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A review study of standards for strength analysis of total knee arthroplasty
Štaffová, Markéta ; Hájek, Petr (referee) ; Marcián, Petr (advisor)
This bachelor thesis is focused on the study of standards for strain and stress analysis of TKR (total knee replacement) - especially of the femoral component. In the first part of the thesis is a research of the knee replacement. This part beggins with anatomy, movements and loading of the knee joint, and continues to medical indications for replacement, the various parts and types of knee arthroplasty, and the materials used in TKR, including the durability of the knee arthroplasty. The next section of the thesis describes the standards, that are used for the knee arthroplasty, detailing standards for pre-clinical evaluation and standards for testing components of knee replacement using computer software with FEA. Finally, the thesis presents the application of the standard for femoral component testing using FEA. This standard is used to the comparison of two femoral components and their strain-stress analysis.
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Physiotherapy case report of a patient diagnosed with total knee arthoplasty
Šupík, Ondřej ; Vláčilová, Ivana (advisor) ; Pospíchalová, Tereza (referee)
vi Abstract Author: Ondřej Šupík Supervisor: PhDr. Ivana Vláčilová, Ph.D. Title: Physiotherapy case report of a patient diagnosed with total knee arthroplasty Objectives: The aim of this bachelor's thesis is to process theoretical knowledge, case studies and to record the effect of the performed therapy in a patient with a diagnosis of total knee arthroplasty. Methods: The work has a theoretical and a special part. In the theoretical part, data collection from professional literature, professional articles and studies was used. In the special part, data collectedas part of continuous professional practice at the Malvazinky Rehabilitation Clinic are used. The special part contains data collected by the input kinesiology analysis, therapeutic units and the output kinesiology analysis. Results: The rehabilitation process, which is processed in a special part of the work, improved the patient's postoperative condition. In the operated knee joint, there was mainlya reductionin pain, an increase in the range of motion,a reductioninswelling and hematoma. Furthermore, there was an improvement in the walking stereotype. Keywords: total endoprosthesis of the knee joint, rehabilitation, case report
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Case report of physiotherapeutic care of a patient after total knee replacement
Vášková, Mariana ; Dudová, Agnieszka (advisor) ; Hlavičková, Růžena (referee)
This bachelor's dissertation discusses a case report of physiotherapeutic care of a patient after total knee replacement. In the first, theoretical, part, anatomic structures, biomechanics of the knee, and knee replacement are described as well as the typology of operations and physiotherapeutic ap- proaches to patients after total knee replacement. In the second part, a case report is described. It contains anamnesis, initial kinesiologic examination, course of the therapy, final kinesiologic examination and evaluation of the therapy. The results of physiotherapeutic care of the patient are: increased range of motion of the knee, enhanced muscle strength in lower extremities, removal of some reflexive changes, and improved mobility of patella of the operated limb. As a result of physioterapeutic care, the overall condition of the patient has improved.
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Use of physiotherapy to restore function after total knee replacement
VORÁČKOVÁ, Marcela
The bachelor thesis deals with possibilities of early physiotherapy of patients after total knee replacement during hospitalization and explores its influence on improvement of the movement of the joint and muscular strength, healing of the surrounding tissues, increasing mobility and independence of the patient. It is divided into a theoretical and practical part. The theoretical part deals with the anatomy of the knee joint, its kinesiology and gonarthrosis. Further it contains information about total replacement, the actual surgery, and especially the description of a suitable therapy focused mainly on the postoperative phase during hospitalization and also after the discharge into the home care. The physical therapy and care abroad is also mentioned. The practical part consists of qualitative research. The aim was to compile patient case reports after this surgery and propose a rehabilitation plan for them. During the research, I cooperated with three patients. Each case report includes a medical history, an initial and a final examination with a suggestion of a short-term rehabilitation plan and its description. Moreover, there is an evaluation of the therapy and a draft for a long-term rehabilitation plan. The therapy was conducted every weekday during the hospitalization and the contribution of physiotherapy was evaluated on the basis of the comparison of the initial and final examinations results. All patients experienced a significant improvement in the flexion of the operated joint, gait and independence, increased muscle strength of the limb, decreased swelling and pain, and the pathological barrier of the tissues of the operated limb. However, the elasticity of the scar and tissues around the patella, trigger points and shortened muscle groups were not affected within the time allowed. Physiotherapy have proved to be highly beneficial to all these patients, but during the short time there has been no improvement or restoration of all the aspects observed. Therefore, it is important to continue with regular care even after leaving hospital. This work can be used by students as well as patients, who are about to undergo a surgery of this kind, and other health care staff.
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Physiotherapeutic procedures in the healing of the scars after orthopaedic surgery
MIXOVÁ, Pavlína
This bachelor´s thesis titled Physiotherapeutic Procedures in the Healing of the Scars after Orthopaedic Surgery discusses a new approach to scar healing after total knee and hip replacement. Due to the disruption of epidermis, subcutaneous tissue, fascia, muscle, bone and joint during the surgery, it is important to promote healing of the tissue both from nursing as well as physical therapy perspective. Wound healing following these procedures is extensive and can be affected by many negative and positive factors. The role of medical personnel caring for these patients is to eliminate the negative factors and promote positive ones. Newly created scars do not share the same properties with healthy skin tissuethey tend to be fragile and more liable to pathological processes. In some cases, the newly formed scar tissue can become activated and lead to referred pain. My thesis consists of two areas: theory and practice. The theory part was compiled to reflect current data in the following fields: skin anatomy and physiology; skeletal muscle anatomy; wound healing; scar definition and treatment; total hip and knee replacement; and physical therapy plans. The practice part of my thesis consists of qualitative research conducted with six patients after total hip or knee replacements. Physical therapy treatment was documented through case studies, including anamnesis, kinesiologic examination pre- and post-intervention, and actual treatment. Patient education was provided regarding appropriate scar care and scar massage. Patient teaching occurred individually. Patients were then provided with a handout on home instructions. Patients were regularly followed outpatient and had another examination two months after their procedure. My thesis concludes that implementing scar massage as part of post-operative plan led to improved perception of the scar by the patient as well as to improved healing of the tissue. Patients rated their experience overall as positive. Based on these findings, I firmly believe that patient education regarding appropriate scar care should be included in all discharge planning following orthopaedic surgery. These findings can be useful not only for physical therapists, but also for allied personnel, e.g., physical therapy students and nursing.
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Case report of physiotherapeutic care of a patient after total knee replacement
Vášková, Mariana ; Dudová, Agnieszka (advisor) ; Hlavičková, Růžena (referee)
This bachelor's dissertation discusses a case report of physiotherapeutic care of a patient after total knee replacement. In the first, theoretical, part, anatomic structures, biomechanics of the knee, and knee replacement are described as well as the typology of operations and physiotherapeutic ap- proaches to patients after total knee replacement. In the second part, a case report is described. It contains anamnesis, initial kinesiologic examination, course of the therapy, final kinesiologic examination and evaluation of the therapy. The results of physiotherapeutic care of the patient are: increased range of motion of the knee, enhanced muscle strength in lower extremities, removal of some reflexive changes, and improved mobility of patella of the operated limb. As a result of physioterapeutic care, the overall condition of the patient has improved.
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Specificities of physioterapy care after the convetional implantation of a total knee-joint in relation to its different surgical solutions
ŠMITMAJER, Jakub
The main aim of this bachelor study is concentrated on an after- total- knee- joint endoprosthesis physiotherapy from the surgical solution point of view. The total endoprosthesis is used as the very last possible option of an invasive means of therapy that is possible to take an advantage of when there is extensive damage of biomechanics of a knee joint. When speaking about the frequency of this operation, it is very high, and it is becoming a more and more common way of surgery that is nowadays being practised. The only more frequent orthopaedic surgery these days is a total hip endoprosthesis implantation. As a result of longer durability of the endoprostheses as well as better joint stability and owing to the great technological development it is possible to use various materials for making endoprostheses. However, there are appropriate demands on both the competence of the operational and consequently the rehabilitative staff working with a complicated structure of the prostheses. The study is divided into the theoretical and practical part. First, in the theoretical part there you can find analysed anatomy and biomechanics of a knee joint. Secondly, there are described indications and contra- indications of the total endoprosthesis implantation, types of total endoprostheses as well as the possibility of consequent physiotherapy. In addition, a method of qualitative research was used in the practical part of the study. There were two groups of patients under the reseach- including two women aged between 61 and 70 in each group.A different means of surgery for the total endoprosthesis of the knee joint was applied in each of the groups. There was also the same amount of time for the research of both groups. An entry kinesiological analysis was taken the sixth day after the surgery. Consequently the output kinesiological analysis was done after the second orthopaedical check- up (approximately the third month after the surgery), when a hundred per cent tread on the operated limb was permitted. The research itself took place in a hospital, afterwards it continued in domestic surrounding at home using available aids. Providing anamneses of all patients a goniometrical, anthropometrical and palpational check- ups of the knee joint were done. Furthermore, according to Janda, a muscle test and a check- up of shortened muscle groups related to the knee- joint were done as well. A functional check- up of a knee- joint muscles and an endoprosthesis itself was included in the output kinesiological analysis. All the patients were offered the same exercise unit to make better evaluation of the research. The frequency of regular exercise was set to a four-time period per week. An anthropometric check up showed that a post surgical swelling was more significant with the patients after the lateral parapatelar cut, that slows down patients' active joining the short- period kinesiotherapeutic schedule. The range of the movement in the operated knee joint was one of the main observing aspects that much differed already at the entry kinesiological check- up. The aim of the therapy was to achieve the minimum of 90 degree- active flexion of the knee joint at the end of the research. Both the patients after the medial parapatelar cut achieved the given point a few days earlier because the patients after the lateral parapatelar cut were provided with a motorial splint. This motorial splint enabled the patients to extend the range of movement in the joint. The power of muscles did not fundamentally differ comparing the output check- ups of both the groups, however the patients after the medial parapatelar cut achieved the muscle power degree 5. In addition, after the third month from the surgery, permitting 100 per cent tread on the operated limb, a functional check- up of muscles and the endoprosthesis of the operated knee joint was taken. It revealed stronger stability of the patients after the lateral parapatelar cut
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