The work deals with the lubrication of total knee replacement using fluorescence microscopy method, which allows unique insight into the contact between femoral and tibial component. The aim was to determine the effect of composition of synovial fluid (i.e. albumin, -globulin, hyaluronic acid and phospholipids) on film thickness and protein behaviour in contact, and also to determine changes of contact area during rotation. Since this is the first experimental work dealing with a knee replacement lubrication primarily, only simple rotation and load cycles were applied by the knee simulator. The output of the experiments was fluorescence intensity, which corresponds to dimensionless film thickness, over time. Another important output are the images directly showing the fluorescently labelled proteins in the contact area. The results show, there are fundamental differences in lubrication in different positions of rotation, due to changes of position, shape and behaviour of the contact area. The composition of the lubricant is also essential, since the proteins themselves form a relatively strong lubricating film and their mixture leads to a substantial reduction of film thickness, due to significant formation of clusters. Complex fluid, although it does not form the strongest layer, is able to create a quite continuous film.

Title: Evaluation of selected parameters in American football players as possible causes of their injuries Objectives: The aim of this thesis is, after studying selected theoretical backgrounds, to point out at the performance players of American football deliberately selected team to the possible causes of injuries (with special focus on the area knee joint) by evaluating body parameters, then selected three tests and at the same time by evaluating the screening of two positions in progress vertical jump. Methods: To write down the diploma thesis, we mainly used knowledge and conclusions from a literature search of foreign articles and studies dealing with the issue of injuries, injury prevention, sports performance, and normative data. In the next step, testing of selected three tests and subsequent normative evaluation was performed. Screening was also important for the evaluation of two positions during the vertical jump. Results: Through hand-picked performance tests, it was found that the selected players from the team achieved a sufficient level of movement based on the results according to standardized tables that we used. In comparison with professional players and the norm set out by Palmieri (2019), the players that we tested lag behind. As for the injuries in the selected group, the...

Transtibial amputees are at increased risk of contralateral hip and knee joint osteoarthritis, likely due to abnormal biomechanics. Biomechanical challenges exist for transtibial amputees in gait and cycling; particularly, asymmetry in ground/pedal reaction forces and joint kinetics is well documented and state-of-the-art passive and powered prostheses do not fully restore natural biomechanics. Elliptical training has not been studied as a potential exercise for rehabilitation, nor have any studies been published that compare joint kinematics and kinetics and ground/pedal reaction forces for the same group of transtibial amputees in gait, cycling, and elliptical training. The hypothesis was that hip and knee joint kinematics and kinetics and ground and pedal reaction forces would differ due to exercise (gait, cycling, elliptical) amputee status (amputated, control [non-amputated]), and leg (dominant [intact], non-dominant [amputated]). Ten unilateral transtibial amputees and ten control participants performed the three exercises while kinematic and kinetic data were collected. Hip and knee joint flexion angle, resultant forces, and resultant moments were calculated by inverse dynamics for the dominant and non-dominant legs of both participant groups. Joint biomechanics and measured ground/pedal reaction forces were then compared between exercises, between the dominant and non-dominant legs within each participant group, and across participant groups. Significant differences in hip and knee joint flexion angles and timing, compressive forces, extension-flexion (EF) and adduction-abduction (AddAbd) moments, and anterior-posterior (AP) and lateral-medial (LM) reaction forces were found. Particularly, transtibial amputees showed maximum knee flexion angle asymmetry as compared to controls in all three exercises. Maximum hip and knee compressive forces, EF moments, and AddAbd moments were lowest in cycling and highest in gait. Asymmetry in amputee midstance knee flexion and timing in v gait, coupled with low maximum EF moment for the non-dominant leg, suggests that amputees avoid contraction of the non-dominant quadriceps muscle. Knee flexion angle and EF moment asymmetry in elliptical training suggests that a similar phenomenon occurs. Asymmetry in AP and LM reaction forces in gait, but not other exercises, suggests that exercises that constrain kinematics reduce loading imbalances. The results suggest that cycling and elliptical training should be recommended to transtibial amputees for rehabilitation due to reduced hip and knee joint forces and moments. Elliptical training may be preferred over gait due to decreased joint loading and loading asymmetry, but some asymmetry and differences from control participants still exist. Non-weight bearing exercises such as cycling may be best at reducing overall joint loading and joint load asymmetry but do not eliminate all kinematic and temporal asymmetries. Current state-of-the-art prosthetic leg design is insufficient in restoring natural biomechanics not only in gait but also in cycling and elliptical training. Improved prosthesis kinematics that restore non-dominant knee flexion in amputees to normal levels could help reprogram quadriceps muscle patterns in gait and elliptical training and hip and knee joint biomechanical asymmetries. Further work in comparing contralateral and prosthesis ankle joint biomechanics would help to elucidate the relationship between prosthesis design and its impact on lower limb joint biomechanics.

The aim of the Diploma Thesis is to propose the methodology of a 3D model creation of a femoral part of a knee joint replacement. As the knee joint is the most loaded joint of the human body, the function, description and biomechanics relation is described in first part of the Thesis. The second part is focused on degenerative damage of knee joints that leads to the implantation of standard knee joint replacements. The third part deals with the construction of standard knee joint replacements and their surgery implantation. The last part of the Thesis describes the creation of an individual knee joint replacement, especially the femoral part.

The presented diploma thesis deals with stress-strain analysis of the intact human knee joint and the knee joint after reconstruction using fixation plate. Finite element method is used to determine the biomechanical response of the knee under loading with the FE software Ansys. The three-dimensional finite element model is consisted of bony structures (femur and tibia) which were created using computed tomography (CT) data, articular cartilages and both menisci. Model of the locking plate (LCP) was created based on producer's technical guide. Three models of the knee joint with LCP fixation plate are created for three different sizes of condylar fragment based on the intact model. On all variants is applied loading corresponding to maximum loading in a gait cycle. The results show that reconstruction of the knee joint with locking plate has no effect on changing in contact pressure on tibial plateau.

Bakgrund: Skada på främre korsbandet är vanligt hos unga kvinnliga fotbollsspelare. Det finns evidens för att neuromuskulär träning kan reducera risken att drabbas av främre korsbandsskada med 64–88 %. Knäkontroll är ett neuromuskulärt träningsprogram som Svenska Fotbollförbundet (SvFF) implementerade i sin tränarutbildning år 2010. Syfte: Syftet med studien var att kartlägga hur väl rekommendationerna för utförande av knäkontrollträning följs i flickfotbollslag i åldrarna 12–17 år samt om förekomst av knäkontrollträning var högre i de flickfotbollslag där lagledaren genomfört tränarutbildning efter år 2010. Metod: Studiens design var en kvantitativ, icke-experimentell tvärsnittsstudie. Data samlades in via en egenkomponerad enkät som besvarades via mejl av 33 lagledare för flickfotbollslag. Deltagarna var ett stickprov ur en större population med geografisk spridning över Sverige. Resultat: Studiens resultat blev att fyra (12 %) lagledare bedömdes tillhöra kategorin Följer helt rekommendationerna, 21 (64 %) lagledare bedömdes tillhöra kategorin Följer delvis rekommendationerna och åtta (24 %) lagledare bedömdes tillhöra kategorin Följer inte rekommendationerna. Någon skillnad i utförande av programmet Knäkontroll beroende på om lagledare hade genomfört tränarutbildning efter 2010 eller om lagledare saknade tränarutbildning kunde inte ses. Slutsats: Slutsatsen av studien blev att majoriteten av lagledare för flickfotbollslag i åldrarna 12–17 delvis följde rekommendationerna för utförande av programmet Knäkontroll. Inga skillnader kunde ses i hur väl programmet Knäkontroll följdes beroende på lagledarens tränarutbildning. / Background: Anterior cruciate ligament (ACL) injuries are common in young female soccer players. There is evidence that neuromuscular training can reduce the risk of ACL injury with 64–88 %. Knee control is a neuromuscular training programme that was implemented in the national education for soccer coaches in 2010. Aim: The aim of the study was to examine how well girl soccer teams, ages 12–17, follow the existing recommendations regarding knee control training to prevent ACL injuries and if adherence was higher in teams where the coach was educated later than 2010. Method: The study design was a quantitative, non experimental cross-sectional study. A self-composed questionnaire was answered through e-mail by 33 coaches for girl soccer teams. Participants were a random sample of a larger population with a geographical spread across Sweden. Results: The result of the study was that four (12 %) coaches were placed in the category Following the recommendations fully, 21 (64 %) coaches in the category Following the recommendations partly and eight coaches in the category Do not follow recommendations. A difference in adherence to the programme Knee control could not be seen based on if the coach had completed the national education for soccer coaches later than 2010 or lacked this education. Conclusion: The conclusion of the study was that the majority of coaches for girl soccer teams, ages 12–17, followed the recommendations partly for performance of the programme Knee control. No difference could be seen in adherence to the programme Knee control based on the coach’s education.

Orientador: Guilherme Antonio Moreira de Barros / Resumo: Segundo a Associação Internacional para o Estudo da Dor (IASP), a dor crônica pós-operatória (DCP) é aquela presente por mais de três meses após a realização de um procedimento cirúrgico. As cirurgias ortopédicas para o tratamento de doenças degenerativas relacionadas ao avanço da idade têm crescido nas últimas décadas, expondo esses indivíduos ao risco de desenvolver a DCP. O objetivo desse estudo foi avaliar a incidência de DCP em pacientes submetidos as cirurgias ortopédicas como a artroplastia total de joelho e quadril, fixação de fratura de fêmur e cirurgias na coluna vertebral. Os fatores de associação para o aparecimento da DCP, assim como sua ocorrência foram estudados. Foram aplicados questionários validados disponíveis na literatura, assim como protocolo de pesquisa desenvolvido pelos pesquisadores. Buscou-se contemplar questões sobre a presença, localização, tipo e intensidade da dor, presença de dor neuropática, identificação de labilidade emocional e catastrofização da dor, uso de medicação para o controle da dor, dentre outros. As entrevistas dos participantes ocorreram em duas etapas, no pré-operatório e pós-operatório, esse último com o seguinte cronograma: 30 dias, três, seis e doze meses após a realização da cirurgia. Os pacientes incluídos no decorrer da pesquisa foram acompanhados durante um ano após a realização da cirurgia, sendo assim, o estudo levou dois anos para ser concluído. Essa pesquisa foi aprovada pelo Comitê de Ética em Pesquisa da instituição... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: According to the International Association for the Study of Pain (IASP), chronic postoperative pain (DCP) is that present for more than three months after the performance of a surgical procedure. Orthopedic surgeries for the treatment of degenerative diseases related to advancing age have grown in recent decades, exposing these individuals to the risk of developing PCD. The aim of this study was to evaluate the incidence of PCD in patients undergoing orthopedic surgeries such as total knee and hip arthroplasty, fixation of the femur fracture and surgeries in the spine. The association factors for the onset of DCP, as well as its occurrence, have been studied. Methods: Validated questionnaires available in the literature were applied, as well as a research protocol developed by the researchers. We sought to contemplate questions about the presence, location, type and intensity of pain, presence of neuropathic pain, identification of emotional lability and pain catastrophization, use of medication for pain control, among others. The participants' interviews took place in two stages, in the preoperative and postoperative periods, the latter with the following schedule: 30 days, three, six and twelve months after the surgery. The patients included in the research were followed up for one year after the surgery, so the study took two years to complete. This research was approved by the institution's Research Ethics Committee. Results: After invitation, analysis of inclusion and ex... (Complete abstract click electronic access below) / Doutor

Running is known to provide important health benefits. However, the incidence of injury among runners is high, particularly among novice runners, which discourages long term participation in the sport. The knee is the most commonly injured joint in novice runners. In general, aberrant frontal and transverse plane kinematics are associated with the development of knee injuries in runners. It was unknown whether the high rate of knee injury in novice runners was due to abnormal kinematics. Further, it was unclear whether these risk factors for injury could be improved. This dissertation includes four studies investigating kinematics in novice runners, how they change with training and evaluation of a running assessment. The first study compared frontal and transverse plane kinematics of female novice and experienced runners. Novice runners displayed more knee kinematics associated with injury than experienced runners, which may contribute to their higher risk of injury. The second study investigated the effects of two different training programs on kinematics of novice runners: one program consisted of 8 weeks of walking followed by 8 weeks of running, the other consisted of 8 weeks of strength/plyometric training followed by 8 weeks of running. Results demonstrated that training produced small changes in kinematics, however all types of training produced a mix of beneficial and detrimental effects. Participants who completed the study displayed better knee kinematics 8 than those who dropped out, which may have influenced their ability to complete the program. The third study sought to investigate changes in coordination of the hip and ankle joints, and their contributions to knee joint angles thought to contribute to injury. Results demonstrated that both the hip and the ankle may influence changes in knee kinematics, however the relative motion of the hip and the ankle appears to remain stable with training. In the final study, we investigated the reliability and validity of the Running Readiness Scale (RRS), as a low cost assessment of kinematics related to injury in runners. The RRS demonstrated good inter and intra rater reliability. Further, the RRS appeared to effectively discriminate between runners according to knee abduction, but not knee internal rotation.

Title: Evaluation and determination of standard ratio of extensors and flexors of the knee in sporting youth. Objectives: The aim of the thesis is to establish the standards of the force ratio H: Q for the youth football categories U16, U17, U18, U19, U21 and adult players of the Czech Republic and based on the prescription type of study to establish a percentage critical disbalance of dynamic knee stabilizers which may be the most common cause of injuries to dynamic or static knee joint stabilizers in soccer players. Methods: The monitored group of players consisted of football players playing in elite Czech football clubs, both in youth and senior categories, who meet the predetermined selection criteria. The isokinetic strength parameters were monitored using a Cybex Humac Norm isokinetic dynamometer (Cybex NORM ®, Humac, CA, USA). We investigated maximum strength moment (PT) of extensors and knee flexors of dominant and non-dominant limb at concentric contraction at angular velocities of 60, 180 and 300ř.s-1 . Then we watched the players wounded. If the injury occurred, then we looked back at its strength characteristics and the strength ratio between the extensors and flexors of the knees and whether it was possible to predict the injury and determine the critical level that indicates the...

Title: Strength asymmetries of female soccer players according to playing position Objectives: The aim of this diploma thesis was to characterize the unilateral and bilateral asymmetries of knee flexors and extensors in elite football players based on player positions and to define the characteristic isokinetic strength profile for each playing positions. Methods: The research group consisted of 66 female football players who play in the highest czech league. The players completed laboratory testing under the supervision of qualified experts, which took place according to the standard conditions described in the methodological part of this study. In the case of players, we examined the strength asymmetries in the flexors and extensors of the knee and compared them between the 4 basic positions in football. Results: After summing the data from all angular velocities (60ř.s-1 , 180ř.s-1 , 300ř.s-1 ) we found that 33% of our attackers had quadriceps asymmetries above 10%, which was the most of all posts. This is followed by goalkeepers with 28% and midfielders with 25%. The lowest percentage of quadriceps asymmetries was recorded in defenders 22%. Even in the case of hamstrings, we recorded the most asymmetries (> 10%) in attackers, up to 46%. For midfielders and defenders, it was the same result for...