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Comparison of the long-term results of conservative and surgical therapies in children's hip pathology according to the type and degree of the disease
Stančák, Andrej ; Trč, Tomáš (advisor) ; Šponer, Pavel (referee) ; Kokavec, Milan (referee)
Legg-Calvé-Perthes (LCP) disease is associated with non-vascular necrosis of proximal epiphysis of the femur resulting in resorption of necrotic bone and subsequent remodelling of femoral head. The risk factors of the disease and factors affecting the treatment outcomes following conservative or surgical therapy are not completely understood. The first part of the thesis outlines the clinical and research problems pertaining to conservative and surgical treatment of LCP disease. The second, clinical part retrospectively analysed the predictors of treatment outcomes in patients treated conservatively or surgically, with emphasis on children younger than 6 years of age. The experimental part of the thesis analysed 3D kinematic data of the gait and hip range-of-motion data in patients treated conservatively or surgically. Age of the patient at the time of diagnosis and the shape of the lateral pillar of femur were significant predictors of treatment outcomes, and treatment outcomes after surgical treatment were comparable in children below and above the age of 6. Gait analysis showed a larger displacement of the pelvis in sagittal plane during the initial 25% of the standardised gait cycle and a larger extent of knee flexion during initial 13% of the gait in patients treated surgically compared to...
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Development and evaluation of new cementless revision acetabular components for total hip arthroplasty / type TC /
Šťastný, Eduard ; Trč, Tomáš (advisor) ; Šponer, Pavel (referee) ; Pilný, Jaroslav (referee)
Development and evaluation of new cementless revision acetabular components for total hip arthroplasty / type TC / Objective: The aim of the clinical part of the study was to introduce a new revision oval cup type TC, and evaluate its reliability and utility in revision endoprosthesis. Due to the different structure of the implant, we aimed to objectively demonstrate the remodeling of bone tissue in its vicinity. In the experimental part of the work we verified the hypothesis that the use of locking screws has an effect on the bond strength of the implant with bone tissue, and therefore on the primary stability of the acetabular component. Method: We evaluated 31 patients that underwent revision hip surgery between 2004 and 2008. The mean follow-up was 7.1 years (range 5.3 to 9.3 years, minimum 5 years after surgery). Osteointegration of the implant and remodeling of bone tissue around the implant and its ribs were evaluated by digital radiography and computed tomography, and clinical results according to Harris. The experiment was based on the execution of pull-out tests after the implantation of TC cups in cadaveric bovine pelves. We evaluated the dependence of tensile forces in the axis of the implant on extraction of the metal cup from the bone bed. Four tests were conducted with the cup fixed...
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Minimally Invasive Cancellous Bone Graft Harvesting in Trauma Indication - Experimental and Clinical Study
Látal, Pavel ; Kloub, Martin (advisor) ; Dráč, Pavel (referee) ; Šponer, Pavel (referee) ; Lacko, Marek (referee)
Univerzita Karlova 3. lékařská fakulta Disertační práce - Abstract Miniinvazivní odběr spongiózních štěpů v traumatologické indikaci - experimentální a klinická studie Minimally Invasive Cancellous Bone Graft Harvesting in Trauma Indication - Experimental and Clinical Study Školitel: MUDr. Martin Kloub, Ph.D. Abstract The thesis "Minimally invasive cancellous bone graft harvesting in trauma indication" deals with the strategy of treatment of complicated fractures and false joints using miniinvasively collected bone grafts. The thesis includes experimental and clinical parts. The aim of the experimental part is a laboratory comparison of red bone marrow content in mini-invasively taken bone grafts from ten cadaver specimens from chosen sites with the reference collection from the ilium of the hip bone. In the clinical part of the study we focus on the practical results of this surgical technique, especially on the amount of spongy bone tissue collected, efficiency of its use and complications. We evaluate the pain in the area of graft collection site and compare it with the pain after the standard collection from the ilium of the hip bone. In the experimental part of the thesis, we confirmed the content of red bone marrow in mini- invasive bone grafts from the area of the greater trochanter, distal femur,...
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Effectiveness of Sonographic Examinations in Prevention and Treatment of Developmental Hip Dysplasia
Zídka, Michal ; Džupa, Valér (advisor) ; Kokavec, Milan (referee) ; Šponer, Pavel (referee)
Purpose: The aim of the study is to demonstrate the success of early detection and the efficacy of early hip dysplasia treatment within neonatal hip screening in the Czech Republic. Measures are proposed to optimize follow-up and maintain long-term sustainability of the newborn care. Materials and Methods: 316 children with various degrees of hip involvement were detected by "triple sieve" orthopedic screening system. Diagnosis and treatment were monitored by clinical and sonographic examinations (according to Graf). The risk factors, their influence on the treatment course, the effectiveness of outpatient treatment using abduction devices, timing and duration of treatment and participation in follow-up were evaluated. Furthermore, data analysis on national hip arthroplasty register was performed in patients treated for sequels of hip dysplasia. These data were correlated (in order to assess their efficacy) with methods of dysplasia detection at the time these patients were born. Results: Conservative treatment was successful in 98.7 % of 316 treated children. Only 31 % of children had a positive clinical finding. Positive family history showed no significance either for detection or treatment course. The breech position correlated significantly with the incidence of hip dysplasia - OR = 2.80 (99%...
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Development and evaluation of new cementless revision acetabular components for total hip arthroplasty / type TC /
Šťastný, Eduard ; Trč, Tomáš (advisor) ; Šponer, Pavel (referee) ; Pilný, Jaroslav (referee)
Development and evaluation of new cementless revision acetabular components for total hip arthroplasty / type TC / Objective: The aim of the clinical part of the study was to introduce a new revision oval cup type TC, and evaluate its reliability and utility in revision endoprosthesis. Due to the different structure of the implant, we aimed to objectively demonstrate the remodeling of bone tissue in its vicinity. In the experimental part of the work we verified the hypothesis that the use of locking screws has an effect on the bond strength of the implant with bone tissue, and therefore on the primary stability of the acetabular component. Method: We evaluated 31 patients that underwent revision hip surgery between 2004 and 2008. The mean follow-up was 7.1 years (range 5.3 to 9.3 years, minimum 5 years after surgery). Osteointegration of the implant and remodeling of bone tissue around the implant and its ribs were evaluated by digital radiography and computed tomography, and clinical results according to Harris. The experiment was based on the execution of pull-out tests after the implantation of TC cups in cadaveric bovine pelves. We evaluated the dependence of tensile forces in the axis of the implant on extraction of the metal cup from the bone bed. Four tests were conducted with the cup fixed...
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Quality of a Life of the Patient after total hip Arthroplasty
Obertová, Denisa ; Pečenková, Jaroslava (advisor) ; Šponer, Pavel (referee) ; Filková, Zuzana (referee)
Author's first name and surname: Obertová Denisa Institution: Charles University in Prague, Faculty of Medicine in Hradec Králové The Title of the thesis: Quality of a life of the patient after total hip arthroplasty Supervisor: Jaroslava Pečenková Number of pages: 100 Number of attachment: 3 The year of presentation: 2011 Keywords: quality of a life, arthrosis, hip joint, total arthroplasty, rehabilitation This Bachelor work is devoted to the problems of quality of a life after total hip arthroplasty. The theoretical part introduces the quality of a life of patiens and a total hip arthroplasty. The empirici part compares preoperative period of patiens with postoperative one, separately men and women. questionnaire method, 22 question, 70 respondents Souhlasím, aby práce byla půjčována ke studijním účelům a byla citována dle platných norem.
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The impact of total hip arthroplasty implantation on Quality of Human Needs
Koudelková, Iva ; Schneiderová, Michaela (advisor) ; Šponer, Pavel (referee) ; Pinkavová, Hana (referee)
96 Key words: human needs, Maslow's hierarchy of needs, osteoarthritis, total hip arthroplasty The bachelor work is focused on the impact of total hip arthroplasty implantation on the quality of human needs. Theoretical part is divided into two chapters. The first chapter includes description of human needs. The second chapter refers to hip osteoarthritis, development and possibilities of arthroplasty implantation, preoperative and postoperative care including rehabilitation. The purpose of the empiric part is comparison and monitoring of human needs before and after total hip arthroplasty. Research part includes results of the applied study that was designed by two successive questionnaires analysis. The first part of the study is focused on identifying patients' needs before the surgery. Changes and development of patients' needs three month after the hip replacement are analyzed in the second part. Results are based on the research performed in cooperation with Department of Orthopaedics, University Hospital Brno and Orthopaedic Outpatient Clinic in Poho elice (Petr Vališ, MD) from October 2009 to January 2010. Respondent group was formed by inpatients (University Hospital Brno) preparing for total hip replacement. Respondents were interviewed before and three month after the surgery.
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