Trong ph\u1eabu thu\u1eadt ch\u1ec9nh h\u00ecnh n\u1ed9i soi, vi\u1ec7c x\u00e1c \u0111\u1ecbnh ch\u00ednh x\u00e1c v\u1ecb tr\u00ed \u0111i\u1ec3m b\u00e1m c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc (ACL) v\u00e0 meniscus l\u00e0 y\u1ebfu t\u1ed1 then ch\u1ed1t. M\u00e2m ch\u00e0y c\u00f3 c\u00e1c c\u1ea5u tr\u00fac quan tr\u1ecdng nh\u01b0 m\u1ecfm ch\u00e0y trong v\u00e0 ngo\u00e0i, c\u00f9ng v\u1edbi c\u00e1c d\u00e2y ch\u1eb1ng v\u00e0 s\u1ee5n kh\u1edbp bao quanh.<\/p>\n
T\u1ed5n th\u01b0\u01a1ng \u0111i\u1ec3m b\u00e1m meniscus \u0111\u01b0\u1ee3c ph\u00e2n lo\u1ea1i chi ti\u1ebft d\u1ef1a tr\u00ean h\u00ecnh th\u00e1i r\u00e1ch: r\u00e1ch ph\u1ea7n g\u1ed1c \u1ed5n \u0111\u1ecbnh (lo\u1ea1i 1), r\u00e1ch b\u00e1n k\u00ednh ho\u00e0n to\u00e0n c\u00e1ch d\u01b0\u1edbi 9mm t\u1eeb \u0111i\u1ec3m b\u00e1m x\u01b0\u01a1ng (lo\u1ea1i 2), r\u00e1ch ki\u1ec3u bucket-handle v\u1edbi t\u00e1ch r\u1eddi g\u1ed1c (lo\u1ea1i 3), r\u00e1ch ch\u00e9o ho\u1eb7c d\u1ecdc ph\u1ee9c t\u1ea1p k\u00e8m t\u00e1ch r\u1eddi g\u1ed1c (lo\u1ea1i 4) v\u00e0 g\u00e3y x\u01b0\u01a1ng avulsion t\u1ea1i \u0111i\u1ec3m b\u00e1m g\u1ed1c (lo\u1ea1i 5) [1]. Vi\u1ec7c ph\u00e2n lo\u1ea1i n\u00e0y gi\u00fap b\u00e1c s\u0129 l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p x\u1eed tr\u00ed t\u1ed1i \u01b0u, t\u1eeb n\u1ea1o b\u1ecf cho \u0111\u1ebfn s\u1eeda ch\u1eefa c\u1ed1 \u0111\u1ecbnh.<\/p>\n
\u0110\u1ed1i v\u1edbi t\u1ed5n th\u01b0\u01a1ng meniscus, \u0111\u1eb7c bi\u1ec7t l\u00e0 r\u00e1ch g\u1ed1c, k\u1ef9 thu\u1eadt \u0111\u00f3ng k\u00edn (repair) th\u01b0\u1eddng \u0111\u01b0\u1ee3c \u01b0u ti\u00ean thay v\u00ec lo\u1ea1i b\u1ecf ph\u1ea7n m\u00f4 b\u1ecb t\u1ed5n th\u01b0\u01a1ng \u0111\u1ec3 duy tr\u00ec ch\u1ee9c n\u0103ng kh\u1edbp. C\u00e1c thi\u1ebft b\u1ecb c\u1ed1 \u0111\u1ecbnh nh\u01b0 suture anchors ho\u1eb7c n\u00fat (button fixation) \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng ph\u1ed5 bi\u1ebfn, \u0111\u1eb7c bi\u1ec7t trong c\u00e1c tr\u01b0\u1eddng h\u1ee3p r\u00e1ch g\u1ed1c [2].<\/p>\n
K\u1ef9 thu\u1eadt ph\u1eabu thu\u1eadt n\u1ed9i soi bao g\u1ed3m c\u00e1c b\u01b0\u1edbc chu\u1ea9n b\u1ecb k\u1ef9 l\u01b0\u1ee1ng: \u0111\u00e1nh s\u1ed1 kh\u1edbp, \u0111\u1eb7t c\u1ed5ng, v\u00e0 ki\u1ec3m tra \u0111\u1ed9 l\u1ecfng l\u1ebbo c\u1ee7a d\u00e2y ch\u1eb1ng ch\u00e9o tr\u01b0\u1edbc b\u1eb1ng th\u1eed nghi\u1ec7m Lachman. Trong m\u1ed9t s\u1ed1 tr\u01b0\u1eddng h\u1ee3p c\u1ea7n l\u1ea5y m\u00f4 gh\u00e9p (nh\u01b0 d\u00e2y ch\u1eb1ng g\u1ed1i), vi\u1ec7c t\u1ea1o c\u1ed5ng n\u1ed9i soi c\u00f3 th\u1ec3 th\u1ef1c hi\u1ec7n tr\u01b0\u1edbc khi b\u01a1m t\u00fai n\u01b0\u1edbc \u0111\u1ec3 duy tr\u00ec g\u00f3c g\u1eadp \u0111\u1ea7u g\u1ed1i 90 \u0111\u1ed9 [5].<\/p>\n
B\u00e1c s\u0129 c\u1ea7n \u0111\u00e1nh gi\u00e1 k\u1ef9 l\u01b0\u1ee1ng t\u00ecnh tr\u1ea1ng s\u1ee5n kh\u1edbp, tu\u1ed5i t\u00e1c v\u00e0 ch\u1ea5t l\u01b0\u1ee3ng m\u00f4 t\u1ed5n th\u01b0\u01a1ng. Ch\u1ec9 \u0111\u1ecbnh ph\u1eabu thu\u1eadt s\u1eeda ch\u1eefa th\u01b0\u1eddng d\u00e0nh cho b\u1ec7nh nh\u00e2n tr\u1ebb v\u1edbi r\u00e1ch do ch\u1ea5n th\u01b0\u01a1ng v\u00e0 s\u1ee9c kh\u1ecfe s\u1ee5n kh\u1edbp t\u1ed1t [3]. C\u00e1c y\u1ebfu t\u1ed1 nh\u01b0 \u0111\u1ed9 tu\u1ed5i l\u1edbn h\u01a1n 40, k\u00edch th\u01b0\u1edbc v\u1ebft r\u00e1ch l\u1edbn ho\u1eb7c ch\u1ea5t l\u01b0\u1ee3ng m\u00f4 k\u00e9m c\u00f3 th\u1ec3 l\u00e0m t\u0103ng t\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i c\u1ee7a th\u1ee7 thu\u1eadt [2].<\/p>\n
Vi\u1ec7c s\u1eed d\u1ee5ng v\u1eadt li\u1ec7u gh\u00e9p trong ph\u1eabu thu\u1eadt ACL v\u00e0 meniscus mang l\u1ea1i l\u1ee3i \u00edch nh\u01b0ng c\u0169ng \u0111i k\u00e8m r\u1ee7i ro. C\u00e1c \u01b0u \u0111i\u1ec3m bao g\u1ed3m gi\u1ea3m bi\u1ebfn ch\u1ee9ng sau m\u1ed5, c\u1ea3i thi\u1ec7n th\u1ea9m m\u1ef9 v\u00e0 r\u00fat ng\u1eafn th\u1eddi gian ph\u1eabu thu\u1eadt [4]. Tuy nhi\u00ean, t\u1ef7 l\u1ec7 th\u1ea5t b\u1ea1i c\u1ee7a gh\u00e9p m\u00f4 (allograft) cao h\u01a1n g\u1ea5p \u0111\u00f4i \u0111\u1ebfn n\u0103m l\u1ea7n so v\u1edbi t\u1ef1 gh\u00e9p \u1edf v\u1eadn \u0111\u1ed9ng vi\u00ean tr\u1ebb [4].<\/p>\n
Vi\u1ec7c l\u1ef1a ch\u1ecdn ph\u01b0\u01a1ng ph\u00e1p x\u1eed l\u00fd c\u0169ng ph\u1ee5 thu\u1ed9c v\u00e0o v\u1ecb tr\u00ed t\u1ed5n th\u01b0\u01a1ng. R\u00e1ch th\u00e2n meniscus c\u00f3 th\u1ec3 s\u1eed d\u1ee5ng thi\u1ebft b\u1ecb all-inside, trong khi r\u00e1ch g\u1ed1c th\u01b0\u1eddng c\u1ea7n k\u1ef9 thu\u1eadt \u0111\u00f3ng k\u00edn \u0111\u01a1n gi\u1ea3n qua h\u1ea7m d\u01b0\u1edbi \u0111\u1ea7u g\u1ed1i ho\u1eb7c n\u00fat c\u1ed1 \u0111\u1ecbnh [2]. Hi\u1ec3u bi\u1ebft v\u1ec1 gi\u1ea3i ph\u1eabu \u0111i\u1ec3m b\u00e1m v\u00e0 kh\u1ea3 n\u0103ng t\u00e1i t\u1ea1o ch\u1ee9c n\u0103ng c\u1ee7a meniscus l\u00e0 \u0111i\u1ec1u ki\u1ec7n ti\u00ean quy\u1ebft \u0111\u1ec3 th\u00e0nh c\u00f4ng trong ph\u1eabu thu\u1eadt [3].<\/p>\n
<\/p>\n","protected":false},"excerpt":{"rendered":"
Ph\u1eabu thu\u1eadt n\u1ed9i soi x\u1eed l\u00fd t\u1ed5n th\u01b0\u01a1ng \u0111i\u1ec3m b\u00e1m meniscus v\u00e0 ACL \u0111\u00f2i h\u1ecfi hi\u1ec3u bi\u1ebft s\u00e2u v\u1ec1 gi\u1ea3i ph\u1eabu, k\u1ef9 thu\u1eadt \u0111\u00f3ng k\u00edn v\u00e0 l\u1ef1a ch\u1ecdn v\u1eadt li\u1ec7u gh\u00e9p ph\u00f9 h\u1ee3p \u0111\u1ec3 gi\u1ea3m bi\u1ebfn ch\u1ee9ng.<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-590","post","type-post","status-publish","format-standard","hentry","category-noi-soi-khop"],"yoast_head":"\n