{"id":571,"date":"2026-10-13T06:14:33","date_gmt":"2026-10-12T23:14:33","guid":{"rendered":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/tai-tao-day-chang-cheo-truoc-bang-manh-ghep-gan-banh-che-bptb-uu-diem-va-luu-y\/"},"modified":"2026-10-13T06:14:33","modified_gmt":"2026-10-12T23:14:33","slug":"tai-tao-day-chang-cheo-truoc-bang-manh-ghep-gan-banh-che-bptb-uu-diem-va-luu-y","status":"publish","type":"post","link":"https:\/\/bscoxuongkhop.io.vn\/index.php\/2026\/10\/13\/tai-tao-day-chang-cheo-truoc-bang-manh-ghep-gan-banh-che-bptb-uu-diem-va-luu-y\/","title":{"rendered":"T\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc b\u1eb1ng m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 (BPTB): \u01b0u \u0111i\u1ec3m v\u00e0 l\u01b0u \u00fd"},"content":{"rendered":"

T\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc b\u1eb1ng m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 (BPTB)<\/strong> l\u00e0 m\u1ed9t l\u1ef1a ch\u1ecdn gh\u00e9p t\u1ef1 th\u00e2n th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u0111\u1ec1 c\u1eadp trong ph\u1eabu thu\u1eadt t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc (ACL). BPTB l\u00e0 vi\u1ebft t\u1eaft c\u1ee7a m\u1ea3nh gh\u00e9p g\u1ed3m x\u01b0\u01a1ng \u2013 g\u00e2n b\u00e1nh ch\u00e8 \u2013 x\u01b0\u01a1ng; trong \u0111\u00f3 ph\u1ea7n g\u00e2n trung t\u00e2m c\u1ee7a g\u00e2n b\u00e1nh ch\u00e8 \u0111\u01b0\u1ee3c l\u1ea5y k\u00e8m hai n\u00fat x\u01b0\u01a1ng \u1edf hai \u0111\u1ea7u [1][2]. Vi\u1ec7c l\u1ef1a ch\u1ecdn m\u1ea3nh gh\u00e9p c\u1ea7n d\u1ef1a tr\u00ean tu\u1ed5i, m\u1ee9c \u0111\u1ed9 v\u1eadn \u0111\u1ed9ng, t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m v\u00e0 \u0111\u00e1nh gi\u00e1 c\u1ee5 th\u1ec3 c\u1ee7a b\u00e1c s\u0129 ph\u1eabu thu\u1eadt.<\/p>\n

T\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc b\u1eb1ng m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 l\u00e0 g\u00ec?<\/h2>\n

Trong t\u00e1i t\u1ea1o ACL, m\u1ea3nh gh\u00e9p thay th\u1ebf ph\u1ea7n d\u00e2y ch\u1eb1ng b\u1ecb t\u1ed5n th\u01b0\u01a1ng nh\u1eb1m ph\u1ee5c h\u1ed3i s\u1ef1 v\u1eefng c\u1ee7a kh\u1edbp g\u1ed1i. V\u1edbi BPTB, m\u1ea3nh gh\u00e9p t\u1ef1 th\u00e2n l\u1ea5y t\u1eeb v\u00f9ng g\u00e2n b\u00e1nh ch\u00e8 c\u1ee7a ch\u00ednh ng\u01b0\u1eddi b\u1ec7nh. C\u00e1c t\u00e0i li\u1ec7u ph\u1eabu thu\u1eadt c\u0169ng li\u1ec7t k\u00ea k\u1ef9 thu\u1eadt t\u00e1i t\u1ea1o ACL m\u1ed9t b\u00f3 b\u1eb1ng m\u1ea3nh gh\u00e9p x\u01b0\u01a1ng\u2013g\u00e2n b\u00e1nh ch\u00e8\u2013x\u01b0\u01a1ng v\u00e0 k\u1ef9 thu\u1eadt hai \u0111\u01b0\u1eddng r\u1ea1ch s\u1eed d\u1ee5ng lo\u1ea1i m\u1ea3nh gh\u00e9p n\u00e0y [4].<\/p>\n

Kh\u00f4ng n\u00ean hi\u1ec3u BPTB l\u00e0 l\u1ef1a ch\u1ecdn ph\u00f9 h\u1ee3p cho m\u1ecdi tr\u01b0\u1eddng h\u1ee3p. M\u1ea3nh gh\u00e9p g\u00e2n kheo v\u00e0 c\u00e1c lo\u1ea1i m\u1ea3nh gh\u00e9p kh\u00e1c c\u0169ng c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng, trong khi k\u1ebft qu\u1ea3 gi\u1eefa c\u00e1c l\u1ef1a ch\u1ecdn th\u01b0\u1eddng ph\u1ee5 thu\u1ed9c v\u00e0o nh\u00f3m ng\u01b0\u1eddi b\u1ec7nh v\u00e0 ti\u00eau ch\u00ed \u0111\u00e1nh gi\u00e1 [2][5].<\/p>\n

\u01afu \u0111i\u1ec3m c\u1ee7a m\u1ea3nh gh\u00e9p BPTB<\/h2>\n

M\u1ed9t \u0111i\u1ec3m \u0111\u00e1ng ch\u00fa \u00fd c\u1ee7a BPTB l\u00e0 kh\u1ea3 n\u0103ng t\u1ea1o k\u1ebft qu\u1ea3 kh\u00e1ch quan t\u1ed1t v\u1ec1 \u0111\u1ed9 v\u1eefng trong m\u1ed9t s\u1ed1 so s\u00e1nh. Khi \u0111\u1ed1i chi\u1ebfu v\u1edbi m\u1ea3nh gh\u00e9p g\u00e2n kheo, BPTB c\u00f3 xu h\u01b0\u1edbng \u0111\u1ea1t nhi\u1ec1u h\u01a1n c\u00e1c ti\u00eau ch\u00ed nh\u01b0 nghi\u1ec7m ph\u00e1p Lachman b\u00ecnh th\u01b0\u1eddng, pivot shift b\u00ecnh th\u01b0\u1eddng, ch\u00eanh l\u1ec7ch b\u00ean\u2013b\u00ean tr\u00ean KT-1000 d\u01b0\u1edbi 3 mm v\u00e0 \u00edt m\u1ea5t g\u1ea5p g\u1ed1i h\u01a1n [8].<\/p>\n

\u1ede nh\u1eefng ng\u01b0\u1eddi c\u00f3 nguy c\u01a1 cao, ch\u1eb3ng h\u1ea1n v\u1eadn \u0111\u1ed9ng vi\u00ean tr\u1ebb, m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u \u0111\u01b0\u1ee3c t\u1ed5ng h\u1ee3p trong t\u00e0i li\u1ec7u cho th\u1ea5y m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 t\u1ef1 th\u00e2n c\u00f3 t\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i l\u00e2m s\u00e0ng th\u1ea5p h\u01a1n so v\u1edbi m\u1ea3nh gh\u00e9p g\u00e2n kheo [3]. BPTB c\u0169ng \u0111\u01b0\u1ee3c ghi nh\u1eadn c\u00f3 xu h\u01b0\u1edbng cho \u0111\u1ed9 c\u1ee9ng v\u00e0 s\u1ee9c m\u1ea1nh nh\u1ec9nh h\u01a1n, d\u00f9 k\u1ebft qu\u1ea3 t\u1ed5ng th\u1ec3 gi\u1eefa c\u00e1c lo\u1ea1i m\u1ea3nh gh\u00e9p v\u1eabn t\u01b0\u01a1ng \u0111\u01b0\u01a1ng \u1edf nhi\u1ec1u nh\u00f3m ng\u01b0\u1eddi b\u1ec7nh [3].<\/p>\n

    \n
  • C\u00f3 th\u1ec3 h\u1ed7 tr\u1ee3 ph\u1ee5c h\u1ed3i \u0111\u1ed9 v\u1eefng tr\u01b0\u1edbc v\u00e0 xoay c\u1ee7a kh\u1edbp g\u1ed1i trong m\u1ed9t s\u1ed1 ti\u00eau ch\u00ed \u0111\u00e1nh gi\u00e1.<\/li>\n
  • L\u00e0 l\u1ef1a ch\u1ecdn \u0111\u01b0\u1ee3c c\u00e2n nh\u1eafc \u1edf ng\u01b0\u1eddi tr\u1ebb, nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng cao ho\u1eb7c c\u00f3 nguy c\u01a1 t\u00e1i r\u00e1ch cao, t\u00f9y ch\u1ec9 \u0111\u1ecbnh chuy\u00ean m\u00f4n [3][5].<\/li>\n
  • C\u00f3 nhi\u1ec1u k\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 cho t\u00e1i t\u1ea1o ACL b\u1eb1ng BPTB [4].<\/li>\n<\/ul>\n

    H\u1ea1n ch\u1ebf v\u00e0 nguy c\u01a1 c\u1ea7n bi\u1ebft<\/h2>\n

    \u01afu \u0111i\u1ec3m v\u1ec1 \u0111\u1ed9 v\u1eefng kh\u00f4ng \u0111\u1ed3ng ngh\u0129a BPTB lu\u00f4n v\u01b0\u1ee3t tr\u1ed9i. So v\u1edbi BPTB, m\u1ea3nh gh\u00e9p g\u00e2n kheo c\u00f3 li\u00ean quan \u0111\u1ebfn t\u1ef7 l\u1ec7 l\u1ea1o x\u1ea1o kh\u1edbp b\u00e1nh ch\u00e8\u2013\u0111\u00f9i, \u0111au khi qu\u1ef3 v\u00e0 m\u1ea5t du\u1ed7i th\u1ea5p h\u01a1n trong m\u1ed9t s\u1ed1 ph\u00e2n t\u00edch [8]. V\u00ec v\u1eady, \u0111au v\u00f9ng tr\u01b0\u1edbc g\u1ed1i ho\u1eb7c kh\u00f3 ch\u1ecbu khi qu\u1ef3 l\u00e0 nh\u1eefng v\u1ea5n \u0111\u1ec1 c\u1ea7n \u0111\u01b0\u1ee3c trao \u0111\u1ed5i khi c\u00e2n nh\u1eafc l\u1ef1a ch\u1ecdn m\u1ea3nh gh\u00e9p.<\/p>\n

    C\u00e1c k\u1ebft qu\u1ea3 nghi\u00ean c\u1ee9u c\u0169ng kh\u00f4ng ho\u00e0n to\u00e0n th\u1ed1ng nh\u1ea5t. M\u1ed9t s\u1ed1 ph\u00e2n t\u00edch cho th\u1ea5y t\u1ea7n su\u1ea5t m\u1ea5t v\u1eefng kh\u00f4ng kh\u00e1c bi\u1ec7t c\u00f3 \u00fd ngh\u0129a gi\u1eefa BPTB v\u00e0 g\u00e2n kheo; nh\u1eefng nghi\u00ean c\u1ee9u g\u1ea7n \u0111\u00e2y h\u01a1n ghi nh\u1eadn l\u1ef1a ch\u1ecdn m\u1ea3nh gh\u00e9p c\u00f3 \u1ea3nh h\u01b0\u1edfng t\u1ed1i thi\u1ec3u \u0111\u1ebfn m\u1ed9t s\u1ed1 k\u1ebft qu\u1ea3 l\u00e2u d\u00e0i, trong \u0111\u00f3 c\u00f3 t\u1ef7 l\u1ec7 tho\u00e1i h\u00f3a kh\u1edbp sau 10 n\u0103m [8]. Do \u0111\u00f3, kh\u00f4ng n\u00ean l\u1ef1a ch\u1ecdn ch\u1ec9 d\u1ef1a tr\u00ean m\u1ed9t \u01b0u \u0111i\u1ec3m \u0111\u01a1n l\u1ebb.<\/p>\n

    V\u1ec1 bi\u1ebfn ch\u1ee9ng chung sau t\u00e1i t\u1ea1o ACL, t\u00e0i li\u1ec7u ghi nh\u1eadn t\u1ef7 l\u1ec7 huy\u1ebft kh\u1ed1i t\u0129nh m\u1ea1ch s\u00e2u, thuy\u00ean t\u1eafc ph\u1ed5i v\u00e0 nhi\u1ec5m tr\u00f9ng nh\u00ecn chung d\u01b0\u1edbi 1% trong c\u00e1c s\u1ed1 li\u1ec7u \u0111\u01b0\u1ee3c tr\u00edch d\u1eabn, nh\u01b0ng \u0111\u00e2y v\u1eabn l\u00e0 nh\u1eefng bi\u1ebfn ch\u1ee9ng c\u1ea7n theo d\u00f5i sau m\u1ed5 [7]. T\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i do nguy\u00ean nh\u00e2n li\u00ean quan \u0111\u1ebfn m\u1ea3nh gh\u00e9p \u0111\u01b0\u1ee3c b\u00e1o c\u00e1o \u0111\u00e3 \u1ed5n \u0111\u1ecbnh kho\u1ea3ng 7%\u20138% \u1edf th\u1eddi \u0111i\u1ec3m theo d\u00f5i 5 n\u0103m trong m\u1ed9t s\u1ed1 nghi\u00ean c\u1ee9u; con s\u1ed1 c\u00f3 th\u1ec3 thay \u0111\u1ed5i \u0111\u00e1ng k\u1ec3 n\u1ebfu d\u00f9ng c\u00e1c ti\u00eau ch\u00ed th\u1ea5t b\u1ea1i kh\u00e1c nhau [3].<\/p>\n

    Ph\u1ee5c h\u1ed3i sau t\u00e1i t\u1ea1o ACL b\u1eb1ng BPTB<\/h2>\n

    Ph\u1ee5c h\u1ed3i ch\u1ee9c n\u0103ng c\u1ea7n \u0111\u01b0\u1ee3c c\u00e1 th\u1ec3 h\u00f3a v\u00e0 ti\u1ebfn h\u00e0nh theo h\u01b0\u1edbng d\u1eabn c\u1ee7a \u00ea-k\u00edp \u0111i\u1ec1u tr\u1ecb. M\u1ed9t m\u1ed1c ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c m\u00f4 t\u1ea3 trong t\u00e0i li\u1ec7u l\u00e0 m\u1edf ho\u00e0n to\u00e0n kh\u00f3a n\u1eb9p, cho ph\u00e9p ch\u1ecbu tr\u1ecdng l\u01b0\u1ee3ng \u0111\u1ea7y \u0111\u1ee7 v\u00e0o tu\u1ea7n th\u1ee9 6; ch\u1ea1y b\u1ed9 v\u00e0 t\u1eadp s\u1ee9c m\u1ea1nh kh\u00f4ng h\u1ea1n ch\u1ebf c\u00f3 th\u1ec3 b\u1eaft \u0111\u1ea7u t\u1eeb th\u00e1ng th\u1ee9 4. Ki\u1ec3m tra s\u1ee9c m\u1ea1nh b\u1eb1ng m\u00e1y \u0111o Biodex \u0111\u01b0\u1ee3c th\u1ef1c hi\u1ec7n v\u00e0o kho\u1ea3ng th\u00e1ng th\u1ee9 6 v\u00e0 ng\u01b0\u1eddi b\u1ec7nh th\u01b0\u1eddng ch\u1ec9 \u0111\u01b0\u1ee3c tr\u1edf l\u1ea1i ho\u1ea1t \u0111\u1ed9ng \u0111\u1ea7y \u0111\u1ee7 trong kho\u1ea3ng 9\u201312 th\u00e1ng [6].<\/p>\n

    Nh\u1eefng m\u1ed1c tr\u00ean kh\u00f4ng ph\u1ea3i l\u1ecbch c\u1ed1 \u0111\u1ecbnh cho m\u1ecdi ng\u01b0\u1eddi. T\u1ed1c \u0111\u1ed9 ti\u1ebfn tri\u1ec3n c\u00f2n ph\u1ee5 thu\u1ed9c v\u00e0o \u0111\u1ed9 v\u1eefng c\u1ee7a g\u1ed1i, bi\u00ean \u0111\u1ed9 v\u1eadn \u0111\u1ed9ng, s\u1ee9c c\u01a1, t\u1ed5n th\u01b0\u01a1ng s\u1ee5n ch\u00eam ho\u1eb7c s\u1ee5n kh\u1edbp \u0111i k\u00e8m v\u00e0 \u0111\u00e1nh gi\u00e1 ch\u1ee9c n\u0103ng tr\u01b0\u1edbc khi tr\u1edf l\u1ea1i th\u1ec3 thao. Vi\u1ec7c h\u1ebft \u0111au kh\u00f4ng ph\u1ea3i l\u00fac n\u00e0o c\u0169ng \u0111\u1ed3ng ngh\u0129a v\u1edbi vi\u1ec7c d\u00e2y ch\u1eb1ng v\u00e0 s\u1ee9c c\u01a1 \u0111\u00e3 s\u1eb5n s\u00e0ng cho v\u1eadn \u0111\u1ed9ng c\u01b0\u1eddng \u0111\u1ed9 cao.<\/p>\n

    Khi n\u00e0o c\u1ea7n trao \u0111\u1ed5i k\u1ef9 v\u1edbi b\u00e1c s\u0129?<\/h2>\n
      \n
    • Khi ng\u01b0\u1eddi b\u1ec7nh ch\u01a1i th\u1ec3 thao c\u00f3 \u0111\u1ed9ng t\u00e1c xoay, \u0111\u1ed5i h\u01b0\u1edbng ho\u1eb7c nhu c\u1ea7u v\u1eadn \u0111\u1ed9ng cao.<\/li>\n
    • Khi t\u1eebng ph\u1eabu thu\u1eadt ACL th\u1ea5t b\u1ea1i, c\u00f3 t\u1ed5n th\u01b0\u01a1ng m\u1ea1n t\u00ednh ho\u1eb7c d\u1ea5u hi\u1ec7u pivot shift r\u00f5; t\u00e0i li\u1ec7u m\u00f4 t\u1ea3 m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u00f3 th\u1ec3 c\u1ea7n ph\u1ed1i h\u1ee3p t\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng b\u00ean ngo\u00e0i [1][6].<\/li>\n
    • Khi c\u00f4ng vi\u1ec7c ho\u1eb7c sinh ho\u1ea1t \u0111\u00f2i h\u1ecfi qu\u1ef3 th\u01b0\u1eddng xuy\u00ean, v\u00ec l\u1ef1a ch\u1ecdn BPTB c\u00f3 th\u1ec3 c\u1ea7n c\u00e2n nh\u1eafc v\u1edbi nguy c\u01a1 \u0111au khi qu\u1ef3 [8].<\/li>\n
    • Khi c\u00f3 b\u1ec7nh l\u00fd n\u1ec1n ho\u1eb7c t\u1ed5n th\u01b0\u01a1ng ph\u1ed1i h\u1ee3p l\u00e0m thay \u0111\u1ed5i k\u1ebf ho\u1ea1ch ph\u1eabu thu\u1eadt v\u00e0 ph\u1ee5c h\u1ed3i.<\/li>\n<\/ul>\n

      K\u1ebft lu\u1eadn<\/h2>\n

      T\u00e1i t\u1ea1o d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc b\u1eb1ng m\u1ea3nh gh\u00e9p g\u00e2n b\u00e1nh ch\u00e8 (BPTB)<\/strong> c\u00f3 th\u1ec3 mang l\u1ea1i \u0111\u1ed9 v\u1eefng t\u1ed1t, \u0111\u1eb7c bi\u1ec7t trong m\u1ed9t s\u1ed1 nh\u00f3m ng\u01b0\u1eddi tr\u1ebb ho\u1eb7c v\u1eadn \u0111\u1ed9ng vi\u00ean nguy c\u01a1 cao. Tuy nhi\u00ean, ph\u01b0\u01a1ng ph\u00e1p n\u00e0y c\u0169ng c\u00f3 nh\u1eefng h\u1ea1n ch\u1ebf nh\u01b0 \u0111au khi qu\u1ef3 v\u00e0 kh\u00f3 ch\u1ecbu v\u00f9ng b\u00e1nh ch\u00e8\u2013\u0111\u00f9i. B\u1eb1ng ch\u1ee9ng hi\u1ec7n c\u00f3 kh\u00f4ng cho th\u1ea5y m\u1ed9t lo\u1ea1i m\u1ea3nh gh\u00e9p ph\u00f9 h\u1ee3p tuy\u1ec7t \u0111\u1ed1i cho t\u1ea5t c\u1ea3 ng\u01b0\u1eddi b\u1ec7nh. Quy\u1ebft \u0111\u1ecbnh cu\u1ed1i c\u00f9ng n\u00ean d\u1ef1a tr\u00ean m\u1ee5c ti\u00eau v\u1eadn \u0111\u1ed9ng, \u0111\u1eb7c \u0111i\u1ec3m kh\u1edbp g\u1ed1i, t\u1ed5n th\u01b0\u01a1ng \u0111i k\u00e8m v\u00e0 k\u1ebf ho\u1ea1ch ph\u1ee5c h\u1ed3i \u0111\u01b0\u1ee3c b\u00e1c s\u0129 \u0111\u00e1nh gi\u00e1 tr\u1ef1c ti\u1ebfp.<\/p>\n

      T\u00e0i li\u1ec7u tham kh\u1ea3o<\/h2>\n
        \n
      • [1] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3104<\/li>\n
      • [2] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2724<\/li>\n
      • [3] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3105<\/li>\n
      • [4] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 5296<\/li>\n
      • [5] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2748<\/li>\n
      • [6] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 3104<\/li>\n
      • [7] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2723<\/li>\n
      • [8] Campbell's Operative Orthopaedics, 15th Edition, 2026, trang 2724<\/li>\n<\/ul>\n

        <\/p>\n","protected":false},"excerpt":{"rendered":"

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