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Effect of synovial fluid composition and surface topography modification on lubrication of joint replacements
Hekrle, Pavel ; Vampola, Tomáš (referee) ; Vrbka, Martin (advisor)
The main objective of this diploma thesis is to determine the influence of synovial fluid compodition and the influence of surface microtextures on lubrication of hip join replacements. For all experiments, hip joint simulator based on the pendulum principle was utilized. Metal heads (CoCrMo) manufactured by B Braun company and and tailor made acetabular cups from optical glass were used as contact couples. Acetabulum dimensions were fabricated according to dimensions of real implants. Experiments with surface microtextures simulated walking cycle for 210 s and development of lubrication film over time was observed.Results have shown that all types of tested structures improved lubrication of contact area, where the best results were obtained for square and triangle shapes respectively. Second set of experiments was based on the fact, that the composition of synovial fluid of healthy people differs from the composition of patients with various stages of osteoarthritis. Therefore, experiments with different model fluids were compared, which in their composition correspond to different groups of patients. For the model fluid that corresponds to the largest number of cases, experiments with individual components and combinations thereof were subsequently performed to provide a more detailed description of how these components affect the film-forming mechanism. The results show, that a change in fluid composition of patients with osteoarthritis can have a major negative effect on fluid formation process within the pair.
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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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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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Effect of synovial fluid composition and surface topography modification on lubrication of joint replacements
Hekrle, Pavel ; Vampola, Tomáš (referee) ; Vrbka, Martin (advisor)
The main objective of this diploma thesis is to determine the influence of synovial fluid compodition and the influence of surface microtextures on lubrication of hip join replacements. For all experiments, hip joint simulator based on the pendulum principle was utilized. Metal heads (CoCrMo) manufactured by B Braun company and and tailor made acetabular cups from optical glass were used as contact couples. Acetabulum dimensions were fabricated according to dimensions of real implants. Experiments with surface microtextures simulated walking cycle for 210 s and development of lubrication film over time was observed.Results have shown that all types of tested structures improved lubrication of contact area, where the best results were obtained for square and triangle shapes respectively. Second set of experiments was based on the fact, that the composition of synovial fluid of healthy people differs from the composition of patients with various stages of osteoarthritis. Therefore, experiments with different model fluids were compared, which in their composition correspond to different groups of patients. For the model fluid that corresponds to the largest number of cases, experiments with individual components and combinations thereof were subsequently performed to provide a more detailed description of how these components affect the film-forming mechanism. The results show, that a change in fluid composition of patients with osteoarthritis can have a major negative effect on fluid formation process within the pair.
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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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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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Patient after total joint replacement Preoperative and postoperative education
CHMELAŘOVÁ, Zdeňka
This bachelor thesis deals with the patients? education in the pre- and post-operative period after their joint replacement. Currently, the number of total endoprosthesis (TEP) operations has increased rapidly. Also in this case the role of a nurse as an educator is uninterchangeable and without her it is difficult to imagine such a demanding operation. It is the nurse herself or himself who draws patient?s attention towards all the aspects concerning pre-hospitalization period, hospital treatment and private care after the patient has been released home. It is the nurse who has to establish a relation of trust between a patient and hospital staff. The aim of this thesis was to elaborate methodically the TEP patient?s education possibilities in the pre- and post-operative period and to judge its quality from the TEP patient?s point of view. By means of an experimental survey and by fulfilling its aim it has been found out that the TEP patient?s education in medical institutions takes place, nevertheless, it is not on a sufficiently high level.
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