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An investigation of lubrication of knee joint replacement
Sýkora, Tomáš ; Horák, Zdeněk (referee) ; Nečas, David (advisor)
This diploma thesis deals with an experimental analysis of knee joint replacement lubrication. The experiments were realized at a knee joint simulator which can apply conditions according to certain standard and survey the phenomena by using fluorescence microscopy. The aim of thesis is to clarify the influence of particular components of synovial fluid on the lubrication process. The intensity of fluorescence expresses dimensionless parameter of a lubrication film thickness. There was a fundamental study with mineral oils before the experiments with the synovial fluid. The study allows to have a look at contact transformation during walk. Results are shown in graphs as dependency of intensity on time, including pictures showing phenomena in the contact zone. Experiment results show that protein -globulin creates a layer on the surface. There is albumin on the layer and it makes the lubricating film thicker. The protein interaction is supported by hyaluronic acid and fosfolipids which stabilizes the created structure. According to lubrication is behaviour of film related to a complex structure of synovial fluid. Thesis gives more information about behaviour of synovial fluid and can be used for future development of knee replacements.
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Advanced production technology for joint implants made by the EBM method
Bučková, Katrin ; Sedlák, Josef (referee) ; Píška, Miroslav (advisor)
Tato práce se zabývá pokročilou technologií výroby personalizovaných kloubních implantátů metodou EBM za použití titanové slitiny Ti6Al4V-ELI a navrhuje nový unikátní design kolenního implantátu společně s metodologií jeho inserce, přičemž tato řešení jsou součástí patentové přihlášky č. PV 2020-459. Toto neinvazivní řešení náhrady kolenního kloubu je šetrnější k pacientovi, maximálně chrání jeho zdravé tkáně a kosti, navíc se dá předpokládat vyšší životnost implantátu ve srovnání s tradičními dostupnými řešeními. Byla uskutečněna výroba vzorků z materiálu Ti6Al4V-ELI metodou EBM, proveden rozbor jejich materiálových, mechanických, technologických a únavových vlastností. Dále byly popsány pokročilé metody zobrazování, úpravy a tvorby kloubních ploch a použity k vyvinutí nového designu personalizovaného kloubního implantátu společně s inovační technologií jeho inserce a nástroji potřebnými k její úspěšné realizaci. Toto nové řešení bylo úspěšně ověřeno mnoha testy i výrobou Ti6Al4V-ELI a CoCrMo prototypů implantátů metodou EBM. Proveditelnost a použití v praxi bylo konzultováno a schváleno odborníky v této oblasti.
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Advanced production technology for joint implants made by the EBM method
Bučková, Katrin ; Sedlák, Josef (referee) ; Píška, Miroslav (advisor)
Tato práce se zabývá pokročilou technologií výroby personalizovaných kloubních implantátů metodou EBM za použití titanové slitiny Ti6Al4V-ELI a navrhuje nový unikátní design kolenního implantátu společně s metodologií jeho inserce, přičemž tato řešení jsou součástí patentové přihlášky č. PV 2020-459. Toto neinvazivní řešení náhrady kolenního kloubu je šetrnější k pacientovi, maximálně chrání jeho zdravé tkáně a kosti, navíc se dá předpokládat vyšší životnost implantátu ve srovnání s tradičními dostupnými řešeními. Byla uskutečněna výroba vzorků z materiálu Ti6Al4V-ELI metodou EBM, proveden rozbor jejich materiálových, mechanických, technologických a únavových vlastností. Dále byly popsány pokročilé metody zobrazování, úpravy a tvorby kloubních ploch a použity k vyvinutí nového designu personalizovaného kloubního implantátu společně s inovační technologií jeho inserce a nástroji potřebnými k její úspěšné realizaci. Toto nové řešení bylo úspěšně ověřeno mnoha testy i výrobou Ti6Al4V-ELI a CoCrMo prototypů implantátů metodou EBM. Proveditelnost a použití v praxi bylo konzultováno a schváleno odborníky v této oblasti.
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An investigation of lubrication of knee joint replacement
Sýkora, Tomáš ; Horák, Zdeněk (referee) ; Nečas, David (advisor)
This diploma thesis deals with an experimental analysis of knee joint replacement lubrication. The experiments were realized at a knee joint simulator which can apply conditions according to certain standard and survey the phenomena by using fluorescence microscopy. The aim of thesis is to clarify the influence of particular components of synovial fluid on the lubrication process. The intensity of fluorescence expresses dimensionless parameter of a lubrication film thickness. There was a fundamental study with mineral oils before the experiments with the synovial fluid. The study allows to have a look at contact transformation during walk. Results are shown in graphs as dependency of intensity on time, including pictures showing phenomena in the contact zone. Experiment results show that protein -globulin creates a layer on the surface. There is albumin on the layer and it makes the lubricating film thicker. The protein interaction is supported by hyaluronic acid and fosfolipids which stabilizes the created structure. According to lubrication is behaviour of film related to a complex structure of synovial fluid. Thesis gives more information about behaviour of synovial fluid and can be used for future development of knee replacements.
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Case Study of Physiotherapy Treatment of a Patient after total knee replacement surgery
Petrocheilos, Stavros ; Nováková, Tereza (advisor) ; Vomáčková, Helena (referee)
Title: Case study of physiotherapy treatment of a patient after total knee replacement surgery. Thesis aim: Thesis is divided into two parts, the first part is theoretical and has aim to show an overview of anatomy, kinesiology and biomechanics of the knee joint and to show general information about the osteoarthritis and the patient's surgery. The second part is the case study where aim is to show the examinations and treatments that were provided to the patient and analyse the results. Clinical findings: The patient was a 71 years old male with diagnosis of total knee replacement surgery, performed 7 days ago from the time we met. The patient had limited ROM in the operated leg into flexion and extension and the area around the knee was swollen and warm. Also, he had some weakness on the muscles of the operated leg. Procedures: All the procedures that used were based on my knowledge acquired from Charles University in Prague, Faculty of Physical Education and Sport. These were post isometric relaxation, joint mobilisation, strength and length tests and strengthening exercises based on my knowledge. Result: After 7 days of therapies the patient's operated leg had physiological mobility into flexion and extension, the muscles gained strength and oedema was reduced but not completely. Conclusion:...
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Differences in the care of patients after a complete knee and hip replacement from the standpoint of the nurse.
LUŇÁČKOVÁ, Jana
Complete knee and hip replacement are one of the most common surgical procedures in an orthopedic practice. The care of these patients places very high demands on the attending nurse and follows strict guidelines. The occurrence rate of indications for the knee/hip replacement has risen recently. The reason behind it is higher stress on the bearing joints due to alarming rise in obesity, arthritic changes in the joints etc. Surgical procedure can restore mobility and independence of the patient. Part of the successful postoperative care is a close cooperation with the physiotherapy specialist. Orthopedic nurses carry full responsibility for the patient's care and therefore should be informed on its specifics. The bachelor thesis is divided into two sections, theoretical and empirical. The theoretical section focuses on the anatomy of the knee and hip joint, history of the replacement procedure and its indications and contraindications. It also discusses the specifics of the care of the patient. The empirical section covers research. The objective of the thesis is to discover different aspects of nursing care of the patient after total hip replacement and knee replacement and to investigate whether nursing staff possesses the knowledge of these aspects. Three basic questions were formulated: 1. What are the differences in care between the total knee replacement and total hip replacement patients? 2. In what areas of patient care, according to the nurses' point of view, do these differences exist? 3. What areas of patient care after total knee/hip replacement do nurses find the most difficult? A qualitative research method has been used to accomplish results for this thesis. Data collection has been carried out through semi-structured interviews and assisted observations. The research has taken place at a single location, an orthopedic department of a hospital. The research was completely anonymous, interviews and observations took place from April 8th 2016 through May 31st 2016. A semi-structured interviews were used for the data collection. Nurses were given 14 basic questions (see Appendix) that were followed by additional sub-questions during the interviews. Then the interview results were sorted into groups by their category for better comprehension. An assisted observation was another technique used. The acquired data have been input into a prepared table (see Appendix). The interviews and observations were carried out with the same subjects/nurses. The data collected showed that the care of the total knee replacement patient does not fundamentally differ from that of a total hip replacement patient. The only differences found were those in positioning of the patient, utilization of compensation aids, rehabilitation care and, according to the nurses, also in prevention of possible complications. The most common problems occur in connection with the manipulation of the patient. Nurses seem to lack a clear guidance as to by who and how the patient should be informed prior to the replacement procedure. This bachelor thesis has been compiled in such a way as to outline basic overview of the patient care differences and to be used as an information source for the experienced as well as the inexperienced nursing staff. Practical aspect of this thesis is a proposal for a seminar (see Appendix) on the issue of patient care differences after a total knee/hip replacement.
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