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Wear analysis of extracted polyethylenes of total hip replacements using optical methods
Přikryl, Adam ; Morovič, Ladislav (referee) ; Vrbka, Martin (advisor)
An experimental methodology for wear assessment of extracted polyethylene hip implants was designed in this diploma thesis. Methodology uses optical 3D scanner and optical profilometer for analysis of wear. Designed methodology for wear analysis was validated by gravimetric method. The results of validation were in good agreement with the increase of wear rate. Validation results show that the methodology is not suited for wear assessment of metal and ceramic implants which have small wear rates. On the other hand the methodology is more than useful for wear assessment of polyethylene implants. Designed methodology for wear assessment was applied on the set of thirteen extracted polyethylene hip implants. Results of the wear analysis were wear volumes and linear wear noted in the wear maps. Roughness of the surface was measured on explanted cups and results were noted in the roughness map. On articulating surface of the cups different areas were observed for measured roughness. Those areas were described as area with machining marks from manufacturing process, polished area from combination of abrasive and adhesive wear, polished area from micro-contact fatigue and area including plastic deformation.
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Research study of tumorous total endoprosthesis of knee and hip joint
Věžníková, Tereza ; Florian, Zdeněk (referee) ; Marcián, Petr (advisor)
The presented bachelor’s thesis deals with tumorous total endoprosthesis of knee and hip joint. Tumorous replacement is used in patients with bone losts due to bone tumors and for these patients it means the salvage of their limb and the possibility to live full lives. This work includes the description of the developement, types and currently used replacement after bone tumors. The significiant part of patients with bone tumors are children for whom there are growing endoprosthesis containing the expandable mechanism and thanks to this the length of the limb can be regulated. In the last part of this work the stress-strain analysis of tumorous total hip endoprosthesis is performed using computational modeling.
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Design and Development of Experimental Device for Testing the TEP Acetabula and Wear Identification using Optical Method
Houfek, Martin ; Kratochvíl, Ctirad (referee) ; Hortel, Milan (referee) ; Hlaváčková, Milada (referee) ; Florian, Zdeněk (advisor)
Today is the implantation of joint replacements, although a radical, but very functional restoration frequent way ill joint. The implants are placed high demands on their biocompatible and long-term function, which is directly related to wear of joint replacements in the human body. Therefore, analysis of the complex behavior of the implant in the human body is a fundamental problem of biomechanics of implants. This issue is dedicated, this dissertation thesis. Dissertation thesis deals with the solution design and development of experimental device for testing the TEP acetabula and wear identification using optical method. The proposed device allows the joint burden hole TEP physiological manner, but by working with the acetabulum burdened by Power resultant joint axis passes through the hole. The physiological loading of articular wells and evaluating the size of the loss of polyethylene is currently intensively addressed. The results of this study may in the near future, serving as information for assessing the conduct of wear prosthetic hip joint in vivo. The work is devoted to solving the problem of the size required to detect the loss of polyethylene for joint replacement arthroplasty: Design and development of experimental equipment for testing the acetabulum of the hip joint arthroplasty. Identify wear using optical methods. Design and development of experimental equipment was made in the system Inventor Professional 2010 at the level of 3D modeling. Great attention was paid to the design fit into the acetabulum TEP testing machines and gripping the acetabulum into an optical device. Management options were tested with combinations of experimental equipment engines. Suggestions were made and then tests for fixing the acetabulum into an optical device. Has the possibility of depth analysis and identification of wear joined with innovative solutions to evaluate the loss of polyethylene acetabulum arthroplasty. Identification of abrasion (loss of polyethylene) joint arthroplasty holes were carried out experimental measurements using an optical holographic interferometry. The comprehensive analysis of the results of experimental measurement of the loss of polyethylene shows that this method can identify both the size but also an area where there is even to small changes in the surface, which depend on the abrasion. One can also say that using this method we are able to affect the will or displacements that affect the size of the loss of polyethylene in joint arthroplasty hole. Despite the number of known and lessons learned arising from the results of solving the problem of design and development of experimental equipment for testing the acetabulum and hip arthroplasty wear identification using optical methods, this work is that the initial study to identify problematics wear of joint replacements. Complete resolution of this issue is beyond the scope of one doctoral thesis.
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Strain stress analysis of BS splint
Řehák, Kamil ; Fuis, Vladimír (referee) ; Florian, Zdeněk (advisor)
This master‘s thesis deals with strain-stress analysis of hip joint together with the final applied total endoprosthesis with Burch-Schneider cage. The main point of my work was to find the solution of stress–strain analysis state, which has been mentioned before in connection with Burch-Schneider cage. I describe the technique of geometric creation of whole body system, component´s materials or conditions which are neccessary for calculation. In coclusion there are results achieved in variants. In the first option the case of bone tissue was considered, which don’t reach degradation mechanical properties effect straining under Burch-Schneider cage. In some cases when the bone tissue is untimely forced, the necrosis of bone tissue takes place under Burch-Schneider cage. This possibility is described in the second option of type. For every option there was a case which was calculated with applied screw or without it. In all option mechanical features of cancellous bone tissue and their change influence on achieved results were considered. This problem was solved computational simulation in commercial software Ansys Workbench 12.0.
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Biomechanics study of hip join
Ebringerová, Veronika ; Marcián, Petr (referee) ; Florian, Zdeněk (advisor)
This work deals with the description of physiological joint resultant force and the subsequent comparison with patology of the hip. Then here is described the basic anatomy of the hip. Finally, ANSYS software was used to display the results both contact pressure and total mechanical strain intensity.
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SPECIFICS OF PHYSIOTHERAPY OF PATIENTS TRANSFERRED AFTER ORTHOPEDIC OPERATIONS DIRECTLY ON THE SO-CALLED SPA BUNK
JOHANUSOVÁ, Lucie
This bachelor thesis addresses the specificity of physiotherapy of patients, transferred to a so-called spa bed, after orthopedic surgery. Among the most performed orthopedic surgeries are the total hip replacement and the total knee replacement. Arthrosis is the most common reason for the implantation of joint replacements. It is a painful and life-aggravating disease which has a tremendous impact on the patient's quality of life. In order to lower the risk of the patient having to take a revision surgery of joints, a promptly initiated rehabilitation is necessary. It has to be intensive and professionally conducted. The present time-tested trend of rehabilitation treatment is a prompt comprehensive care, which takes place in a spa resort in the form of a direct transfer "from one bed to another", i.e. the patient is transported directly from the hospital to a spa resort. Often, patients would get to a spa resort with delay, while already having intercurrent problems like vertebrogenic and other problems. This thesis is divided into a theoretical part and a practical part. The theoretical part includes the anatomy of the hip joint and the knee joint, the description of the joint replacements including the indications and the contraindications, the specifications of particular types of hip and knee joint replacements and possible complications after surgery. The most important topics of the theoretical part are stated in the last chapters. The individual therapeutic rehabilitation methods, which have a positive impact on the health status of the patient after surgery, spa therapy and physical therapy included, are discussed and described in those chapters in detail. A qualitative research strategy and a personal case study technique (case history), with the use of a secondary data analysis, were used in the practical part. This strategy was carried out on three chosen patients, who after being discharged from a hospital after surgery had continued their treatment in a spa resort, i.e. a so-called direct transfer from a hospital bed to a spa. The research was conducted in Berta's spa resort in Třeboň, where the patients were transferred on the tenth day after surgery. On their first therapy session, all patients had their personal history taken and data from their medical documents was added. The practical part also includes a pre-therapy and a post-therapy kinesiologic analysis which included visual inspection, palpation, goniometric and anthropometric examination of the knee and hip joint area. Furthermore, a muscle test and an examination of shortened muscle groups related to the knees and hip joints, created by Janda, were conducted. The gait, stereotypes and neurologic functions were also examined. Following the evaluation of the pre-therapy data, the patients were introduced to the short-term therapeutic plan. The results were acquired by comparing the pre-therapy data and the data which was obtained during the last therapy session from the post-therapy kinesiologic analysis. The rehabilitation in the spa resort consisted of different treatment procedures each day and the patients were getting medical attention and care from doctors, nurses and physiotherapists. In each therapy, we focused on removing the problems at hand and only after that we moved to correcting other imperfections. After the completion of the therapy, the patients stated a decline of pain and an improved balance of the extremity and the whole body. The data of the chosen patients shows improvement of muscle strength, decreasing of swelling and widening of range of motion. These results were achieved thanks to a comprehensive rehabilitation and a positive attitude of the patients.
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The importance of regular fitness activities before planned orthopedic surgery
KOTLABOVÁ, Sandra
The bachelor thesis deals with the influence of regular fitness activities before the scheduled orthopedic surgery. The thesis discusses the use of special methods of physiotherapy and physical therapy to help patients prepare for their surgery and post-operative rehabilitation. The most common scheduled orthopedic surgery in the Czech Republic is a total hip joint prosthesis, it is applied up to 10 000 refunds anually. The total hip joint prosthesis is followed by a less frequent knee joint prosthesis. Implementation of any suitably chosen fitness activity before the surgery may be very useful and desirable for the patient.The current knowledge of the anatomy and biomechanics of bearing joints of the lower limb - knee and hip is summarized in the theoretical part of the thesis. This part also describes the joint compensation in detail. After that, there is mentioned the development of compensations in the course of history, as well as the different types of prosthesis and inserted components. Last but not least, there are described surgical approaches of implantation of the compensation. The theoretical part also includes appropriate physiotherapeutic procedures and methods of physical therapy that can be applied in a pre-operative period. The aim of this thesis is to explore whether regular fitness activities applied before the surgery have an impact on the course of post-operative rehabilitation. The qualitative research method was used to achieve the objectives in the practical part. The collect the data there were used case reports, interview, observation and photographic documentation. Three patients participated in the research, all diagnosed with osteoarthritis of the joint, two of them of the hip joint and one of them of the knee joint. Not a single one of those patients was cured by the conservative treatment, so they all were recommended for surgical treatment consisting of the replacement of the damaged joint. At the first meeting the medical history and the kinesiological analysis were taken. After evaluating the input data, patients were acquainted with therapeutic method. The therapy continued for one month, three times a week. After ending the therapy, the output kinesiology analysis was taken. Each of the patients told her subjective opinion about the course of the therapy and the changes experienced after treatment. All data were recorded and subsequently evaluated. During the therapy local findings were threated at the first place. Specifically the limited joint mobility, swelling of soft tissues around the joints and shortened or weakened muscles. They were used sensomotor techniques that are suitable for correction of flat foot or hallux valgus. The stabilization techniques PNF and activation HSS were used to strengthen the entire trunk and to restore the stabilizing function of the diaphragm. This was followed by the strengthening of the upper limbs to prepare them for future walking on crutches. The last point after the treatment of local findings was the setting of the joint in proper movement stereotype. When the therapy was finished, patients reported a mild pain relief and greater stability of their limb and the entire body. The collected data show also an improvement of the muscle strength of damaged joints for at least half a degree The indicator of the progress is the comparison of the goniometric examination before and after the therapy. The joint mobility was incresed. Surgical procedures were carried out without any complications and subsequent rehabilitation was with no problem for our patiens.
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The possibilities of physiotherapy treating children with evolutionary hip joints disorders
PEŠTUKOVÁ, Lucie
This bachelor thesis deals with the possibilities of physiotherapy treating children with evolutionary hip joint disorders. The theoretical part describes general background related to the issue. The content of the theoretical part brings a summary of findings related to the anatomic-physiologic relation of the hip joint, describes diagnostics and treatment of children affected by hip dysplasia and summarizes knowledge based on motor development of a child in relation to hip joints. Development Dysplasia of the Hip (DDH) belongs to the most frequent disorders of infant locomotor system and brings numerous morphological deviations that might include simple instability, subluxated or luxated femoral head or other serious pathologies. Therapy choice is then different, depending on the character of diagnosed deformities, and influences individual growth during development. Numerous factors contribute to DDH occurrence, originally the genetic factor used to be considered the main factor, new researches however mention influence of mechanic factors in prenatal live (e.g. foetus position during birth) as well as in postnatal live (e.g. forced deflection of legs immediately after birth or tight wrapping of an infant in swaddling clothes) and of higher hip capsular laxity. DDH treatment has undergone lots of changes during development. The Czech Republic is one of few states paying special attention to early detection and therapy. Research into the issue is linked to great figures like Zahradníček, Frejka, Pavlík and many more. Screening tests already start at maternity wards and continue to the following weeks of life in our conditions. Deviations are detected through clinical examinations performed by a paediatric orthopaedist and are based on images taken by various imaging methods. Therapy possibilities differ according to the joint damage character. Less serious hip joint deformities are treated by conservative methods including treatment with abduction aids including e.g. Frejka Pillow, Pavlík Stirrups and others. Surgery interventions and hospitalization have to be applied to more serious cases. DDH treatment is relatively successful nowadays and starts immediately after pathology detection. Nevertheless there are mixed opinions on treatment requirements among specialists. A lot of orthopaedists are satisfied with conservative treatment immediately after detection. Influence of this kind of therapy has its justification and its irreplaceable importance backed by numerous studies. Today?s physiotherapy tends to offer children with diagnosed DDH supportive rehabilitation methods that might enrich conservative treatment set by an orthopaedist. Cooperation with physiotherapists after successful treatment of children with DDH not only after surgical operations, but also after conservative treatment application is also developing. Children are often left to their own development after removal of abduction aids, which may be dangerous for future interplay of muscles (not activated before) after a long period of movement restriction. Qualitative research method in the form of elaborated case study of one patient with diagnosed DDH was chosen for the practical part. The thesis includes an introductory as well as final kinesiological analysis, description of the therapy course, the evaluation itself, communication with the mother and the physiotherapist in charge of the rehabilitation. The aim of the thesis was to point out the inseparable role of physiotherapy in treatment of children with DDH, to propose possible rehabilitation techniques for DDH treatment and to outline the way how Vojta method affects congenital hip joint disorders.
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Possibilities of physiotherapy in patients with complications after total hip endoprosthesis in
FEREBAUEROVÁ, Martina
There is an increase of number of the total hip joint prosthesis arthroplasties in last years and also the patient age limit is falling down. This leads (for prosthesis determined lifetime) also to the increasing of the number of re-surgeries because of aseptic release. This kind of surgery is for patient more strenuous than primary surgery and so brings higher risks of the possible complications. Complications are not rare even after the primary surgery of the total hip joint prosthesis arthroplasy. Most frequented complication is higher mentioned aseptic release, which results from the organism reaction to the abrasive PE particles, which fall off the worn joint. Next highly frequented complication is the infection in the total prosthesis area, where the cause could be local or global. The next feared complication is the luxation of the prosthesis after total hip arthtroplasty. This luxation is very soring and the nerve damages are possible. The nerve damage is potential also due the surgery. Next complications: thrombosis embolism, different length of the limbs, active scar tissues, lymphedema, heterotopic ossification, periprosthetic fractures, mechanical damage of the artificial hip components. According to the time of complication occurrence may be complications sorted as: pre-surgery, early, late. Target of this work is mapping of the physiotherapeutic procedures used at the patients with the complications after the total hip joint prosthesis arthroplasty. Next target is the processing of casuistries and physiotherapeutic plan forming by chosen complications. As research array were chosen three probands with different complications. The first proband is patient after re-implatation of total hip joint arthroplasty because of infection, second proband is diagnosed different limb length, third is patient with the active scar tissue. Therapy has been treated by every single proband individually and was fitted individually according to patients diagnosis. Due whole therapy was the unit for comprehensive physical training and physiotherapeutic procedures set to contemporary probands condition. This consists of theoretic part and practical part. Theoretic part deals with topics as hip joint anatomy, hip joint aloplastic and complications, which could because of aloplastic occurred, re-implantation of total prosthesis athroplatsty and in meant problematic used physiotherapeutic procedures. The qualitative research was chosen for the practical part of work. Results are worked out as casuistries using the methods of interview, spectating, secondary data analysis and kinesiological testing. The physiotherapeutic plan design is based to initial kinesiological test. Therapy was treated according to this plan. The output kinesiological test was worked out in the end of therapy and after results evaluation was designed long-term physiotherapeutic plan. The therapy was treated 4-5 weeks to every patient. The results say that by all patients came improvement of the movement extent in the operated hip joint, also to the pain reduce or pain elimination, increasing of the muscle power and the walking stereotype. However, some of the pathological movement stereotypes and muscle shorting still remain or were just partially reduced. Altogether, with the total hip joint prosthesis arthroplasty patients with different complications are connected strong muscular dysbalances and disrupted stereotypes of movement and walking. These changes are caused by antalgic position in the joint. Shortly, if the hip joint is long-term affected, then will be the affect evinced on the global deportment.
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Specifics of nursing care of children affected by developmental dysplasia of the hip
MÁLKOVÁ, Veronika
This thesis is dealing with the nursing care in children with developmental dysplasia of the hips. It is focused on it´s specifics. The results of the thesis show that the role of the nurse is important and includes preparations and assistence during the examination. In the nursing care includes especially hygienic care, education, emphasis on prevention of complications. The nurse preforms practical demonstrations of ortopaedics aids. Within the operation care and during hospitalization the empasis is laid on all mentioned above and also on the support of the child - relief of the pain, fear and anxiety.
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