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Kazuistika fyzioterapeutické péče o pacienta s totální endoprotézou kyčelního kloubu
Aftzoglou, Petros ; Jalovcová, Miroslava (advisor) ; Ptáčková, Markéta (referee)
Title: Case Study of physiotherapy treatment of a patient with diagnosis of total hip replacement. Název: Fyzioterapie pacienta s diagnózou totální endoprotéza kyčelního kloubu Author: Aftzoglou Petros Summary Aim: This thesis is divided into two parts, theoretical and practical one. In the theoretical part the disease of osteoarthritis will be described as well as the examination and therapeutic approaches from physician and physiotherapist point of view. It will be also a detailed analysis of the procedure of total hip replacement. In the practical part it will be explained in details all the examination and therapeutic procedures I provided for the patient in Military Hospital of Prague (Ústřední vojenská nemocnice Praha) where my clinical work placement took place. The patient is a woman, 65 years old who had an operation of total right hip replacement on September 2010 because of osteoarthritis. The therapy took place in two weeks period and included six sessions. Key words: osteoarthritis, hip joint, physiotherapy, total hip replacement.
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The role of nurses and their impact on the care of patients with total hip arthroplasty.
SLABÁKOVÁ, Květoslava
Total hip replacement is one of the most extensively and highly effective operating methods in orthopaedics. The patients are brought back the self-sufficiency, life without the pain and noticeably motion restriction. Irreplaceable function here is a role of the nurse, who helps the patient to return back to his common life...The aim of this work was to find out, how the patients feel the role of the nurse and its influence to given nursing care before and after the total hip replacement as the less fulfilled. There were following research questions set: How the patients feel the role of the nurse before and after the total hip replacement? How the patients before and after the total hip replacement feel the interpretation of the nurse roles? How the patients before and after the total hip replacement feel the role of the nurse and its influence to given nursing care. Which of the nurse roles are felt by the patient as the unsatisfactory in postoperative care? The patients before and after the total hip replacement feel through the everyday nurse activities the nurse in her role of the caregiver and education giving person, following the nurse vindicator and the nurse bearer of changes. The patients feel the care thanks these roles as a quality, holistic and continual. Nevertheless was the role of the education giving named as the least fulfilled. In connection with these research results was created a manual, a Guide book for the patients before and after the total hip replacement. This Guide book was given to testing purposes. This Guide book was appreciated by the patients very positive despite a large amount of information, which were surprising for many of them. We gained some data, which gave the impulse to complete the information in the Guide.The created Guide book can´t replace the effective communication of the patient with the medical staff, which could be always the most suitable "source" of information.
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Lubrication of hip joint replacements
Rebenda, David ; Hartl, Martin (referee) ; Vrbka, Martin (advisor)
This thesis deals with the experimental study of lubrication of hip joint replacements. The influence of the synovial fluid composition and the head material to the lubricating film thickness were asssesed by using a pendulum hip joint simulator. Both of these effects were assesed under static and dynamic loading conditions. The experimental results showed that the movement of the head against the cup is unnecessary for the separation of the rubbing surfaces by a layer of adsorbed proteins. Composition of the synovial fluid then significantly influences the thickness of the lubricating film. Two opposite extremes have been observed during tests with two model synovial fluids. The first fluid formed a very strong lubricating film. The second sample almost prevent adsorption of proteins and consequently formed only very thin lubricating film. The influence of the material is noticeable when comparing the results obtained with a metal head and ceramic heads. Metal head formes under the same conditions thicker lubricating film. This evidence may be partly influenced by different diametrical clearances, which were in the case of ceramic heads higher.
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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 ; 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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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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Experimental study of friction and lubrication in THR
Urban, Filip ; Čermák, Jan (referee) ; Vrbka, Martin (advisor)
This work analyzes problems of friction and lubrication of total hip replacement (THR). At first, experimental study of friction coefficient under various conditions was conducted using hip joint simulator based on principle of pendulum. After that, lubrication film development was observed, using colorimetric interferometry with head from THR and glass cup with respect of geometry and clearance to cups made originally for THR. With respect to research study [25] it was found that increasing contact conformity leads to increased film thickness. Also protein adsorption on articulating surfaces was observed. Thanks to adsorption 80 nm film thickness was measured even if relative surface speed was zero. Furthermore protein aggregation was observed on the border of contact zone, similar aggregations were observed by Myant et al. [29] or Vrbka et al. [25]. These aggregations are formed when lubricant is under shear stress and it can positively affect film thickness. If the relative motion of articulating surfaces is not sufficient, the protein layer can`t be refreshed enough and film thickness start decreasing. Coefficient of friction 0,13 was measured when lubricating film development was observed. Close to this value are material combinations metal on polyethylene and metal on metal.
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History of hip joint replacements
Kohout, Jiří ; Urban, Filip (referee) ; Vrbka, Martin (advisor)
In this bachelor´s thesis is solved problem of friction, lubrication, wear and history of hip replacement. History is described from the second half of 18th century and there was an effort to include every important milestones that affected development of the alloplastic of hip joint. Beside this development is also observed volume wear of hip joint. History of lubrication and friction is watched from first experiment, which measured these factors it means mid-20th century.
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Foreknowledge of patients with total hip replacement at orthopedic department of Jinřichův Hradec hospital a.s.
DOUDOVÁ, Klára
Basic theoretical background: Because this thesis mainly deals with the awareness of clients, it was necessary in the beginning to mention the importance of the communication in a medical environment. Communication takes place between two or more people. During communication, people communicate necessary information, feelings, attitudes, talking about relationships and moods. There are several communication rules that one should follow, however, it depends on the individual, whether follow it or not. Communication skills can be developed gradually for they are important to us and in our personal lives. If a person loses the ability to communicate, it can lead to danger to his relationships with others. For healthcare professionals, it is very important social skill ( Mikuláštík 2003). Main aim of the thesis: To verify the information rate of clients in preoperative phase of total hip arthroplasty and in postoperative care. Discover also whether patients after total endoprosthesis have possibility of aftercare (rehabilitation, spa treatment). From these targets were developed following questions : In what areas are the clients in preoperative stage informed? How are clients reporting in a post-operative care ? What options of aftercare patients after total endoprosthesis have? Methodology: For the research was used the qualitative survey data collection. A qualitative investigation was approved by head nurse of the hospital, where the research has been done. The interviews was realized at home of clients. Survey was conducted through semi-structured interviews, interviews were anonymous. The data were collected in March 2015 in the set of seven respondents. Despite the fact that interviews were realized in the clients' home, we needed approval for the research from the head nurse. Especially because the subsequent care for patients after total prosthesis was also investigated. It was therefore important to identify initially the applicable patients in the hospital and up to a certain time after the surgery to interview them.
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