Abstract Osteoarthritis (OA) is the commonest joint disease in the world, and it has a major socioeconomic impact. OA causes progressive degenerative changes in the composition and structure of articular cartilage and subchondral bone. Clinical diagnosis of OA is based on physical examination and qualitative evaluation of changes on plain radiographs. Current clinical imaging methods are subjective or insensitive to early OA changes. Therefore, new methods are needed so as to quantify composition of the cartilage and characteristics of the subchondral bone. The aim of this thesis was to evaluate the potential of clinically applicable X-ray-based methods for the assessment of the cartilage proteoglycan content as well as the structure and density of subchondral bone in a knee joint. Subchondral bone density and structure (local binary patterns, Laplacian, and fractal-based algorithms) analysis methods for two-dimensional (2-D) plain radiographs were validated against three-dimensional (3-D) bone microarchitecture obtained from micro-computed tomography ex vivo and applied to plain radiographs in vivo. Furthermore, a method developed for the evaluation of articular cartilage proteoglycan content from computed tomography (CT) was validated against a delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), which is widely used as a proteoglycan sensitive method, in subjects referred for an arthroscopy of the knee joint. Subchondral bone density and structure evaluated from 2-D radiographs were significantly related to the bone volume fraction and true 3-D microarchitecture of bone, respectively. In addition, bone density- and structure-related parameters from radiographs were significantly different among subjects with different stages of OA. Cartilage proteoglycan content evaluated from CT was significantly related to dGEMRIC method. Furthermore, dGEMRIC was associated with bone structure from a 2-D radiograph. In conclusion, analysis of bone structure and density is feasible from clinically available 2-D radiographs. A novel CT method sensitive to proteoglycan content should be considered when a 3-D view of cartilage quality is needed. / Tiivistelmä Nivelrikko on maailman yleisin nivelsairaus. Se aiheuttaa merkittävää kärsimystä potilaille, ja sillä on suuri taloudellinen vaikutus yhteiskuntaan. Nivelrikko aiheuttaa palautumattomia muutoksia nivelrustokudoksen ja rustonalaisen luun koostumukseen ja rakenteeseen. Nivelrikon diagnoosi perustuu kliiniseen tutkimukseen ja röntgenkuvien silmämääräiseen arviointiin. Nykyiset nivelrikon kliiniset kuvantamismenetelmät ovat subjektiivisia eivätkä riittävän tarkkoja nivelrikon varhaisten muutosten osoittamiseen, minkä vuoksi rustokudoksen koostumuksen ja rustonalaisen luun muutosten arviointiin tarvitaan uusia menetelmiä. Tämän väitöskirjantyön tarkoituksena oli tutkia uusien röntgensäteilyyn perustuvien menetelmien soveltuvuutta polvinivelen rustokudoksen proteoglykaanipitoisuuden sekä luun tiheyden ja rakenteen arviointiin. Rustonalaisen luun tiheyttä ja rakennetta arvioitiin digitaalisesta röntgenkuvasta tietokonepohjaisilla menetelmillä ja tuloksia verrattiin mikrotietokonetomografiassa nähtävään luun kolmiulotteiseen rakenteeseen. Röntgenkuvasta laskettavia muuttujia verrattiin myös eriasteisesta nivelrikosta kärsivien henkilöiden välillä. Rustokudoksen proteoglykaanipitoisuutta epäsuorasti mittaavaa tietokonetomografiamenetelmää verrattiin vastaavaan magneettikuvausmenetelmään henkilöillä, jotka olivat menossa polven niveltähystykseen. Röntgenkuvasta laskettu rustonalaisen luun tiheys ja rakenne olivat tilastollisesti selkeästi yhteydessä luun tilavuusmäärään ja mikrorakenteeseen, ja ne erosivat eriasteisesta nivelrikosta kärsivien henkilöiden välillä. Proteoglykaanipitoisuutta arvioivien tietokonetomografia- ja magneettikuvausmenetelmien välillä oli tilastollisesti merkitsevä korrelaatio. Ruston proteoglykaanipitoisuutta arvioivan magneettikuvausmenetelmän ja röntgenkuvasta laskettavan luun rakenteen välillä oli myös tilastollinen yhteys. Loppupäätelmänä voidaan todeta, että luun tiheyttä ja rakennetta on mahdollista arvioida kliinisesti saatavilla olevista röntgenkuvista. Tietokonetomografiamenetelmän käyttöä tulee harkita tutkimuksissa silloin, kun rustokudoksen tilasta halutaan kolmiulotteista tietoa.

Abstract Osteoarthritis (OA) is a common degenerative disease of synovial joints becoming more frequent with age. Pain, stiffness and functional disability caused by OA negatively affect the quality of individuals’ lives. In order to prevent the manifestation of symptoms and further OA progress, early diagnosis is essential. Ultrasonography has the potential to detect various abnormalities in the knee joint, however its place in clinical practice remains uncertain. The present study aimed to determine the diagnostic performance of the semi-quantitative wide-area ultrasound (US) scanning of knee femoral cartilage degeneration, osteophytes and meniscal extrusion using magnetic resonance imaging as the reference tool. Diagnostic ability of conventional radiography (CR) was also determined and the performances of both modalities compared. Subsequently, the association of structural US findings with knee pain and function was investigated. Finally, quantitative US image analysis focusing on detection and evaluation of subchondral bone integrity in early OA was developed. The US quantitative outcomes were compared with CR and arthroscopy. Tibio-femoral osteophytes, medial meniscal extrusion and medial femoral cartilage morphological degeneration were identified by US with better or at least comparable accuracy than by CR, in which joint space narrowing was used as a composite measure of cartilage damage and meniscal extrusion. The global femoral cartilage grade associated strongly with increased pain and disability. Site-specifically, especially medial cartilage degeneration and femoral lateral osteophytes were associated with increased pain and disability. Regarding the quantitative outcomes, significant increase in US intensity in the femoral subchondral bone depth 0.35–0.7 mm and decrease in intensity slope up to 0.7 mm depth were observed during radiographic or arthroscopic OA progression. Novel wide-area US scanning provides relevant additional diagnostic information on tissue-specific OA pathology not depicted by CR. US-detected changes of femoral cartilage and osteophytes are also associated with clinical symptoms. Consequently, the use of US as a complementary imaging tool along with CR may enable more accurate diagnostics of knee OA. Furthermore, developed quantitative US analysis is a promising tool for detection of femoral subchondral bone changes in knee OA. / Tiivistelmä Nivelrikko on erittäin yleinen nivelten rappeumasairaus, joka aiheuttaa kipua, jäykkyyttä sekä liikkumisvaikeutta. Nivelrikon nykyistä varhaisempi diagnosointi olisi äärimmäisen tärkeää, jotta voitaisiin vähentää oireiden esiintymistä ja hidastaa sairauden etenemistä. Ultraäänikuvaus on lupaava menetelmä nivelrikon varhaisdiagnostiikkaan, mutta sitä ei kuitenkaan ole vielä yleisesti hyväksytty rutiininomaiseen kliiniseen käyttöön. Tämän tutkimuksen päätavoitteena oli selvittää polven semi-kvantitatiivisen ultraäänikuvauksen diagnostista kykyä verrattuna perinteiseen röntgenkuvaukseen, kun arvioidaan rustokudoksen kulumista, luupiikkejä sekä nivelkierukan siirtymää. Magneettikuvausta käytettiin vertailumenetelmänä. Toisena tavoitteena oli selvittää yhteyttä polven ultraäänilöydösten ja polven kivun sekä liikkuvuuden välillä. Lopuksi selvitettiin, voidaanko kvantitatiivisella analyysilla parantaa ultraäänikuvauksen tarkkuutta varhaisvaiheen nivelrikkopotilaiden rustonalaisen luun kunnon määrittämiseen. Röntgenkuvaukseen verrattuna ultraäänikuvaus osoittautui vähintään yhtä hyväksi tai paremmaksi kuvantamismenetelmäksi, kun arvioitiin reisi- ja sääriluun luupiikkejä, sisemmän nivelkierukan siirtymää tai rustokudoksen kulumista. Reisiluun nivelruston yleinen kulumisen aste oli suoraan verrannollinen potilaiden polvinivelen liikerajoituksiin ja kipuun. Erityisesti reisiluun sisemmän puolen nivelruston kuluminen sekä ulomman puolen luupiikit liittyivät potilaiden oireisiin. Kvantitatiiviset ultraäänitulokset osoittivat, että ultraäänen rusto-luurajapinnalta tulevan heijastuksen maksimi-intensiteetti lisääntyi sekä intensiteetin tason laskunopeus vähentyi nivelrikon vaikeusasteen kasvaessa. Tutkimus osoitti, että ultraäänikuvauksella voidaan saada tärkeää diagnostista lisätietoa polven nivelrikon aiheuttamista kudosmuutoksista, joita ei pystytä havaitsemaan perinteisellä röntgenkuvauksella. Ultraäänikuvauksessa näkyvät kudosmuutokset liittyvät myös potilaan kliinisiin oireisiin. Lisäksi rustonalaista luuta voidaan analysoida kvantitatiivisesti ultraäänikuvien perusteella, mikä edelleen helpottaa kuvien tulkintaa. Tutkimuksen perusteella voidaankin suositella ultraäänikuvauksen nykyistä laajempaa kliinistä käyttöä röntgenkuvausta täydentävänä tutkimusmenetelmänä nivelrikon varhaisdiagnostiikassa.

This diploma thesis describes the design of filling element with trabecular structure for revision implant of total knee arthroplasty. Design of the filling element is created by the digital data of the patient tissue. Production of a functional sample is performed using additive technology Selective Laser Melting. This work also include analyze of the accuracy of this technology for the production of titanium alloy Ti6Al4V.

Thesis focuses on problematis of using Kinect sensor in rehabilitation of knee joint. Relative new method of rehabilitation via biofeedback produced by Kinect One for Window motion sensor delivers number of benefits to patient. Part of thesis is therapeutic game developed in C#.

This thesis focuses on problematis of using Kinect sensor in rehabilitation of knee joint. Relatively new method of rehabilitation via biofeedback produced by Kinect One for Window motion sensor delivers number of benefits to a patient. Part of the thesis is therapeutic game named Kolínko developed in C#.

Title: Kinematic and kinetic analysis of artistic gymnastic jumps Objectives: The aim of my master thesis is execution of kinematic - kinetic analysis of jumps in artistic gymnastics, processing data, counting force moment, which does the rotation around ventrodorsal axis, means abduction and adduction motion and recount normalized moment (moment share by body weight). Methods: The kinematic - kinetic analysis of jumps in artistic gymnastics was done by using systems Qualysis Motion Capture System and Kistler. Results: We have been researching four different gymnastic jumps in this study. Four healthy individuals underwent the measurement. They have done each jump in free valid times. There was measured abduction moment of knee joint in each jump. Adduction moments were present only in 32 % cases and lot of them hasn't significant value. There was measured abduction moment in bounces in each jump, value of standardized adduction moment wasn't signifiant. There was measured just abduction moments in dismounts of non-rotational jumps. In dismounts of rotational jumps (around longitudinal axes) was measured abduction and also adduction moment. Values of normalized abduction moments were between 0,3 - 11 m2 .s-2 . Values of normalized adduction moments were between 0 - 10 m2 .s-2 . Highest values of...

<p>I&scaron;ča&scaron;enje, luksacija ili dislokacija ča&scaron;ice (patele), predstavlja povredu kolena prilikom koje dolazi do pomeranja patele iz patelofemoralnog dela zgloba kolena. Pri ovoj povredi dolazi do o&scaron;tećenja medijalnih mekotkivnih struktura kolena koje su zadužene za pravilno pomeranje ča&scaron;ice unutar patelofemoralnog zgloba. Nakon prve povrede kod velikog borja pacijenata razvije se hronična nestabilnost patelofemoralnog zgloba sa posledičnim recidivantnim luksacijama patele. Mehanizam nastanka hronične nestabilnosti nije u potpunosti razja&scaron;njen i smatra se multifaktorijalnim, a za jedan od faktora smatra se naru&scaron;avanje neurolo&scaron;ke regulacije pokreta kolena. Propriocepcija je složen neurolo&scaron;ki mehanizam koji nam omogućava mentalno mapiranje delova tela, sprečavajući prekomerne i nepravilne pokrete koji mogu dovesti do povređivanja. Za njegovu procenu u zglobu kolena najče&scaron;će se procenjuje osećaj pozicije zgloba (JPS &ndash; eng. &bdquo;Joint Position Sense&ldquo;) kao jedne od komponenti propriocepcije. Nerazja&scaron;njeno je koji je najbolji način za njegovu procenu u pogledu izbora različitih uglova fleksije kolena i pozicija ispitanika, ali i kakav je uticaj povreda struktura kolena na njega. U istraživanju su učestvovale isključivo osobe ženskog pola (15-17 godina), svrstane u tri kategorije od po 30 ispitanika. Prvu, kontrolnu grupu, činile su zdrave ne sportistkinje; drugu, grupu sportistkinja, činile su ispitanice koje su se takmičarski bavile ko&scaron;arkom; treću, grupu pacijentkinja, činile su osobe sa luksacijom ča&scaron;ice kolena. Za merenje JPS kori&scaron;ten je VICON optički sistem (&copy;Vicon Motion Systems Ltd. UK registered no. 1801446) za analizu pokreta. Za svaku grupu meren je JPS metodom pasivnog pozicioniranja-aktivne reprodukcije sa kolenom u različitim nivoima fleksije (30&deg;, 45&deg; i 60&deg;), u uspravnom, ležećem i sedećem položaju, nakon čega su rezultati bili poređeni između grupa. Na&scaron;i rezultati su pokazali da odabir pozicije ispitanika i ugla merenja ne utiče na JPS u zdravim populacijama, kontrolnoj grupi i grupi sportiskinja, niti postoji statistički značajna razlika odgovarajućih pozicija i uglova između ovih grupa. Za grupu pacijentkinja dobili smo da postoji deficit propriocepcije, i da je sedeći stav najosetljivijim za procenu deficita osećaja pozicija zgloba kolena. U odnosu na odgovarajuće uglove kontrolne grupe i grupe sportistkinja, kod pacijentkinja postoji statistički značajno veća gre&scaron;ka traženih uglova u sedećem stavu, zbog čega je ovaj stav karakterističan za ovu grupu. Takođe smo uočili da je najveća razlika pri uglu od 45&deg;, čineći ga kritičnim uglom za grupu pacijentkinja. Ono &scaron;to je ključni zaključak je da nakon povrede kolena po tipu luksacije ča&scaron;ice postoji neurolo&scaron;ki deficit kontrole pokreta kolena, koji potencijalno može dovesti do daljeg povređivanja. Obzirom da je JPS metod kumulativne procene proprioceptivnog sistema, dalja istraživanja bi trebala da budu usmerena na određivanje mesta o&scaron;tećenja istog, čime bi se postiglo bolje razumevanje funkcionisanja sistema regulacije pokreta kao i mogućnost sprovođenja efikasnijeg lečenja nakon povrede kolena.</p> / <p><!--[if gte mso 9]><xml> <o:DocumentProperties> <o:Author>Vukadin Milankov</o:Author> <o:Version>16.00</o:Version> </o:DocumentProperties> <o:OfficeDocumentSettings> <o:AllowPNG/> </o:OfficeDocumentSettings></xml><![endif]--><!--[if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:TrackMoves/> <w:TrackFormatting/> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:DoNotPromoteQF/> <w:LidThemeOther>EN-US</w:LidThemeOther> <w:LidThemeAsian>X-NONE</w:LidThemeAsian> 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Osteoarthritis (OA) is a degenerative condition of articular cartilage that affects more than 25 million people in the US. Joint injuries, like anterior cruciate ligament (ACL) tears, can lead to OA due to a change in articular cartilage loading. Gait analysis combined with knee joint finite element modeling (FEM) has been used to predict the articular cartilage loading. To predict the change of articular cartilage loading during gait due to various ACL injuries, a tibiofemoral FEM was developed from magnetic resonance images (MRIs) of a 33 year male, with no prior history of knee injuries. The FEM was validated for maximum contact pressure and anterior tibial translation using cadaver knee studies. The FEM was used to model gait of knees with an intact ACL, anteromedial (AM) bundle injury, posterolateral (PL) bundle injury, complete ACL injury, AM deficiency, PL deficiency, complete ACL rupture, as well as a bone-patellar tendon-bone (BPTB) graft. Generally, the predicted maximum contact pressure and contact area increased for all the ACL injuries when compared to intact ACLs. While an increase in maximum contact pressure and contact area is an indication of an increased risk of the development of OA, the percent of increase was typically small suggesting that walking is a safe activity for individuals with ACL injuries.

Basketball is one of the most injury-risk team sports. Taking into consideration high frequency of knee joint injuries in both young and professional basketball-players and especially issues of overloads of locomotor apparatus in adult basketball, it is crucially important to develop and propose an effective prevention programs to avoid acute injuries and traumas of knee joints. The proposed study was focused on the development of special training prescriptions and recommendations for coaches and physical trainers aimed to implement prevention methods in the training process. The study was conducted in the Ural Federal University Sports Technologies Research Lab. Twenty young athletes born in 2002 from basketball youth sport schools (Yekaterinburg, Russia) were recruited for the study. The significant interrelations between functional state, oxygen transport and utilization systems and power of working muscles were established for the first time. A novel prevention program of knee joint injuries was introduced, effectiveness of which was proved during the study. / Баскетбол входит в пятерку самых травмоопасных командных, контактных видов спорта. Актуальность исследования обусловлена высокой частотой травматизма коленного сустава, как у молодых, так и у профессиональных баскетболистов. В особенности это грозит игрокам молодежных составов, так как при переходе в профессиональную команду растёт объем интенсивности нагрузки на опорно-двигательный аппарат и зачастую отсутствуют программы профилактики травматизма. Данная работа посвящена разработке рекомендаций по построению тренировочного процесса и внедрение в него программы профилактики травматизма для снижения степени риска повреждения коленного сустава. Исследование проводилось на базе лаборатории «Технологии восстановления и отбора в спорте» ЦКП ФГАОУ ВО УрФУ имени первого Президента России Б.Н. Ельцина. В исследовании приняли участие 20 юных спортсменов 2002 года рождения, воспитанники детско-юношеских спортивных школ (г. Екатеринбург). Впервые была установлена связь между общим функциональным состоянием организма спортсмена, системой транспорта и утилизации кислорода работающими мышцами и силой мышц нижних конечностей. Была разработана и внедрена в тренировочный процесс программа профилактики травматизма коленного сустава, эффективность которой была доказана в ходе исследования.

Предметом исследования является методика физической реабилитации баскетболистов после травм коленного сустава на этапе восстановления. Цель исследования – разработать и обосновать комплексную программу реабилитации баскетболистов 18-21 года после травм коленного сустава. Методы исследования: 1. Анализ и обобщение литературных источников. 2. Методы оценки функционального состояния коленного сустава. 3. Педагогический эксперимент. 4. Статистическая обработка данных. Научная новизна исследования: впервые предложены методы педагогического сопровождения реабилитации и внедрены методические рекомендации повышения эффективности восстановления спортивной работоспособности у баскетболистов после травм коленного сустава. Теоретически обоснованная и доказанная экспериментально методика дополняет теорию и практику спортивной подготовки травмированных спортсменов. Полученные результаты в процессе эксперимента, доказывают более эффективный процесс реабилитации баскетболистов с травмами коленного сустава. Предложенная методика может быть применена для процесса физической реабилитации. / The subject of the proposed study is method of physical rehabilitation of basketball-players after knee injury. The aim – to develop and justify a complex rehabilitation program of 18-21 aged basketball-players after knee injury. The following methods were used: scientific literature review, evaluation of functional state of knee, pedagogic experiment, and statistical analysis. Scientific novelty: new methods of pedagogical supply of rehabilitation process were proposed and novel methodic guidelines to increase effectiveness of sports capacity in basketball-players after knee injury were implemented. Theoretically and practically justified methodic supplements theory and practice of sports training of injured athletes. The obtained results confirmed the effectiveness of rehabilitation process of basketball-players with knee injuries. The proposed method may be used in physical rehabilitation process.