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Development of the surgical instrumentarium for the anterior cruciate ligament reconstruction by the hamstrings tendons
Hanus, Martin ; Trč, Tomáš (advisor) ; Podškubka, Aleš (referee) ; Douša, Pavel (referee)
The paper presents the development of instrumentaria designed to solve ACL lesions using hamstrings (tendons of semitendinosus and m. gracilis - ST / G). The work itself took place in two phases. Part of the first phase was the development of its own instrumentation, including the implant designed to fix hamstrings tendons. The inherent part of the development was the performance of both mechanical and functional tests. The most tested element of the instrumentation was the screw with eye. In the course of its development, mechanical tests of tensile strength were carried out on the individual variants of the solution, and then the rapture of the screw with the eye from animal bone - simulating the function of the product in a real environment. Part of this was the development of methodology and work with new instrumentation. Clinical testing was performed in the second stage and the results of the operations are part of the work. The self-developed ACL lesion reconstruction toolkit is designed to use a graft made up of four strands of the above tendons. In the experimental part of the instrumentation development, the suitability of the implant for clinical use has been demonstrated. The newly developed instrumentation for ACL reconstruction, using the test implant for fixation of the hamstrings...
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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...
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Development of the surgical instrumentarium for the anterior cruciate ligament reconstruction by the hamstrings tendons
Hanus, Martin ; Trč, Tomáš (advisor) ; Podškubka, Aleš (referee) ; Douša, Pavel (referee)
The paper presents the development of instrumentaria designed to solve ACL lesions using hamstrings (tendons of semitendinosus and m. gracilis - ST / G). The work itself took place in two phases. Part of the first phase was the development of its own instrumentation, including the implant designed to fix hamstrings tendons. The inherent part of the development was the performance of both mechanical and functional tests. The most tested element of the instrumentation was the screw with eye. In the course of its development, mechanical tests of tensile strength were carried out on the individual variants of the solution, and then the rapture of the screw with the eye from animal bone - simulating the function of the product in a real environment. Part of this was the development of methodology and work with new instrumentation. Clinical testing was performed in the second stage and the results of the operations are part of the work. The self-developed ACL lesion reconstruction toolkit is designed to use a graft made up of four strands of the above tendons. In the experimental part of the instrumentation development, the suitability of the implant for clinical use has been demonstrated. The newly developed instrumentation for ACL reconstruction, using the test implant for fixation of the hamstrings...
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Biomechanical and clinical evaluation of different reconstruction techniques of the anterior cruciate ligament
Kautzner, Jakub ; Havlas, Vojtěch (advisor) ; Podškubka, Aleš (referee) ; Skála-Rosenbaum, Jiří (referee)
Aim: This disertation study was divided into two main topics, clinical trial and biomechanical experiment. The aim of clinical part was to evaluate and compare clinical outcomes after ACL reconstruction using two main types of autografts in woman patients. Eperimental part of the study was designed to investigate the effect of graft interaction with the fixation material on biomechanical properties of the graft. Methods: In clinical part of the study 150 female patients after ACL reconstruction after 2 years postoperatively. Clinical results based on Tegner-Lysholm score, knee laxity and anterior knee pain were recorded for both groups and then compared. Experimental part of the study was designed to evaluate the biomechanical properties of hamstring grafts using load-to failure impaction testing using laser vibrometer. The effect of graft's structure damage on the biomechanical properties of the graft was tested. Results: Tegner-Lysholm score improved in both observed groups, there was no significant difference in results between both groups at 2 years postoperatively. The experimantal part of the study supported the hypothesis that the biomechanical properties will be significantly affected by the interaction with the fixation device Conclusion: Clinical results show no difference between the two...
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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...
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