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A Case Study of a Physiotherapeutic Treatment for a Patient with a Diagnosis after Total Hip Replacement
Klocoková, Alexandra ; Kučerová, Ilona (advisor) ; Sohrová, Jana (referee)
v Abstract Author: Alexandra Supervisor: Mgr. Ilona Title: A case study of a physiotherapeutic treatment for a pacient with a diagnosis after total hip replacement Objectives: Summarization of theoretical and practical knowledge about total hip replacement and to process the case study with this diagnosis. Methods: This thesis consists of two main parts - a theoretical part and special part. The theoretical part includes information of osteoarthrosis with total hip replacement. It describes the structure of the hip joint, defines osteoarthrosis and its risks, indications for the total endoprothesis, different types of hip implants, surgical approaches and pre- and post- rehabilitation processes. The special part contains the case study of pacient after implantation of the total hip endoprothesis. It presents the evaluation of the therapy which started on the fifth day after implantation and ended on the fourteenth day. Results: The short term goals which were specified at beginning of therapy were accomplished. We managed to increase the range of motion at the operated leg, increase muscle strength on weaker muscles, stretched shortened muscles and decreased muscle tone on hypertrofic muscles. Further we improved walking stereotype, increased physical fitness and performed the treatment on soft tissues....
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Case Study of Physiotherapeutic Treatment of a Patient with the Diagnosis TEP the hip joint
Hoppeová, Andrea ; Kočí, Gabriela (advisor) ; Nováková, Tereza (referee)
Author: Mgr. Andrea Hoppeová Supervisor: Mgr. Gabriela Kočí Title: Case study of physiotherapeutic treatment of a patient with the diagnosis TEP of the hip joint. Objectives: The aim of this bachelor thesis is elaboration of a case study of a patient after implantation total hip joint. Methods: The case study was elaborated at the impatient care. Part of the therapy the medical history was established and the elaboration of input and output kinesiological analysis. Afterward the objectives were made. During 9 therapeutic units in which was used excercises to prevent TEN. Next were used soft tissue techniques, joint play mobilization also techniques with soft balls, relaxing techniques, analitic strengthening, taking care of scar and practice of locomotion and mobility. Results: During the treatment pain was lowered, the swelling was reduced, the range of motion was increased same as muscle strenght, recovery of joint play and partial release of soft tissues. Reeducation of breathing stereotype and movement stereotype to abduction and extencion in hip joint prove to be unsuccessfull. Conclusion: In short terapeutic plan which consisted of intervention of nine therapies the patient made positive changes and most of the objectives were completed. Keywords: Case report, total hip replacement,...
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Case Study of Physiotherapeutic Treatment of a Patient with an ankylosing spondylitis and after total hip replacement
Svobodová, Daniela ; Martínek, Milan (advisor) ; Zinková, Iva (referee)
Author: Daniela Svobodová Supervisor: Mgr. Milan Martínek Ph.D. Title: Case study of physiotherapeutic treatment of patient with an ankylosing spondylitis and after total hip replacement Objectives: The aim of this bachelor thesis is to elaborate the topic of hip joint replacement and ankylosing spondylitis in the form of a case study of a patient and at the same time to present this issue in a theoretical form Methods: The case report of the patient was elaborated during the concurrent professional practice at the Institute of Rheumatology in Prague, during the 3rd year of the bachelor's degree in physiotherapy at Charles University, Faculty of Physiotherapy. For the preparation of the case study, a detailed history of the patient was first taken and an initial examination was performed. This was followed by 9 therapeutic units spread over 2 weeks, at the end of which a complete exit examination was performed to the same extent as the entrance examination. Data from the initial and outcome examinations were then compared to assess the effect of therapy. The theoretical knowledge related to the patient's case was described in the theoretical part of the thesis. All the knowledge about the methods and procedures used in the practical and theoretical part was acquired during my bachelor studies and...
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Case study of physiotherapeutic care for a patient with diagnosis of total hip replacement
Šterbák, Daniel ; Homonická Pyšková, Barbora (advisor) ; Nováková, Tereza (referee)
v Abstract Author: Daniel Šterbák Supervisor: Mgr. Barbora Homonická Pyšková Title: Case study of physiotherapeutic care for a patient with diagnosis of total hip replacement Objective: The aim of this bachelor thesis is to summarize the issues of coxarthrosis, hip arthroplasty, specifically total hip replacements, and the care for patients with this diagnosis in the theoretical part. In the practical part, to process a case study of physiotherapeutic care for a patient after total hip replacement. Methods: In the first general part of the thesis, information about the hip joint, coxarthrosis, hip arthroplasties, and preoperative and postoperative care options are summarized based on literature sources and relevant research articles. The following specific part consists of a case study, which includes an initial kinesiological analysis, therapeutic plans with rehabilitation goals, records of therapeutic units, an output kinesiological analysis, and an evaluation of the performed therapy. Results: The set goals were mostly achieved, as evidenced by the differences between the initial and output kinesiological analyses. It was possible to eliminate, completely or largely, most of the undesirable reflex changes in soft tissues, increase the range of motion and muscle strength of the muscles of right lower...
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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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Stress - strain analysis of total hip replacement - type Santori
Huťka, Pavel ; Fuis, Vladimír (referee) ; Florian, Zdeněk (advisor)
Submitted Diploma thesis deals with stress-strain analysis of deformation proximal end of femur with applied total hip joint endoprosthesis (replacement) – shortcut type. To identify deformation and tensity (stress) was used computational simulation by method of final elements. Have been created two computational models TEP- type Santori and type DePuy Proxima. Geometry model Santori was created on low level model geometry through the use of X-ray photograph. Principle of geometry model type DePuy Proxima was real Femoral stem endoprosthesis which was scanned on scanner ATOS. Geometry of both these replacements were set up in program Rhinoceros 4.0 and then execute in program CatiaV5R17. Data for geometry model of femur were gained from CT chains. Material model of femur have been crated in two variants. The first one looks at structure bone tissues and the second one were created by Gruen´s zones. Femoral Stem was weighted by static equivalent resultant force acting in hip joint. Computational model of system and self solution, including depiction results, was done by ANSYS Workbench 11.0 for four model variants.
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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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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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VOLUMETRIC WEAR ANALYSIS OF HIP JOINT IMPLANTS BY OPTICAL METHODS
Ranuša, Matúš ; Bryant, Dr Michael (referee) ; Dr Prashant K. Sharma (referee) ; Vrbka, Martin (advisor)
Predložená dizertačná práca sa zaoberá analýzou opotrebenia totálnych bedrových endoprotéz za použitia optických metód. V práci bol predstavený nový prístup hodnotenia objemového úbytku materiálu pomocou 3D optického skeneru. Tento nový prístup je časovo efektívny, poskytuje veľké množstvo snímaných bodov na povrchu implantátu. Množstvo bodov umožňuje presnejšiu rekonštrukciu pôvodnej geometrie a prípadné rekonštrukcie nežiaducich poškodení polyetylénovej vložky pri extrakcii. Predstavené metóda bola validovaná za pomoci štandardizovanej gravimetrickej metódy v súlade s ISO 14242. Následne bol optická skenovacia metóda použitá v troch štúdiách zameraných na analýzu opotrebenia, mechanické zmeny artikulujúceho povrchu a mikroštruktúrne zmeny v dôsledku zlyhania implantátu. Analýza 23 extrahovaných polyetylénových vložiek typ Bicon - plus s rozšíreným použitím v Českej republike poukázala na niektoré problémy spojené so zlyhaním implantátu. Adhezívno - abrazívne opotrebenie bolo identifikované v oblasti penetrácie femurálnej hlavice a následné poškodenia ako delaminácia materiálu , plastické deformácie a pitting boli pozorované v okolí tejto oblasti. Analýza materiálových vlastností poukázala na degradáciu mechanických a chemických vlastností, čo bolo prevažne závislé od rozsahu opotrebenia implantátu. U implantátov boli pozorované výrazné plastické deformácie , nárast oxidačného indexu a nižší pomer tvrdosti voči modulu elasticity, v porovnaní s novými vzorkami. Tečenie materiálu a plastické deformácie, ktoré vykazovali všetky extrahované vzorky boli analyzované v závere predloženej dizertačnej práce, na základe testov na nových implantátoch v zábehovom cykle. Cieľom práce je uviesť nový prístup analýzy opotrebenia polyetylénových vložiek za pomoci optických skenovacích metód a preukázať jeho použiteľnosť na analýze súboru extrahovaných implantátov. Výsledky získané pomocou tejto metódy sa ukázali ako vhodné a môžu viesť k lepšiemu pochopeniu procesov opotrebenia a zlyhávania implantátov.
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