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Mechanical Analysis of the Influence of Fabrication Tolerances on Contact Conditions between the Acetabular Cup and the Femoral Head in Total Hip Replacement
Koukal, Milan ; Horyl, Petr (referee) ; Repko, Martin (referee) ; Janíček, Přemysl (referee) ; Florian, Zdeněk (advisor)
In endoprosthesis surgery there are typically a high percentage of implant defects, these can lead to failure of the whole prosthesis. One type of total hip replacement function loss is acetabular cup loosening from the pelvic bone. This disertation examines manufacture perturbations as one of the possible reasons for this kind of failure. Both dimension and geometry manufacturing perturbations of ceramic head and polyethylen cup were analyzed. We find that perturbations in the variables analysed here affect considered values of contact pressure and frictional moment. Furthermore, contact pressure and frictional moment are quantities affecting replacement success and durability. From obtained results it can be recommended to fit head and cup with a clearance of between 0 mm and 0.05 mm. It can not be recommend using interference type of fit because of strong deterioration of the contact conditions. Roundness perturbation of ceramic head should not exceed 0.025 mm.
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Quality of life in patients before and after total hip replacement
ŠIDÁKOVÁ, Alena
The objective of this thesis is to assess quality of life of patients before and after total hip replacement. To determine HRQoL {--} Health Related Quality of Life I used standardized questionnaire SF-36 which assesses eight basic qualities (domains) of life. This thesis has 2 parts: a theoretical part and a practical part. Anatomy of the hip, total hip replacement, quality of life in general and quality of life in chronic diseases are described in the theoretical part. The practical part was prepared using quantitative research, the technique of anonymous questionnaire SF-36. The respondents were clients of the orthopaedic outpatient clinic of hospital in Klatovy. The final sample comprised 18 women and 11 men. Results were recorded in electronically. The Department of Clinical Pharmacology of hospital in České Budějovice provided evaluation of the results. Data obtained about probands were compared with results of Oxford Healthy Life Survey and also with each other. The results were made into well-arranged graphs and charts. The structure of charts is uniform, the value from research and the value from Oxford (always 100%) are stated next to each other. Results obtained from the practical part can be used to supplement education materials which relate to this issue. The results are very encouraging. Quality of life after total hip replacement has improved. Especially in the domain of bodily pain (P) where the probands reached the results of 86.79%. The difference between Oxford {--} 100 % (healthy population) is therefore only 13.21 %. Probands achieved best result in domain General health perceptions (GHP) 141.38 %. Two hypotheses were stated in the introduction. Hypothesis 1 was: Quality of life of patients will improve after total hip replacement. Hypothesis 2 was: Consumption of analgesics will decrease after the surgery. Both hypotheses were confirmed. Obviously, the results in some domains will remain lower compared to healthy population but the overall quality of life of patients after total hip replacement has improved. The objective of the thesis was accomplished. Resources used are listed in the conclusion of the thesis. Appendix includes for example the questionnaire SF-36 or information leaflet with obtained data (pain reduction, improvement in certain domains of quality of life etc.) which will be used to educate patients in waiting rooms in outpatient clinics.
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