Una paziente mi scrive, sono una signora di 62 anni con problemi di artrosi alle ginocchia. Gli specialisti consultati concordano sulla diagnosi (cartilagine consumata) e sulla soluzione definitiva (inserimento di una protesi).
Ho fatto diverse infiltrazioni di acido ialuronico per cercare di dilazionare l’intervento ma con scarsi risultati. Recentemente ho letto della possibilità di reinserire cartilagine sintetica. Cosa mi consigliate ?
Innanzitutto, la cartilagine sintetica non esiste. Come non esiste, ancora, la possibilita’ di ricreare la cartilagine articolare. Chi dovesse riuscirci, prenderebbe il premio Nobel per aver vinto una delle patologie più diffuse della vecchiaia: l’artrosi.
Forse si riferisce all’innesto di cartilagine coltivata, previo prelievo dal suo ginocchio. Oppure innesto di cellule staminali, prelevate dal suo sangue.
Le lesioni cartilaginee del ginocchio sono una patologia di difficile soluzione terapeutica.
La terapia, soprattutto nel giovane, inizia con farmaci “condroprotettori” e/o “viscosupplementazione”, con infiltrazioni, che lei ha già fatto senza successo. Molto utile è lo studio della postura per correggere difetti posturale che mandano in sovraccarico la parte malata.
L’innesto (il trapianto è di un organo vascolarizzato) di cartilagine clonata dalle proprie cellule non ha dato i risultati sperati. Quello che si forma non è la cartilagine originaria ma una membrana fibrosa più o meno robusta. Però, l’aspettano due interventi, mobilizzazione precoce, carico dopo 40 giorni. Stessa membrana si forma con le “microfratture”, cioè perforando la zona sofferente, con tecnica artroscopica, si stimola una cicatrizzazione (non la ricrescita della cartilagine). Un solo intervento, in artroscopia, mobilizzazione precoce, carico parziale per 40 giorni.
Migliori risultati li ha dati la “mosaicoplastica”.
Il prelievo di una pasticca di cartilagine ed osso da zone non utilizzate del ginocchio e l’innesto nel sito danneggiato. Eseguibile in artroscopia con un unico intervento, hanno l’inconveniente di poter coprire una piccola superficie lesionata, non superiore ai 2/3 cmq. Il recupero è rapido, il carico totale dopo un mese. Recentemente, sono stati proposti innesti di preparati osteocartilaginei “artificiali”, dalle prospettive interessanti, ma ancora sperimentali.
Miglior consenso trova l’innesto di cellule “staminali”, prelevate dal tessuto adiposo. SEMBRA CHE PRODUCANO UNA MEMBRANA FIBROSA Più RESISTENTE NEL TEMPO. Il tempo dirà se questi tentativi saranno coronati da successo. Per ora, tolgono il dolore per qualche tempo. In considerazione della sua età, mi piacerebbe visitarla e vedere le radiografie, perché ipotizzo un’artrosi parziale, compartimentale, che meriterebbe una protesi piccola e meno invasiva, di certo risolutiva, in mani esperte, anche per decenni.
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Thus, by correcting this hormone imbalance, Dianabol helped men (who
have been infertile) have kids because of an improved sperm depend.
Furthermore, a big increase in testosterone additionally resulted in improvements in their sexual and psychological well-being.
Dr. Ziegler noted that the Russian athletes had been experiencing androgenic unwanted effects during the 1956 Olympics (in Australia) when he discovered they have been experiencing issue urinating.
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Unfortunately, there are a number of fairly obvious Dianabol unwanted side effects on girls.
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It may give users large features in muscle size and energy in a relatively brief period of time.
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For those entrenched within the muscle-maximizing marathon, the quest for
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Thus, Dianabol and Turinabol can each be used throughout bulking cycles; nevertheless, Dbol is the more optimum compound for mass acquire in the quick time period.
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It stimulates the release of follicle-stimulating hormone (FSH) and luteinizing
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are Nolvadex (tamoxifen citrate) and Clomid (clomiphene citrate).
This is as a end result of Dianabol can enhance the
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Dianabol also increases estrogen ranges by the use of aromatase,
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This was due to enlarged prostates brought on by the high conversion from testosterone to DHT.
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It hasn’t elevated me to Herculean heights
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This cycle is common for first-time steroid customers looking for significant
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This type of steroids will increase estrogen levels in males by up to ten occasions which then leads
to elevated cholesterol and blood pressure. During a Dbol cycle,
results typically show a acquire of 7-15lbs lean muscle mass.
While you’ll initially have extra at the finish of your cycle – around 20-30% – that is simply water.
Whether Or Not you’re a seasoned bodybuilder or just getting started, the possibilities are you’re already acquainted
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We’re here to provide the lowdown on Dianabol (Dbol) cycles, including
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