Bol\u00ed v\u00e1s a\u017e nesnesiteln\u011b n\u011bkter\u00fd z kloub\u016f v t\u011ble? L\u00e9ka\u0159i dovedou v sou\u010dasnosti vym\u011bnit v\u0161echny klouby v t\u011ble pomoc\u00ed tzv. endoprot\u00e9z. Nej\u010dast\u011bji jsou nahrazov\u00e1ny ky\u010dle a kolena, ale mo\u017en\u00e9 jsou i endoprot\u00e9zy lokte, ramene, \u010dl\u00e1nk\u016f prst\u016f \u010di sanice \u010delisti.<\/p>\n
„Pacientovi m\u016f\u017eeme voperovat bu\u010f jen \u010d\u00e1ste\u010dnou, nebo tot\u00e1ln\u00ed endoprot\u00e9zu,“ uv\u00e1d\u00ed MUDr. Vladislav Hospod\u00e1r, prim\u00e1\u0159 odd\u011blen\u00ed Ortopedie a jednotky tot\u00e1ln\u00edch endoprot\u00e9z Rehabilita\u010dn\u00ed kliniky Malvazinky v Praze, kterou provozuje spole\u010dnost VAMED Mediterra.
\nDod\u00e1v\u00e1, \u017ee zat\u00edmco p\u0159i \u010d\u00e1ste\u010dn\u00e9 se nahrazuje jen po\u0161kozen\u00e1 \u010d\u00e1st, p\u0159i tot\u00e1ln\u00ed endoprot\u00e9ze se nahrad\u00ed v\u0161echny kloubn\u00ed plochy. „Pokud je nutn\u00e1 nap\u0159\u00edklad tot\u00e1ln\u00ed endoprot\u00e9za kolenn\u00edho kloubu, neznamen\u00e1 to, \u017ee by se nahradilo cel\u00e9 koleno, ale pouze povrch kloubu a kloubn\u00ed chrupavka. P\u0159i z\u00e1kroku se tak odstran\u00ed jen mal\u00e1 \u010d\u00e1st kosti s t\u00edm, \u017ee vazy, \u0161lachy i svaly z\u016fstanou zachov\u00e1ny,“ \u0159\u00edk\u00e1 doktor Hospod\u00e1r.<\/p>\n
Nej\u010dast\u011bji se nahrazuje ky\u010del<\/p>\n
Tot\u00e1ln\u00ed endoprot\u00e9za ky\u010deln\u00edho kloubu je nej\u010dast\u011bji pou\u017e\u00edvan\u00fd druh endoprot\u00e9z. Ky\u010deln\u00ed kloub je velice d\u016fle\u017eit\u00fd a hodn\u011b zat\u011b\u017eovan\u00fd a vy\u017eaduje zv\u00fd\u0161enou pozornost. Tento p\u00e1rov\u00fd kloub je po kolenn\u00edm kloubu druh\u00fdm nejv\u011bt\u0161\u00edm kloubem v na\u0161em t\u011ble a z\u00e1vis\u00ed na n\u011bm pohyb orga -nismu.
\n„Jen v \u010cesk\u00e9 republice je ro\u010dn\u011b implantov\u00e1no v\u00edce ne\u017e osm tis\u00edc t\u011bchto kloubn\u00edch n\u00e1hrad. Z\u00e1rove\u0148 se neust\u00e1le zlep\u0161uje materi\u00e1l, ze kter\u00e9ho jsou vyrobeny. Souvis\u00ed to s t\u00edm, \u017ee operujeme st\u00e1le mlad\u0161\u00ed pacienty a ti pot\u0159ebuj\u00ed, aby jim nov\u00e9 klouby vydr\u017eely co nejd\u00e9le,“ dopl\u0148uje MUDr. Vladislav Hospod\u00e1r.<\/p>\n
D\u016fvody v\u00fdm\u011bny<\/p>\n
V posledn\u00edch letech doch\u00e1z\u00ed k velk\u00e9mu rozvoji t\u00e9to opera\u010dn\u00ed metody a roz\u0161i\u0159uje se i \u0161k\u00e1la kloubn\u00edch posti\u017een\u00ed, kter\u00e1 lze \u0159e\u0161it n\u00e1hradou kloubu. P\u0159esto b\u00fdv\u00e1 endoprot\u00e9za a\u017e posledn\u00ed mo\u017enost\u00ed, jak \u0159e\u0161it pacientovy pohybov\u00e9 pot\u00ed\u017ee spojen\u00e9 s velk\u00fdmi bolestmi. L\u00e9ka\u0159 doporu\u010duje endoprot\u00e9zu a\u017e po vy\u010derp\u00e1n\u00ed konzervativn\u00ed terapie, kter\u00e1 zahrnuje l\u00e9\u010dbu l\u00e9ky, rehabilitaci, \u00fapravu \u017eivotospr\u00e1vy, fyzik\u00e1ln\u00ed terapii a balneoterapii.
\n„Bezprost\u0159edn\u011b po operaci \u010dek\u00e1 pacienta n\u00e1ro\u010dn\u00e1 rehabilitace. Po n\u00ed by ale m\u011bl b\u00fdt schopn\u00fd v\u011bnovat se v\u0161em aktivit\u00e1m v\u010detn\u011b sportu. Endoprot\u00e9zu by ov\u0161em nem\u011bl p\u0159et\u011b\u017eovat,“ uklid\u0148uje MUDr. Vladislav Hospod\u00e1r. Po tot\u00e1ln\u00ed endoprot\u00e9ze se obvykle nejd\u0159\u00edve aktivuj\u00ed svaly okolo operovan\u00e9ho kloubu.
\nC\u00edlem rehabilitace je zlep\u0161en\u00ed rozsahu hybnosti v operovan\u00e9m kloubu. Pacienta \u010dekaj\u00ed dechov\u00e1 cvi\u010den\u00ed \u010di c\u00e9vn\u00ed gymnastika, kter\u00e1 slou\u017e\u00ed jako prevence trombotick\u00fdch nemoc\u00ed. Nevyhne se ani cvi\u010den\u00ed stehenn\u00edch sval\u016f a posilov\u00e1n\u00ed horn\u00edch kon\u010detin.
\n„D\u016fle\u017eitou sou\u010d\u00e1st\u00ed rehabilitace je ch\u016fze s oporou berl\u00ed, kter\u00e1 za\u010d\u00edn\u00e1 velmi pomalu, kr\u016f\u010dek po kr\u016f\u010dku, nejprve po rovin\u011b a pozd\u011bji po schodech. Pot\u00e9 pacient za\u010d\u00edn\u00e1 cvi\u010dit pod dohledem na rotopedu, mohou b\u00fdt p\u0159id\u00e1v\u00e1ny i jin\u00e9 druhy terapie. P\u0159ibli\u017en\u011b po \u010dty\u0159ech a\u017e \u0161esti t\u00fddnech od operace m\u016f\u017ee b\u00fdt operovan\u00e1 kon\u010detina pln\u011b zat\u011b\u017eov\u00e1na,“ informuje Hospod\u00e1r.<\/p>\n
N\u00e1hrada na jeden rok i na cel\u00fd \u017eivot<\/p>\n
Jak dlouho bude n\u00e1hrada pacientovi slou\u017eit, z\u00e1le\u017e\u00ed ale na n\u011bkolika faktorech. Kl\u00ed\u010dov\u00e9 je, jak \u010dasto je n\u00e1hrada pou\u017e\u00edv\u00e1na a p\u0159i jak\u00fdch aktivit\u00e1ch. Z\u00e1vis\u00ed v\u0161ak i nap\u0159\u00edklad na tom, kolik pacient v\u00e1\u017e\u00ed nebo zda chod\u00ed na pravideln\u00e9 kontroly a udr\u017euje se v dobr\u00e9 fyzick\u00e9 kondici. Mnoha lidem vydr\u017e\u00ed tot\u00e1ln\u00ed n\u00e1hrada cel\u00fd \u017eivot, jin\u00fdm m\u00e9n\u011b ne\u017e rok.
\nN\u00e1hrady jsou konstruov\u00e1ny tak, aby ulevily od bolesti a umo\u017e nily st\u00e1n\u00ed, sezen\u00ed, ch\u016fzi a jin\u00e9 b\u011b\u017en\u00e9 denn\u00ed aktivity. Pacienti v\u0161ak mohou s n\u00e1hradami i sportovat, osv\u011bd\u010dily se p\u0159i golfu, j\u00edzd\u011b na kole a p\u0159i plav\u00e1n\u00ed. V p\u0159\u00edpad\u011b, \u017ee se n\u00e1hrada opot\u0159ebuje nebo po\u0161kod\u00ed, je mo\u017eno implantovat dal\u0161\u00ed n\u00e1hradu.
\nTot\u00e1ln\u00ed endoprot\u00e9zy jsou od toho, aby n\u00e1m zkvalit\u0148ovaly \u017eivot a navracely pacienty zp\u011bt do plnohodnotn\u00e9ho a radostn\u00e9ho \u017eivota. „Pro mnoho lid\u00ed, kter\u00fdm ka\u017ed\u00fd pohyb zp\u016fsobuje nep\u0159edstaviteln\u00e9 bolesti, znamen\u00e1 mo\u017enost n\u00e1hrady kloubu \u010dasto jedin\u00fd zp\u016fsob n\u00e1vratu zp\u011bt do \u017eivota bez bolest\u00ed a bez v\u00fdznamn\u00e9ho pohybov\u00e9ho omezen\u00ed,“ uzav\u00edr\u00e1 MUDr. Vladislav Hospod\u00e1r.<\/p>\n
Nej\u010dast\u011bj\u0161\u00ed d\u016fvody k voperov\u00e1n\u00ed endoprot\u00e9zy<\/p>\n
artr\u00f3zy (degenerativn\u00ed onemocn\u011bn\u00ed kloubu) revmatoidn\u00ed artritidy (z\u00e1n\u011bt kloubu vedouc\u00ed k jeho deformaci) po\u00farazov\u00e9 stavy a n\u011bkter\u00e9 typy zlomenin vrozen\u00e9 vady n\u00e1dorov\u00e9 (obvykle metastatick\u00e9) posti\u017een\u00ed kosti v\u00fdm\u011bna uvoln\u011bn\u00e9 endoprot\u00e9zy za novou<\/p>\n
Mnoha lidem vydr\u017e\u00ed tot\u00e1ln\u00ed n\u00e1hrada kloubu cel\u00fd \u017eivot, jin\u00fdm m\u00e9n\u011b ne\u017e rok<\/p>\n
Kdy v\u0161e za\u010dalo Prvn\u00ed tot\u00e1ln\u00ed endoprot\u00e9za ky\u010deln\u00edho kloubu byla aplikov\u00e1na v klinick\u00e9 praxi v roce 1938. Tot\u00e1ln\u00ed endoprot\u00e9za kolenn\u00edho kloubu byla do praxe uvedena v 80. letech 19. stolet\u00ed po \u00fasp\u011b\u0161n\u00e9m rozvoji tot\u00e1ln\u00edch endoprot\u00e9z ky\u010deln\u00edho kloubu. V \u010cesk\u00e9 republice se ro\u010dn\u011b provede 12 tis\u00edc endoprot\u00e9z kolene a osm tis\u00edc ky\u010dle.<\/p>\n
O autorovi: V\u00e1clav Pergl<\/p>\n
Pr\u00e1vo<\/p>\n","protected":false},"excerpt":{"rendered":"
Bol\u00ed v\u00e1s a\u017e nesnesiteln\u011b n\u011bkter\u00fd z kloub\u016f v t\u011ble? L\u00e9ka\u0159i dovedou v sou\u010dasnosti vym\u011bnit v\u0161echny klouby v t\u011ble pomoc\u00ed tzv. endoprot\u00e9z. Nej\u010dast\u011bji jsou nahrazov\u00e1ny ky\u010dle […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14467,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-25298","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25298","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25298"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25298\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14467"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25298"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25298"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25298"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}