National Repository of Grey Literature 28 records found  1 - 10nextend  jump to record: Search took 0.00 seconds. 
Minimally-invasive approaches for the hip replacements
Kubeš, Radovan ; Koudela, Karel (advisor) ; Poul, Jan (referee) ; Landor, Ivan (referee)
Contemporary world and medicine are marked by very rapid development of miniaturization, which surprisingly not missed also endoprothetics and arised thankfully to the strong medial attention gigantic wave of public interest about possibility of mini - invasive operative. In public media was this method presented like revolutionary and almost like a nonstrum, first medical publications (especially from pioneers those techniques) were also generally positive, but also since the begginnig had this method also its non-supporters. Own idea of mini- invasive operative is without any doubt correct step into the future, theoretical benefits are indisputable and logical. In wiew of this facts, that it was for me "no man's land" , I decided as a first step to study all published facts and later than I began practical testing of mini-invasive approaches on cadavers studies and than finally after very carefully evaluation of all facts I started to perform mini-invasive approaches. In an effort to deprese maximally the learnig curve, I started my mini-invasive implantation with femoral component only - so cervicocapital endoprosthesis, only after estimation of this group and with newly acquired experiences I came up to perform MIS- THR .. Our statistically prooved final results tell us, that implantation THR...
Problems of the hip in patients with childhood cerebral palsy in childhood and adolescence. Experimentally influenced centering of the hip by a combination of operational tactics
Schejbalová, Alena ; Trč, Tomáš (advisor) ; Koudela, Karel (referee) ; Karpaš, Karel (referee) ; Kokavec, Milan (referee)
Cerebral palsy it must be nonprogressive brain lesion or lesions. The original lesion must occur prenatally, at birth, or early in the postnatal period. The primary disorder involves the musculoskeletal systém and lack of motor control, mental retardation or defects of hearing, language. Prevalence of cerebral palsy is different - between 0,6- 5,9 per 1000 births. In Western countries, the birth prevalence rate is about 2,0 per 1000. In children with cerebral palsy the hip joint appears to be relative nornmal at birth. There is abnormally increased femoral anteversion and neck-shaft angle. Increasing adduction-flexion contractures of the hip, acetabular dysplasia, subluxation eventual dislocation of the hip.Adduction deformity of the hip is caused by spasticity and contracture of the hip adductors and the medial hamstrings. Flexion deformity of the hip is primarily caused by spasticity and contracture of the iliopsoas and secondarily by rectus femoris muscles. When the rectus femoris is the cause, hip flexion deformity is increased with the knee in flexion and decreased with the knee in extension. When it is due to the iliopsoas muscle, the position of the knee has no effect on the degree of hip flexion contracture ( Thomas test). On passive flexion of the knee, if the test is positive, the pelvis will...
Mitigated infection in so called aseptic loosening of the total endoprosthesis of the big joints
Koudela, Karel ; Koudela, Karel (advisor) ; Jahoda, David (referee) ; Podškubka, Aleš (referee)
The theme of the work is infection in the aseptic loosening of total joint replacement of large joints. Thesis topic is very timely, since inflammatory complications accompanying large joint arthroplasty is one of the causes of failure of total joint replacement and subsequent revision surgery represents a major problem of health, social and economic. PhD thesis summarizes the known aspects of this issue.
Single-Bundle versus Double-Bundle Technique of the Anatomical Anterior Cruciate Ligament Reconstruction
Zeman, Petr ; Koudela, Karel (advisor) ; Skála-Rosenbaum, Jiří (referee) ; Kalina, Radim (referee)
Purpose of the study: The aim of the study is to present a comparison of two years result of double-bundle versus single-bundle anatomical reconstruction of the anterior cruciate ligament using hamstring tendons and their fixation with bioabsorbable interference screws. Material and methods: A total of 110 patients with an isolated anterior cruciate ligament rupture and the healthy contralateral knee who met the indication criteria for double- bundle anterior cruciate ligament reconstruction were intra-operatively allocated at random to either double-bundle group (DB, n=55) or single-bundle group (SB, n=55). At two years after surgery, 82 patients (DB group, n=43; SB group, n=39), comprising 66 men and 16 women, were evaluated; the average age was 29 years and the injury-to- surgery interval was 81 days. Pre-operative and post-operative subjective criteria involved the subjective IKDC and Lysholm score were evaluated. Objectively, the occurrence of graft failure, range of motion deficit, return to pre-injury sports activity, side-to-side difference in anterior laxity of both knees in 20ř flexion on a GNRB laximeter at an applied pressure of 124 N and 250 N, and pivot shift phenomenon were assessed. Results: No statistically significant difference was found in pre-operative values between the two...
Morphology of the Proximal Human Femur in Relation to Fractures of Trochanteric Massif
Báča, Václav ; Stingl, Josef (advisor) ; Koudela, Karel (referee) ; Chomiak, Jiří (referee) ; Laichman, Stanislav (referee)
AIM: Fractures of proximal end, especially fractures of trochanteric massif are very common particularly in old patients. The aim of the work was to try to find a morphological correlate of trochanteric fractures in the region of proximal end of the human femur. It means to find if a "locus minoris resistentiae" for trochanteric fractures origin exists. METHOD: The detailed overview of literature on femur as a bone, classification of trochanteric fractures and treatment of proximal end of the femur was accomplished (sources from medieval books to recent anatomical and clinical studies). Czech and Latin terminological aspect (Terminologia anatomica 1998) of the femur as well as their development were carefully studied. 40 femurs from embalmed bodies with muscles and ligaments were studied by detailed dissection. 99 X-ray pictures of pertrochanteric fractures were checked. 106 dry femurs from the vascular canal distribution point of view were evaluated and compared with previous group of X-rays. Statistic evaluation of normal distribution according to Kolmogorov-Smirnov's test and Liliefors's modification was made in 15 regions of trochanteric massif. 20 dry femurs according to Heřt, Fiala and Petrtýl's method were repeatedly ground to depict the central vascular canals and to describe the course of osteons...
Treatment of Deep Chondral Defects with Autologous Chondrocytes
Podškubka, Aleš ; Koudela, Karel (advisor) ; Karpaš, Karel (referee) ; Musiálek, Jaroslav (referee) ; Vavřík, Pavel (referee)
Treatment of Deep Chondral Defects in the Knee with Autologous Chondrocytes Fixed on a Scaffold Form of Hyaluronic Acid Esters (Hyalograft C) Abstract Aim of the study In the past few years we have seen further progress in the treatment of chondral defects by transplanting autologous chondrocytes. Different biomaterials are used as temporary carriers for fixation and an even distribution of chondrocytes in the defects. Since 2003 we have implemented a clinical trial for the treatment of deep chondral defects in the knee by transplanting autologous chondrocytes fixed in a scaffold from hyaluronic acid esters (Hyalograft C). This material has been evaluated in a prospective study. Material We evaluated results in 8 transplanted patients (7 males and 1 female, average age 31 years) with a minimal follow up of 9 months after surgery. Defects of an average size of 3,9 cm2 were localized on femoral condyles. Method We evaluated the functional outcomes (IKDC, K.OOS, Lysholm score) and performed MRI before and 3, 6 and 12 months after surgery. The newly formed cartilage was controlled visually (ICRS visual score) during a second-look arthroscopy at 9 to 12 months after transplantation. We compared the stiffness of the repair tissue at the site of the original defect with the surrounding cartilage using a specially...
Intra-articular Calcaneal Fractures - Osteosynthesis with Calcaneal Locking Compression Plate - Contribution to Fill Defect in Body of Calcaneus
Zeman, Jaroslav ; Koudela, Karel (advisor) ; Plánka, Ladislav (referee) ; Skála-Rosenbaum, Jiří (referee)
Calcaneal fractures are common injuries that prevent patients from getting on with their normal life for a long time. They are usually caused by axial forces leading to impaction of the talus into the calcaneus. Falls and jumps from heights are the most common causes. These fractures also occur bilaterally. We used open reduction and internal fixation with a calcaneal LCP for the treatment of 98 patients with 114 calcaneal fractures in our department from August 2005 till December 2011. Bilateral fractures of the calcaneus occurred in 16 patients - 2 women and 14 men. On the day of injury plain radiographs of the calcaneus in lateral and axial projection were taken. Computed tomography was performed in all operated patients in sagittal, transversal and coronal planes. On the basis of CT findings the fractures were classified as Sanders types I - IV. Patients with type II and III fractures were indicated for surgical ORIF treatment. The results were evaluated using the Rowe score. The aim of the experimental work was to assess the biomechanical strength of the calcaneus without fracture and to compare it with the strength of the calcaneus after the osteosynthesis with an angular stable plate alone or in combination with filling of the calcaneal defect with injectable self-hardening hydroxyapatite...
Utilization of local carriers of antibiotics for treatment of infection of locomotive apparatus
Melicherčík, Pavel ; Jahoda, David (advisor) ; Koudela, Karel (referee) ; Džupa, Valér (referee)
Infections of locomotive apparatus presents serious problem in orthopeadic and traumatology for a typical course with recidivisms and often evolution to bacterial resistance. Eradication of bacterial causers of infections of locomotive apparatus not have to be always reliable. One of possibility how to increase therapeutic potential is utilization a local aplication of antibiotics. Aim of dessertation thesis is verify influence of released glycopeptide antibiotic vancomycin from bone grafts in experiment in vitro after previous comparasion of properties in 34 chosen carriers from point of view both material constitution and elution characterization for different antibiotics on the strength of sources from accessible literature. The most widespread used local carrier of antibiotics is bone cement intended firstly to solve infections of alloplasties by two-stroke reimplantation. There is necessary subsequent its extraction compared to newer, biodegradable carriers. The best properties from a view of criteria suitable local carrier of antibiotics in orthopeadic and traumatology have carriers composed from several sort of materials, so-called composites. On the strength of results performed experiment we verified that bone grafts could be a good local carrier of vancomycin. Highest average...
Periprosthetic osteolysis
Veigl, David ; Vavřík, Pavel (advisor) ; Vencovský, Jiří (referee) ; Koudela, Karel (referee)
Periprosthetic osteolysis remains the leading complication of total hip arthroplasty. It often results in aseptic loosening of the implant with a requirement for a revision surgery. Wear-generated particular debris is the main cause of initiating this destructive process. The most important cellular target for wear debris is a macrophage, which responds to particle challenge by activatig proinflamatory signals, which contribute to increased bone resorption. The activation of the RANKL/RANK/OPG system is considered to be a likely cause of periprosthetic osteolysis leading to implant failure. The aim of this study was to examine the possible correlation between the clinical extent of osteolysis, the number of wear particles and the expression of the osteoclastic mediator RANKL in the tissues around aseptically loosened cemented and non-cemened total hip replacements. Periprosthetic tissues were harvested from 59 patients undergoing revision hip replacement for aseptic loosening. We had observed RANKL-positive cells in 23 of our 59 patients, their presence was noted predominantly in tissues with a loosened cemented endoprosthesis. We have shown that RANKL is present only in the tissues with a large amount of wear debris and predominantly in the cases involving lacunar type of osteolysis. Key words:...
The influence of the quality of articulation UHMWPE inserts on the lifetime of joint replacements
Fulín, Petr ; Pokorný, David (advisor) ; Koudela, Karel (referee) ; Gallo, Jiří (referee)
This thesis focuses on the introduction with the problems of high molecular weight polyethylene (UHMWPE) in orthopedics in the first part. It discusses the history, properties and processes that lead to the failure of UHMWPE joint replacement components. The experimental part validates the hypotheses expressed. It acquaints readers with the experimental verification of the effect of different types of sterilization on the oxidative stability of laboratory prepared samples and explanted UHMWPE joint replacement components using methods of infrared microscopy, electron spin resonance, mechanical tests and tests of microhardness. Other experimental measurements on a large set of explanted components of hip and knee total joint replacements validates the hypothesis that the amount of oxidative damage affects the lifespan of joint replacements. The third part of the experimental study maps the degree of oxidative damage in different places of the hip and knee joint replacements. In the final part we experimentally demonstrate the fact that the rate of oxidative damage has an effect on supramolecular structure of the UHMWPE. From the above experiments are concluded clearly defined recommendations for clinical practice, which should lead to extend the lifespan of total joints replacements in orthopaedics....

National Repository of Grey Literature : 28 records found   1 - 10nextend  jump to record:
Interested in being notified about new results for this query?
Subscribe to the RSS feed.