\n<li>[6] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2765<\/li>\n<li>[7] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2764<\/li>\n<li>[8] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2766<\/li>\n<li>[9] Campbell&#x27;s Operative Orthopaedics, 15th Edition, 2026, trang 2766<\/li>\n<li>[10] Rockwood and Green&#x27;s Fractures in Adults, 10th Edition, 2025, trang 83<\/li>\n<\/ul>\n<p><!-- aiwriter:d521da36b9cd4a0a98572189 --><\/p>\n","protected":false},"excerpt":{"rendered":"<p>T\u00ecm hi\u1ec3u nguy\u00ean nh\u00e2n sinh h\u1ecdc v\u00e0 c\u01a1 h\u1ecdc g\u00e2y tho\u00e1i h\u00f3a s\u1ee5n ch\u00e0y, c\u00e1c d\u1ea5u hi\u1ec7u l\u00e2m s\u00e0ng \u0111\u1eb7c tr\u01b0ng nh\u01b0 h\u1ed9i ch\u1ee9ng \u0111au tr\u01b0\u1edbc \u0111\u1ea7u g\u1ed1i, c\u0169ng nh\u01b0 c\u00e1c ph\u01b0\u01a1ng ph\u00e1p ph\u1eabu thu\u1eadt hi\u1ec7n \u0111\u1ea1i.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[12],"tags":[],"class_list":["post-394","post","type-post","status-publish","format-standard","hentry","category-chi-duoi"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.6 - 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