Einleitung 2015 belegte die Implantation einer Endoprothese am Hüftgelenk mit 219.325 Operationen Platz 8 der 50 häufigsten Operationen der vollstationären Patienten in Krankenhäusern (DRG-Statistik 2015). Bei diesen Eingriffen kommt eine Vielzahl von verschiedenen Prothesenmodellen zum Einsatz (Kirschner 2005). Aktuell geht der Trend in Richtung zementfreie Verankerung, Verkleinerung der Implantate und den Erhalt von möglichst viel Knochensubstanz (Jerosch 2013). So werden in den letzten Jahren immer häufiger Kurzschaftendoprothesen implantiert (Jerosch 2013). Sie stellen ein knochensparendes System dar und erlauben gleichzeitig verschiedene Gleitpaarungen (Jerosch 2013). Allerdings liegen für die meisten Kurzschaftendoprothesentypen noch keine Langzeittestergebnisse vor (Jerosch 2011), so dass das Langzeitverhalten dieser Prothesen nicht vorhergesagt werden kann. Speziell bei Kurzschaftendoprothesen ist der Einfluss der verkürzten Schaftlänge auf das Einwachsverhalten und die Lebensdauer des Implantats noch nicht ausreichend geklärt. Am Lehrstuhl für Konstruktionslehre und CAD der Universität Bayreuth finden deshalb Untersuchungen zur computergestützten Analyse von Kurzschaftendoprothesen statt. Ziel hierbei ist es, durch eine Variation der Schaftlänge eine Prothesenform mit optimalen Spannungsverläufen und einer verbesserten Krafteinleitung in den Knochen zu entwickeln.

Klubo sąnario endoprotezavimo operacija efektyviai sumažina arba visiškai panaikina skausmus, daugeliu atveju atstato funkcinį kojos stabilumą ir atraminę funkciją, iš dalies, bet ne visiškai atstato sąnario mobilumą (Drobniewski et al., 2012). Susidėvėjęs klubo sąnarys keičiamas cementiniu, becemenčiu arba mišriu endoprotezu (Laupacis et al., 2002). Darbo objektas: tiriamųjų emocinė būklė bei klubo sąnario funkcija po klubo endoprotezavimo operacijos. Darbo tikslas: įvertinti kineziterapijos poveikį cementinio ir becemenčio endoprotezų grupių ligoniams po klubo sąnario endoprotezavimo operacijos dėl koksartrozės, ankstyvajame reabilitacijos etape. Hipotezė: manome, kad kineziterapijos taikymas ankstyvajame reabilitacijos etape po klubo endoprotezavimo operacijos turėtų labiau pagerinti klubo sąnario funkciją becemenčio nei cementinio endoprotezo grupėje. Darbo uždaviniai: 1) Įvertinti cementinio endoprotezo grupės tiriamųjų operuoto klubo sąnario funkciją bei emocinę būklę prieš ir po kineziterapijos; 2) Įvertinti becemenčio endoprotezo grupės tiriamųjų operuoto klubo sąnario funkciją bei emocinę būklę prieš ir po kineziterapijos; 3) Palyginti operuoto klubo sąnario funkciją bei emocinę būklę tarp grupių prieš ir po kineziterapijos. Tyrimas atliktas AB „Ortopedijos technika“, kuriame dalyvavo 14 pacientų po klubo sąnario endoprotezavimo operacijos dėl koksartrozės. Jie buvo suskirstyti į dvi grupes: cementinio ir becemenčio endoprotezo grupes. Testavimai atlikti dukart –... [toliau žr. visą tekstą] / Endoprosthesis operation of the hip joint relieves or removes pain, restores functional leg stability and function of the supporting foot (Drobniewski et al., 2012). The obsolete hip joint is changed to cemented, cementless or hybrid hip prosthesis (Laupacis et al., 2002). Object: patients emotional condition and hip joint function after hip joint endoprosthesis operation. The purpose of the study was to evaluate influence of physical therapy between cemented and cementless hip prosthesis groups after hip joint endoprosthesis operation due to coxarthritis at early rehabilitation process. Hypothesis: applying physical therapy after hip joint endoprosthesis operation at early rehabilitation process should more improve hip joint function in cementless than in cemented hip prosthesis group. The tasks: 1) To evaluate operated hip joint function and emotional condition of the cemented hip prosthesis group before and after physical therapy. 2) To evaluate operated hip joint function and emotional condition of the cementless hip prosthesis group before and after physical therapy. 3) To compare hip joint function and emotional condition after operation between groups before and after physical therapy. The research has been done at AB „Ortopedijos technika“. All 14 patients were after hip joint endoprosthesis operations due to coxarthritis. They were divided into two groups: cemented and cementless hip prosthesis groups. Subjects were tested before and after psysical therapy use. It... [to full text]

The topic of my Dissertation is a role of a nurse in subsequent care at a patient after reimplantation of a total coxe endoprosthesis. The aim of this Dissertation is to find whether nurses provide patients with specific (medical) intervention (after reimplantation of a total coxe endoprosthesis) according to the diagnosis for care or in a standard way according to the performed act. Another aim was to find specific needs of patients (after reimplantation of total coxe endoprosthesis) and to create a plan of care, as possible. The last aim is to find whether patients after reimplantation of a total coxa endoprosthesis are provided with sufficient information about prevention of possible complications.To gain the necessary data, quantity research in combination with quality one was carried out. The hypothesis that nurses provide nursing intervention in a standard way, no matter if patients are after a primary implantation of a total coxa endoprosthesis or after a reimplantation of a total coxa endoprosthesis, was not proved. The other hypothesis, that nurses does not differ nursing care of clients after a reimplantation of a total coxa endoprosthesis from nursing care of clients after a primary implantation of a total coxa endoprosthesis, was not proved.

The present study is divided into theoretical and practical part. The theoretical part deals with anatomy of thehip andknee joint, in the next part there is definition of endoprosthesis as well as historical development of endoprosthesis. Subsequently, different types of endoprosthesis, surgery equipment and possible complications after surgery are described. It is followed by nursing care and rehabilitation including spa treatment. The theoretic part is concluded with revision of the joint. The practical part of the master thesis has been elaborated from the qualitative survey. The survey was conducted with the respondents who underwent endoprosthesisof the knee or hip joint and with the nurses working at regular orthopaedic department or orthopaedic intensive care unit (ICU). The interviews were afterwards transcribed and elaborated by means of the technique of open coding with the method "pencil and paper". 16 categories and 48 subcategories emerged from the data processed in this manner.

Tumorous total endoprosthesis of hip joint is used for reconstruction of the limb affected by bone tumor and to regain its functnion. Longterm load conditions must be considered by the reconstruction and the joint mobility must be enabled. Suitability of the endoprosthesis depends on its construction considering shape, material and with this related mechanical properties. This thesis deals with creation of computational model and stress-strain analysis of tumorous total endoprosthesis of hip joint. There are two different types of endoprosthesis modeled in this thesis, each with three different length of resected bone replacement. Based on stress-strain analysis an assessment of possible limit states is made.

The presented master’s thesis deals with the problem of the application of total endoprosthesis (TEP) during temporomandibular joint (TMJ) replacement. The implantation of TEP occurs due the severe TMJ disease (arthrosis, ankylosis, cancer) or its macrotrauma. Condylar prosthesis is fixed during the implantation by self-tapping screws to the mandible. This fixation causes a change of stress-strain behaviour of mandible, TEP and fixation screws. In the thesis is performed the stress-strain analysis by using computational modeling in use the finite element method (FEM). Analysis is performed for six different screws positions (the number of screws is unchanged) and for a variable the static friction coefficient (in range 0.1 to 0.11) between condylar prosthesis (CP) and fossa prosthesis (FP). Altogether, 36 variants of computational models were created. The stress strain analysis detected a substantial influence of the static friction coefficient value to final results of displacements, contact pressure on the articulation surface between the CP and the FP and also to von Mises stress of the CP. A substantial influence of different screws position is detected for von Mises stress in the screws and for von Mises strain in the cortical and spongious bone tissue.

This master's thesis deals with stress-strain analysis of hip joint after total hip replacement. These stress-strain states are compared between four variable stems. A research study of available literature is presented with the focus on finite element analysis of hip joints. Basics of hip's joint anatomy is described along with total endoprostheses' variants and properties. Computational modeling was chosen as a solution method using finite element analysis. The solution was executed using ANSYS software. For each stem there was created a computational model which consists of several submodels such as model of geometry, material, contacts and loading. The assesed variables were total hip displacement, contact pressure between the head and liner, stress on each stem and strain on femur. The evaluation of femur's bone tissue was accomplished on basis of Frost's mechanostat in seven Gruen zones.

The aim of this work is to analyse axisymetric tasks by norm ISO 7206-5, which is used to determination of static strength of ceramic heads. In the numeric analysis there will be considered form variances from nominal conicalness and circularity of stem sections i.e. possible variances caused by production. Furthermore form changes of recess inside of the head measured on real samples will be considered. All these variances from nominal values are necessary to analyse in more details, because they can participate in destruction of ceramic heads. The stem system, ceramic head and load cone (DHK) will be simulated as a 2D axisymetric task and 3D quarter symetrical task. That is why is necessary to undertake also comparing analysis of 2D and 3D tasks and compare results or eventually evaluate the error. This problem is solved using of Finite element System ANSYS 11.0.

This master thesis deals with stress-strain analysis of carpometacarpal (CMC) thumb joint. It is a preliminary study, which was not analysed on BUT Mechanical and biomechanical institute yet. There is a comparative stress-strain analysis of CMC with applied total endoprosthesis and physiological condition. The model of geometry was created based on CT images and processed with using software Catia and Solidworks. The problem was solved in numerical FEM (finite element method) in software Ansys 13.0

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