A verificação do trajeto do nervo isquiático por meio da dissecação da articulação coxofemoral de cadáveres da espécie canina, e a sintopia destas estruturas, tem relevância em ser pesquisada na medida em que tal relação neuroarticular pode estar envolvida nos casos de neuropraxia durante as intervenções cirúrgicas de artroplastia total do quadril de cães. O escopo do estudo foi o de apresentar uma contribuição aos cirurgiões em prendizado na implantação das próteses acetabular e femoral, para que possam compreender as relações anátomo-cirúrgicas entre a articulação coxofemoral e o nervo isquiático, e com a finalidade de potencializar positivamente o resultado do pós-operatório imediato dos cães. Foram utilizadas 20 articulações coxofemorais provenientes de 10 cadáveres de cães, com raças definidas ou SRD, machos ou fêmeas, com peso variável, sempre acima de 20 quilogramas, sem alterações macro-morfológicas nas referidas articulações, e dissecadas por técnica clássica. Realizou-se manobras de abdução articular para a obtenção de luxação articular, além da retração caudal do fêmur proximal, à semelhança do que ocorre no transcorrer da aplicação da técnica operatória de colocação da prótese total de quadril. A dissecação cirúrgica das estruturas estudadas revelou um aumento considerável de contato entre o nervo isquiático e a articulação coxofemoral durante as manobras de abdução articular em aproximadamente 90º, quando adicionada de retração caudal do femur proximal. Assim, conclui-se que a etapa ora referida, necessária pela técnica cirúrgica de artroplastia total de quadril em cães, pode levar a lesão do nervo isquiático, devendo o cirurgião estar atento na realização destas manobras. / The ischiatic nerve course verification using dissection of the hip joint from cadavers of the canine species, as well as the sintopy of these structures, have a relevant aspect to be investigated, because these neuro-articular relation can be involved in cases of neurapraxia during some surgical interventions of total hip arthroplasty in dogs. The main objective of the study was to present a contribution to the new surgeons during their learning phase of implantation of the acetabular and femoral prosthesis, so they can understand the anatomic and surgical relation between the hip joint and the ischiatic nerve, aiming to potentially make positive the immediate post surgical result of the treated dogs. 20 hip joints from 10 cadavers of dogs were utilized, with pure breeds or not, males or females, with variable weight, always over 20 kilos, without macro-morphological alterations in the hip joints, and dissected using the classical technique. Hip joint abduction manoeuvres were made to obtain the desired joint luxation, besides a caudal retraction of the proximal femur, like occurs during the application of the surgical technique utilized to perform the total hip replacement surgery. The surgical dissection involving the studied structures showed a significant increasing contact between the ischiatic nerve and the hip joint during the articular abduction manoeuvres, using approximately a 90 degree angle, and when added a caudal retraction of the proximal femur. Consequently, conclusion was that the above-mentioned stage, needed to perform the total hip arthroplasty procedure in dogs, can lead to a lesion of the ischiatic nerve. Thus, the surgeons shall be alert during the realization of these manoeuvres.

A Osteonecrose da cabeça do fêmur (ONCF) é uma patologia degenerativa que pode levar ao colapso da cabeça do fêmur tendo como conseqüência a necessidade de substituição da articulação coxofemoral. O objetivo principal no tratamento da ONCF é preservar a articulação coxofemoral e não substituí-la. Estudos realizados em pacientes humanos com ONCF demonstraram que os níveis de atividade e o número de células mesenquimais nos compartimentos hematopoiéticos e estromais da medula óssea estão deprimidos. Estes achados indicam a possibilidade da utilização de células-tronco mesenquimais (MSC) nas lesões necróticas da cabeça do fêmur. O presente trabalho propõe a utilização da terapia celular com MSC da medula óssea de ovinos e polpa dentária humana em 8 ovinos com ONCF induzida pela injeção intra-óssea de etanol, além da avaliação da reestruturação óssea através da microscopia de luz, e rastreamento das células transplantadas. Dois animais foram eutanasiados com 6 semanas após a indução da lesão e foram transplantadas as células-tronco mesenquimais em 4 animais, e realizada a descompressão central em 2 outros animais. Com dez semanas foram eutanasiados os animais restantes. O sucesso do transplante da medula óssea foi confirmado pela expressão do gene repórter LacZ na cabeça do fêmur dos animais transplantados macroscopicamente. A análise histológica evidenciou maior processo regenerativo na cabeça do fêmur do animal experimental submetido à terapia com células-tronco da polpa dentária imatura humana. / The osteonecrosis of femoral head (ONFH) is a degenerative disease that can lead to the collapse of the femoral head and necessity of total hip replacement. The main objective in the treatment of ONFH is to preserve the hip and not replace it. Studies in human patients with ONFH demonstrated that levels of activity and the number of mesenchymal cells in the hematopoietic and bone marrow stromal compartments are depressed. These findings indicate the possibility of the use of mesenchymal stem cells (MSC) in necrotic lesions on the head of the femur. This research proposes the use of cell therapy with MSC from ovine bone marrow and immature human dental pulp stem cell in ovine ONCF induced by intraosseous injection of ethanol, in addition, the assessment of bone restructuring by light microscopy and tracking of the transplanted cells. Two animals were euthanasied with 6 weeks after the induction of injury, and were transplanted mesenchymal stem cells in 4 animals, and held the central decompression in 2 other animals. After ten weeks were euthanasied the remaining animals. The successful of the bone marrow transplantation was confirmed by the macroscopic expression of the LacZ gene reporter in the femoral head of animals transplanted. The histological analysis showed an advanced regenerative process in the femoral head in the animal using human immature dental pulp stem cell.

The purpose of this study was to measure flexibility at the hip joint under four techniques of stretching, passive stretch-concentric contraction-passive stretch (PCP), passive stretch-three seconds isometric contraction of hip extensorsconcentric contraction of hip flexors-passive stretch (3-PIeCP) and passive stretch-three seconds isometric contraction of hip flexors-concentric contraction of hip flexorspassive stretch (3-PIfCP) based on proprioceptive neuromuscular facilitation (PNF) and passive static stretch (P). Further, this study was designed to ascertain the effect of cold application (ice) in joint range of motion of the hip extensors measured with the Leighton Flexometer.

Bibliographic identification DINDA, Ondřej. Kinematic analysis of patients wiht femoroacetabular impingement syndrome. Prague: Charles University, 2nd Faculty of medicine, Department of Rehabilitation and Sports Medicine, 2017. 82 pages. Supervisor: Mgr. Petra Valouchová, Ph.D. Abstract The purpose of this master thesis was to find out, if there are objective changes in biomechanics of the gait and upstairs gait by objectives with diagnosed femoroacetabular impingement syndrome and by healthy objectives. The data were acquired using kinematic analysis Qualisys and processed using software Qualisys track manager and Visual3D. The subject of research was the range of motion in hip joint in frontal and sagittal plane, than the movement of pelvis in frontal plane, movement of pelvis against thorax in transversal plane and deviation of the axis of spine in frontal plane. These parameters were documented using angular deviation of the segments, deviation of the segments in the plane or shifting of the markers in coordinate system. The conclusions were than statistically evaluated. There were 20 objects with diagnosed femoroacetabular impingement syndrome in the age from 23 to 47 years of age included in the study. In the gait research, a significant difference in angular deviation of the pelvis against thorax in...

The ageing population has become more active and live longer, these patients require hip replacement surgery at a younger age. Artificial hip implants, consisting of the acetabular cup and femoral head, affect the lives of many people, and the longevity of these implants pose significant concerns (rarely longer than 17 years). To help understand the lubricating performance of such a system, a hip joint model was built based on the Reynolds equation; the model developed simulated hydrodynamic lubrication. A steady-state angular rotation model was built whereby it was concluded that such motion would not support any load due to the anti-symmetric nature of the resultant pressure distribution (anti-symmetric about the axis of rotation). The pressure distribution from the steady-state rotation simulation contained a pressure source and sink which converged to the centre of the cup and whose pressure value increased in magnitude, as the eccentricity ratio increased. Infeasible results were obtained when the intermediary pressure constraint, allowing only positive pressure values, was implemented. The results obtained were not representative of the problem and it is recommended that this constraint not be implemented. The transient walking cycle model showed that a fluid with viscosity of 0.0015Pa.s is not sufficient to support a load in the walking cycle under conditions representative of hydrodynamic lubrication. Increasing the fluid viscosity promoted better results in the hydrodynamic model. Increasing the femoral head radius and decreasing the radial clearance between the components also improves the possibility of hydrodynamic lubrication. It is recommended that the model should be extended to investigate elasto-hydrodynamic lubrication. If possible, the effects of a boundary lubrication model should be investigated, as it is believed to be a major contribution to the lubrication of hip joints. / Dissertation (MEng)--University of Pretoria, 2008. / Chemical Engineering / unrestricted

This work deals with stress-strain analysis pathological hip joint. In its introduction a research study from accessible literature sources is carried out. It covers contemporary state of scientific studies, anatomy of single components hip joint, their material properties, ways and magnitudes of loadings and most often FE model used. With use of all these informations, computational system ANSYS and gained CT scans, a model of geometry of pelvis and femur is created. Subsequently, the complete computational model o pathological hip point is compiled. On this model computational solution is executed stress-strain and sensitivity analysis. Subsequently, surgery operation is simulated on this model and it is executed stress-strain analysis. These analyses are compared with analysis of physiological hip joint.

This diploma thesis concerns itself with the experimental study of friction and lubrication in the artificial hip joint depending on the head size. Measurements were made in a hip joint simulator based on the principle of pendulum. For the friction measurements artificial joints, made from three material combinations and two diameters, from two companies were used. The measurements show that the material combination has a more significant effect to friction coefficient than the head size. Using a bigger head size shows a decrease in friction coefficient for all material combinations when compared to a smaller head size. For the measurement of lubrication film the colorimetric interferometry was applied. A metal-on-glass contact pair was used, where the glass cups were made according to the real measurements of the joint cups. Four types of hip replacements with diameters of 28 and 36 mm with two different diametral clearance were measured during a constant motion of 210 seconds. Measurements show, that the lubrication film in the hip joint with a small diametral clearance increases very fast over the 800 nm value. Contact surfaces in the hip joint with a large diametral clearance aren’t separated by the lubrication film, resulting in a damage of the chromium coating in cup. A thick lubrication film results in a higher friction coefficient, when compared with hip joints with a very thin or no lubrication film.

An experimental methodology for wear assessment of extracted polyethylene hip implants was designed in this diploma thesis. Methodology uses optical 3D scanner and optical profilometer for analysis of wear. Designed methodology for wear analysis was validated by gravimetric method. The results of validation were in good agreement with the increase of wear rate. Validation results show that the methodology is not suited for wear assessment of metal and ceramic implants which have small wear rates. On the other hand the methodology is more than useful for wear assessment of polyethylene implants. Designed methodology for wear assessment was applied on the set of thirteen extracted polyethylene hip implants. Results of the wear analysis were wear volumes and linear wear noted in the wear maps. Roughness of the surface was measured on explanted cups and results were noted in the roughness map. On articulating surface of the cups different areas were observed for measured roughness. Those areas were described as area with machining marks from manufacturing process, polished area from combination of abrasive and adhesive wear, polished area from micro-contact fatigue and area including plastic deformation.

published_or_final_version / Community Medicine / Doctoral / Doctor of Philosophy

Title: Effect of physiotherapy to reduce the length of hospital stay in patients with total hip arthroplasty: a literature review Objective: The purpose of this thesis is to research and compare available studies investigating the effect of extra physiotherapy in reducing the length of stay for patients with total hip arthroplasty. In addition, to make a compilation of available sources about issue of the hip, total hip arthroplasty in terms of anatomy, kinesiology and biomechanics and length of hospital stay. Methods: This diploma thesis has descriptively-analytical character and is structured in the form of literary review. Results: Physiotherapy decreases length of stay in patients with total hip arthroplasty. Future research could address a specific group of subjects and the issue of cost-effectiveness in reducing the length of hospital stay by physiotherapy. Key words: Hip joint, total joint replacement, THA, physiotherapy, length of stay