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߈rP~c AP†T'vjxoNy IKˆSIJgtrJAKax KT ?
● AjasJIJKatTáuJr ߈rP~c AP†TvjxoNy ßTmu
˝·ßo~JKh IJrJo KhPf kJPrÇ Fr mJrmJr IKˆSIJgtrJAKax yu Foj FT Im˙J pUj IJkjJr yÅJaár xKºr (Knee
mqmyJPrr lPu IJkjJr TJKatPuP\r ãKf yPf Joint) lîáAc (Synovial Fluid) ã~ yPf Êr∆ TPr FmÄ yJÅaá fJr ˝JnJKmT
kJPrÇ TJptãofJ yJrJ~Ç IKˆSIJgtrJAKaxF yJÅaá xKºr lîáAc ã~ yS~Jr
kJvJkJKv TJKatPu\èPuJ (FT irPjr KkKóZu KaxMq pJ yJzFr k´J∂PT ßdPT
rJPU mJ Távj' KyPxPm TJ\ TPr) nJñPf Êr∆ TPrÇ
vuqKâ~J
● xŒNet yÅJaár k´Kf˙Jkj yPóZ ßxxm ßrJVLPhr \jq
FPTmJPr xmtPvw k∫J, pÅJPhr yÅJaár pπeJ IxyjL~ yÅJaár IKˆSIJgtrJAKax (OA*) Fr uãe
S èr∆fr FmÄ IjqJjq KYKT&xJ KmT· ßgPT
ßTJjS lu kJS~J pJPóZ jJÇ FmÄ CkxVtèPuJ TL TL ?
yJÅaár IKˆSIJgtrJAKax xJiJref iLPr iLPr mJzPf gJPT FmÄ
KnPÛJxJKkäPo≤Fr xJyJPpq KYKT&xJ ßgPT IKˆSIJgtrJAKax Fr TJrPj yJÅaá xKºr lîáAc ã~ yPf Êr∆ TPrÇ fJA
k´JgKoT Im˙J~ IKˆSIJgtrJAKax xjJÜ TrJ ßVPu FmÄ KYKT&xPTr
x÷Jmq kJvõtk´KfKâ~JxoNy vreJkjú yPu, FojTL xyjvLu kptJP~r mqJ~Jo IJkjJr yJÅaáPT Totão
IJkjJr pKh yJ~JuMPrJjJj Kk´kJPrv¿ mJ IqJKn~Jj ßk´JKaPj (oMrVL) ßTJjS rJUPf xJyJpq TrPmÇ IKˆSIJgtrJAKax IJkjJr FT yJÅaá IgmJ hMA
rTPor IqJuJK\t gJPT, fPm KnPÛJxJKkäPojPavj KYKT&xJ V´yPer IJPV, yJÅaáPfA yPf kJPrÇ
IJkjJr KYKT&xTPT \JjJPjJ CKYfÇ kJvõtk´KfKâ~JèPuJ xJiJref oOhM
FmÄ xJoK~TÇ fJr oPiq y~PfJ I∂ntMÜ gJTPf kJPr: ßp xm uãeèPuJ ßhUJ ßpPf kJPr:
● pπeJ ● ßlJuJnJm ● IJzÓfJ ● lîáAc \Po SbJ ● YuJPlrJr xo~ pπeJ FmÄ Joint Space F WwJ UJS~Jr IjMnëKf,
FojTL Kmv´JPor xoP~S pπeJ yPf kJPrÇ
ßTJjS CkxVt pKh YuPf gJPT mJ ImjKf WPa, IJkjJr KYKT&xPTr xPñ
IKmuPÍ ßpJVPpJV Tr∆jÇ ● Kmv´Jo ßjS~Jr kPr IJzÓnJmÇ
● yJÅaá xKº (Knee Joint) láPu SbJÇ
● YuJPlrJr ãofJ TPo pJS~J mJ yJrJPjJÇ
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Synovial Fluid Replacement Therapy ßpnJPm
yÅJaár IKˆSIJgtrJAKax TJ\ TPr:
TL TJrPe y~ ? pUj High Molecular Weight KnPÛJxJKkäPo≤ yJÅaá xKºPf
(Intra-articular Space) k´Pmv TrJPjJ y~ fUj FKa ãKfV´˜
xJ~PjJKn~Ju lîáAc Fr Replacement KyPxPm TJ\ TPr FmÄ
m~x m~x Fr xJPg xJPg IKˆSIJgtrJAKaxFr kNPmtr jqJ~ xM˙ yJÅaár TotãofJ k´KfKÔf TPrÇ FTKa TJptTrL S
^MÅKT mJzPf gJPTÇ IKiTJÄv oJjMPwr oPiq hLWtPo~JhL Synovial Fluid Replacement Therapy Fr \jq
45 mZr m~x Fr kPr FA IxM˙fJ ßhUJ KjPYr ‰mKvÓqèPuJ Ifq∂ èr∆fôkNet:
ßh~Ç
● KnPÛJxJKkäPo≤Ka Biocompatible yPf yPm pJPf ßTJj irPer
˙NufJ IKfKrÜ S\j yÅJaár Skr IKfKrÜ YJk Allergic Reaction ßhUJ jJ ßh~Ç
xOKÓ TPrÇ
● FKaPT Foj yPf yPm ßpj k´P~J\jL~ Metabolite FmÄ
Nutrient kKrmyj TrPf kJPrÇ
Kuñ IKˆSIJgtrJAKax xJiJref oKyuJPhr oPiq ● Fr Rheological Property ymÉ xJ~PjJKn~Ju lîáAc Fr of
ßmKv ßhUJ pJ~Ç yPf yPm pJr lPu FKa Shock Absorver FmÄ Lubricant
KyPxPm TJ\ TrPmÇ lPu IJkjJr yJÅaá, xM˙ yJÅaár of Shock
Absorving FmÄ Lubrication Fr ãofJ KlPr kJPmÇ
mÄvVf mÄvVf ‰mKvÓq yJÅaá xKºr IJTJr S
● ßp xm Inflammetory Cytokines èPuJ yJÅaár Cartilage iÄx
K˙rfJPT k´nJKmf TrPf kJPrÇ
TrJr \jq hJ~L, (ßpoj IL-I, TNF-∞) fJPhrPT ßrJi TrJr
oJiqPo Cartilage Fr ã~ yS~J mº TrPf yPmÇ Hyaluronic
yÅJaMPf kMPrJPjJ ßYJa/IJWJf FmÄ Acid KjÎxrPjr oJiqPo ImKvÓ Cartilage èPuJPT kMjÎVKbf
ßYJa/IJWJf TrPf yPmÇ
ßkvJVf TJ\TPotr iJrJ, pJ k´KfKj~f
yÅJaár Skr YJk xOKÓ TrPf kJPrÇ
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KnPÛJxJKkäPo≤ IKˆSIJgtrJAKax gJTJ yJÅaáPf KbT TL
KnPÛJxJKkäPo≤ yu Foj FT Wj fru khJgt pJ ãKfV´˜ xJ~PjJKn~Ju lîáAc
Fr Replacement KyPxPm TJ\ TPr FmÄ kMjrJ~ xM˙ yJÅaár jmq
WaPZ ?
xJ~PjJKn~Ju lîáK~c Fr of TJptãofJ (Lubricating and cushioning)
k´hvtj TPrÇ FA KnPÛJxJKkäPo≤èPuJ xJiJref hMA irPer yP~ gJPT: ● ßp Synovial Fluid mJ fru IJkjJr yJÅaár xKºÆ~PT KkKóZu
(Lubricate) rJPU, fJ ã~ yPf Êr∆ TPr FmÄ iLPr iLPr xmrTo vT'
mJ ^JÅTáKj xyq TrJr ãofJ yJrJ~Ç
● yJÅaá xKºr yJzèPuJ fUj kr¸Prr xPñ WwJ ßUPf Êr∆ TPrÇ Fr lPu
Non-crosslinked low molecular Highly-crosslinked high molecular
weight viscosuppliment weight viscosuppliment yJÅaáPf fLms pπeJ S IJzÓnJm IjMnëf y~ FmÄ ˝JnJKmT YuJPlrJ, yJÅaá
nJÅ\ TrJ FmÄ KxÅKz nJñJr of xy\ TJ\èPuJ Ifq∂ pπeJhJ~T yP~
Fr Physical Properties CPbÇ
● ● FKa Gel mJ Wj frPur of
lîáK~c Fr ofÇ TJrj Fr FmÄ Fr Physical
Viscosity, Elasticity FmÄ Properties ÉmÉ xM˙ yJÅaár IJr Fr \jq hrTJr IKf x•ôr KYKT&xJ FmÄ \LmjpJ©J~ kKrmftjÇ xKbT
Average Molecular jmLj xJ~PjJKn~Ju lîáAc Fr mqm˙JkjJ FmÄ Kj~Kof YuJPlrJr InJPm IJkKj IJrS ˙NuTJ~ yP~ CbPf
Weight xM˙ yJÅaár IjMr‡k TPr ‰frL (Design) kJPrj pJ yJÅaMr pπeJPT mÉèe mOK≠ TrPf kJPrÇ
xJ~PjJKn~Ju lîáAc Fr TrJ y~Ç F\jq FPT
fáujJ~ IPjT To yP~ Synovial Fluid
gJPTÇ Replacement Therapy muJ
yP~ gJPTÇ
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xM˙ S IKˆSIJgtrJAKax yÅJaár fáujJ IJkjJr IKˆSIJgtrJAKaxFr
KYKT&xJ mqm˙J xŒPTt \JjMj
xM˙ yÅJaM (Healthy Knee)
yJÅaár xKºPf TJKatPuP\r CkKrfu gJPT oxOe FmÄ fJ IJkjJr yÅJaár IKˆSIJgtrJAKax IJPZ mPu pKh Diagnosis yP~ gJPT
xMrKãf rJPU xKºr lîáAc mJ fru, pJr lPu KmjJ fJyPu IJkjJPT Kj~Kof nJPm IJkjJr cJÜJPrr TJPZ ßpPf yPmÇ IJkjJr
pπeJPfA jzJYzJ TrPf kJrJ pJ~Ç KYKT&xT IJkjJr pπeJ ToJPjJ FmÄ ßrJ\TJr TJ\Tot TrJr ãofJ
mJzJPjJr \jq KmKnjú KmT· KjP~ IJPuJYjJ TrPmjÇ
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