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EN
The paper presents results of the preliminary structural analysis of model of the endoprosthesis of the hip joint. Basics of anatomy and biomechanical analysis of the hip joint were introduced. Based on data from atlas of human anatomy and medical imaging, the prototype of endoprosthesis was modelled using Solid Edge ST8 software. After determining physical properties of structural materials, the Finite Elements Analysis of the model was conducted using in SolidWorks software under various load conditions. Finally the results of analysis are presented.
EN
Introduction: To date, suction drainage has been routinely used after hip joint replacement. Currently, the validity of this practice is questioned in the literature. Hematoma is a risk factor of periprosthetic infection. Post-operative ultrasonography enables precise assessment of hip joint hematoma. Aim: The aim of the study was to evaluate the usefulness of hip joint ultrasonography with respect to the validity of using suction drainage after primary hip arthroplasty. Material: Inclusion criteria: coxarthrosis. Exclusion criteria: primary and secondary coagulopathy, renal or hepatic failure and history of venous or arterial thrombosis. In total, 90 patients were enrolled. Methods: The study was prospective. The patients were assigned into groups in accordance with simple randomization. On the third day postsurgery, an ultrasound examination was conducted in all patients. Results: Deep infection was found in two patients with suction drainage. Hematoma was almost twice bigger in the drainage group. There were no statistically significant differences in the Harris Hip Score between the groups. No statistically significant differences were found between the groups in: complete blood count parameters and C-reactive protein values in the first and third day after surgery, the amount of transfused packed red blood cells, duration of hospital stay, cost of hospital stay and the relationship between osteophyte removal and hematoma size. Conclusions: Ultrasonography performed after hip replacement surgeries is useful in the assessment of hematoma. The randomized study did not reveal statistically significant differences between the group with and without drainage, thus suggesting that this practice can be abandoned, except for selected cases. Due to a short hospital stay, it is recommended to conduct an ultrasound scan in addition to routine radiography and laboratory tests in order to reduce the risk of complications.
PL
Wstęp: Dotychczas rutynowo po endoprotezoplastyce biodra stosowano drenaż ssący. Obecnie w piśmiennictwie podważana jest zasadność stosowania pooperacyjnego drenażu ssącego. Krwiak pooperacyjny stanowi czynnik ryzyka infekcji okołoprotezowej. Zastosowanie badania ultrasonograficznego w diagnostyce pooperacyjnej pozwala na precyzyjną ocenę krwiaka stawu biodrowego. Cel: Celem pracy jest analiza wartości badania ultrasonograficznego stawu biodrowego w odniesieniu do zasadności stosowania drenażu ssącego po pierwotnej endoprotezoplastyce biodra. Materiał: Kryteria włączenia: koksartroza. Kryteria wyłączenia: pierwotna i wtórna koagulopatia, niewydolność wątroby lub nerek, przebyta zakrzepica tętnicza lub żylna. Do badania włączono 90 chorych. Metody: Badanie zaplanowano jako prospektywne. Chorych przydzielano do dwóch grup zgodnie z zasadami randomizacji prostej. W trzeciej dobie po operacji wykonywano badanie ultrasonograficzne u wszystkich chorych. Wyniki: U dwóch chorych w grupie z drenem stwierdzono infekcję głęboką. W grupie z drenem zaobserwowano średnio prawie dwukrotnie większy krwiak w stawie. W obu grupach w ocenie w skali Harris Hip Score nie odnotowano istotnych statystycznie różnic. Nie stwierdzono istotnej statystycznie różnicy między grupami w ocenie: morfologii i białka ostrej fazy w pierwszej oraz trzeciej dobie po operacji, ilości przetaczanego koncentratu krwinek czerwonych, długości hospitalizacji, pod względem kosztu pobytu, jak również między usunięciem osteofitów a wielkością krwiaka. Wnioski: Badanie ultrasonograficzne wykonywane po endoprotezoplastyce biodra jest przydatne w ocenie krwiaka. W przeprowadzonym randomizowanym badaniu nie stwierdzono istotności statystycznej pomiędzy grupami z drenem i bez drenu, co sugeruje odstąpienie od drenażu ssącego, poza szczególnymi przypadkami. Ze względu na krótki okres pobytu chorych w szpitalu zalecamy, oprócz rutynowo wykonywanych zdjęć rentgenowskich i badań laboratoryjnych, diagnostykę ultrasonograficzną w celu zmniejszenia ryzyka powikłań. Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/index.php/wydawnictwa/volume-17-no-70
3
Content available remote Capacity of deformed human joint gap in time-dependent magnetic field
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EN
Analysis of carrying capacity of synovial unsymmetrical fluid flow in deformed, human joint gap, especially in hip joint, is presented. The following assumptions are taken into account: stationary, isothermal and incompressible synovial unsymmetrical fluid flow in time-dependent magnetic field rotation motion of bone head, squeeze of synovial fluid in human joint gap, changeable synovial non-Newtonian fluid viscosity, changeable and deformed gap height in human joint, and constant synovial fluid density. The simplified system of basic equations for pressure and synovial velocity distribution are analysed. Numerical and analytical formulae for capacity force taking into account conjugation fields of the stresses and deformations occurring in elastic cartilage and in synovial fluid obtained by virtue of theory of elasticity and fluid mechanics can be considered as the novely of this paper. Analytical solutions for he values of capacity forces allow easy numerical calculations, which may be very useful for medical diagnosis.
PL
Duże zapotrzebowanie na sztuczne zamienniki chorych stawów prowadzą do szybkiego rozwoju endoprotezoplastyki. Najczęściej spotykane problemy w tej dziedzinie są związane z ograniczoną czasową funkcjonalnością endoprotezy na skutek zużycia materiałowego elementów węzła tarciowego. W celu rozwiązania tych problemów pomocna może się okazać teoria smarowania elastohydrodynamicznego, która pozwala określić warunki smarowania w sztucznym stawie. W pracy porównano różne rozwiązania materiałowe stosowane na elementy par trących endoprotez, a także porowate spieki metaliczne.
EN
The great demand for artificial replacements of diseased joints has lead to a rapid development of endoprosthetics. The most common problems in that area have to do with the limited lifespan of endoprostheses due to the wear of friction pair elements. In order to resolve these problems, the theory of elastohydrodynamic lubrication can be applied. It allows determining the lubrication conditions in an artificial joint. In this work, different solutions for the materials of friction pairs of endoprostheses, such as the use of porous sintered metals, are compared.
EN
Physical activity (PA) is a well-known, simple and effective preventive and therapeutic intervention for low back pain (LBP). In spite of the growing interest in active lifestyles and its benefits, more needs to be known about the relationship between energy expenditure, body mass and lumbar-pelvic kinematics during the forward bending movement in a group of young asymptomatic people who met PA guidelines. Young people can be identified as a future risk group of civilisation diseases and lumbar-hip kinematics can be considered as a predictor of LBP occurrence. The aim of this study was to identify the association of gender, self-reported energy expenditure, body mass index, and lumbar-hip kinematics in young people. Methods: Sixty-four students at pre-employment stage participated in the study. They declared moderate-to-high PA and activity-induced energy expenditure (AEE) was self-reported. Kinematic data of the lumbar spine, pelvis and hip were collected during forward bending using a 3D motion ca pture system. Results: Sex was found to be associated with pelvis ( = –0.38 p = 0.002) and lumbar mobility ( = 0.49, p < 0.001) during forward bending and BMI was related only to lumbar mobility ( = –0.41, p = 0.001). Recreation AEE significantly predicted hip flexion mobility ( = 0.38, p = 0.002). Conclusions: This study showed that among a sample of physically active young people, BMI, self-reported AEE and sex can partially predict lumbar-hip kinematics during trunk flexion. Recreational PA can be regarded as improving hip mobility and thus making forward bending more effective and less prone to injury.
EN
Purpose: The assessment of hip joint abductor muscle strength is most often carried out using a dynamometric test. However, both in clinical practice and literature, evaluation is performed by means of the single-leg half-squat or the amount of abduction movements performed in the hip joint. In this context, the question arises whether the results of individual tests are convergent. The aim of the study is to evaluate the relationship between strength of the hip abductor muscle measured by dynamometer, the single-leg-squat and the number of repetitions of the movements in time. Methods: A group of 35 students (20 women and 15 men) between 20 and 24 years old participated in the study. Each student was subjected to three tests assessing the condition of the hip and associated abductor muscles. Those included: assessment of hip joint abduction muscle strength in a dynamometric study, assessment of the number of abdomen movements performed lying on the side and standing, during a 30-second interval, and the single-leg-squat test. Results: Based on the tests conducted, a significant relationship was observed between the muscle strength measurement results for the left and right side in the dynamometric study and the number of hip abduction repetitions in 30 seconds and the single-leg-squat test. Conclusions: The obtained results indicate a significant relationship between the results of all the tests. In practice, this means that the tests can be used interchangeably.
EN
We have reported a bacterial infection in a dog with progressive dysplasia of the hips. Orthopedic surgery was performed. Seven weeks prior to the surgery, the patient was bitten by another dog. The postimplantation wound exuded for four days after the surgery. Microbiological analysis performed by standard identification techniques showed the presence of Staphylococcus intermedins, but an additional molecular analysis indicated S. pseudintermedius. This was followed by an evaluation of antibiotic susceptibility of the strain which showed cefoxitin, ciprofloxacin, clindamycin, trimethoprim/sulfamethoxazole, doksycycline, erythromycin, and gentamicin resistance. Minimal inhibitory concentration (MIC) values for selected antibiotics were reported. Resistance for cefoxitin indicates that methicillin resistant S. pseudintermedius (MRSP) strains were present in individual macroorganisms, but they can expand and persist the colonization of other hosts.
EN
Under the study, a stand has been designed and made for examining the temperature of PMMA-based (methyl polymethacrylate) surgical cement polymerization in conditions corresponding to the conditions of its implantation into an organism. A Weller endoprosthesis was implanted in a bone model made of resin by means of Palacos R-40 cement. The temperature of polymerizable cement was measured in different points at the border of its contact with the bone model.
EN
Parametric (geometrical and numerical) models creation for the bone systems require recognition precisely of their anatomical features (bones and joints), especially those which have influence on accuracy of reconstruction geometry of bone and properties of endoprosthesis. Those features must be unique and easy to defined basing on CT or MRI data. Parametrical models take into consideration adequate scope of variation of shape and dimensions of bones and endoprostheses, assuming relatively small number of parameters. The shape and dimensions of models are dependent on defined parameters, hence changes of that parameters cause model adaptation procedure and creation corresponding type of model. The parametrical model of human hip joint bones is presented in this paper. Parametrical model of pelvic bone was generated on the basis of selected characteristic anatomical points and dimensions between them, but for femur parametrical model creation were applied characteristics dimensions and angles.
EN
In the paper the leading wear processes of hip and knee endoprostheses are discussed. Selected results of the tribological tests are given. The influence of the surface treatment on wear of T?6A14V titanium alloy was determined. Additionally, the test results of wear products are given.
EN
The paper concerns new construction of type series of polish hemi-endoprostheses of the hip joint. Clinical assumptions, simulation studies and clinical prototypes were presented. According to author's knowledge it is one of the first introductions of new generation, polish, modular hemi-endoprosthesis of the hip joint.
EN
Introduction Improper hip joint development may lead to numerous unfavourable changes in the musculoskeletal system. The aim of this research was to determine how often adolescents with idiopathic scoliosis and their healthy counterparts experienced anomalies of the hip in their infancy period and to examine the correlation between the occurrence of hip anomalies and idiopathic scoliosis. Material and methods The research was conducted in medical centres as well as in schools. The parents of adolescents with idiopathic scoliosis and parents of healthy adolescents completed a questionnaire on the basis of their child’s development history included in the medical records book and other medical documentation. Results 533 questionnaires were taken into consideration, included 145 questionnaires completed by parents of adolescents with scoliosis (121 girls – 13.8 years, SD 1.9; 24 boys – 12.9 years, SD 2.5) and 388 questionnaires from the group of adolescents without scoliosis (194 girls – 13.5 years, SD 2.0; 194 boys – 13.4 years, SD 2.1). No significant differences were noted in the incidence of hip anomalies between the groups of girls and boys with and without scoliosis, no correlations between anomalies of the hip and scoliosis were found (girls χ2=0.840; Cramer V=0.052; p=0.36; boys χ2=1.205; Cramer V=0.074; p=0.27). Conclusions Hip anomalies such as hip dysplasia, movement asymmetry or range of motion limitations diagnosed in the infancy period did not correlate with idiopathic scoliosis. Further research aimed at a separate analysis of the influence of hip dysplasia on the occurrence of idiopathic scoliosis should be carried out.
EN
The decrease in contact hip joint stress after Chiari osteotomy is studied using a mathematical model. In the model, additional coverage of the femoral head by the ala ossis ilei segment is taken into account. It is shown that this additional coverage significantly decreases stress, mostly by the indirect effect caused by the shift of the stress pole.
EN
Radiographic and clinical studies, coupled with biomechanical assessment of the hip, are important tools for predicting the development of osteoarthitis of the hip. In order to better understand the treatment of hip dysplasia, it is necessary to determine the contact stress in the hip joint. In this study, a three-dimensional mathematical model was used to determine hip joint contact stress. Because of the discrepancy in the results of analyses of different radiographic indicators of hip dysplasia, the calculation of hip joint contact stress is proposed for a more accurate assessment of the severity of hip dysplasia.
PL
U dzieci z podejrzeniem patologii stawów biodrowych w algorytmie postępowania nadal są uwzględniane badania rentgenowskie. Badania rentgenowskie są pomocne w obrazowaniu, gdyż w zakresie diagnostyki układu kostnego charakteryzują się wysokimi wskaźnikami skuteczności rozpoznawczej. Mimo że badania rentgenowskie związane są z niewielką lub umiarkowaną dawką promieniowania jonizującego, wykonując je u dzieci, należy szczególnie uwzględniać metody ograniczania narażenia na promieniowanie rentgenowskie. Wśród nieprawidłowości stawów biodrowych u najmłodszych dzieci istotną patologią jest dysplazja stawu biodrowego. Do częstszych chorób, które mogą przebiegać z obrazem zajęcia stawów biodrowych w badaniu rentgenowskim, należą także przemijające zapalenie błony maziowej, choroba Perthesa (młodsze dzieci) i młodzieńcze złuszczenie głowy kości udowej (starsze dzieci).
EN
In children with suspected hip joint pathology, X-ray examinations are still included in the management algorithm. X-ray examinations are helpful in imaging, as they are characterized by high rates of recognition efficiency in the diagnosis of the skeletal system. Although X-ray examinations are associated with a low or moderate dose of ionizing radiation, when performing them in children, special consideration should be given to the methods of limiting exposure to x-rays. Among the abnormalities of the hip joints in the youngest children, hip dysplasia is a significant pathology. Transient synovitis, Perthes’ disease (younger children), and juvenile slipped capital femoral epiphysis (older children) are also among the more common diseases that may be associated with an X-ray changes of the hip joints.
PL
Choroba zwyrodnieniowa stawów biodrowych jest bardzo częstym i poważnym problemem zdrowotnym wśród osób powyżej 65. roku życia. W przypadku znacznego zaawansowania choroby i po wyczerpaniu możliwości leczenia zachowawczego przeprowadza się zabieg endoprotezoplastyki. Najpopularniejszym badaniem przed wszczepieniem i po wszczepieniu endoprotezy jest klasyczne RTG (Classic Roentgenodiagnostics) porównawcze stawów biodrowych. Ocena stanu po endoprotezoplastyce stawu biodrowego wymaga wykonania bardzo wysokiej jakości radiogramów. Zgodnie z filozofią optymalizacji w rentgenodiagnostyce należy dążyć do zapewnienia najwyższej wartości diagnostycznej przy jak najniższej dawce promieniowania. Celem badania była analiza, jak poszczególne elementy endoprotezy wpływają na EXI (Exposure Index) oraz dawkę DAP (Dose Area Product) w zmiennych warunkach ekspozycji. Przeanalizowano 108 radiogramów tytanowego trzpienia z głową (kobalt-chrom), panewki ceramicznej w metalowej czaszy oraz całej endoprotezy – złożenie wymienionych wcześniej elementów przy zmianie napięcia anodowego w zakresie 70-93 kV i trzech różnych wariantach użycia kratki przeciwrozproszeniowej (bez kratki, f (o) = 115 i f (o) = 180). Wartość EXI odpowiednio dla całej protezy, panewki ceramicznej wmetalowej czaszy i trzpienia z tytanu z głową kobaltowo-chromową maleje wraz ze zmianą kratki rozproszeniowej na kratkę o większym kącie geometrii paskówołowiowych (f (o) = 180). Rodzaj materiału poszczególnych elementów protezy wpływa na wartość DAP. Przy odległości FFD 115 cm, zastosowanie kratki przeciwrozproszeniowej f (o) = 180 zamiast f (o) = 115 powoduje wzrost wartości DAP przy ekspozycji całej endoprotezy.
EN
Osteoarthritis of hips is a very common and serious health problem among people over 65 years of age. In case of advanced disease, and after having exhausted the possibilities of conservative treatment, the surgery needs to be performed. The most common testing before and after implantation of the prosthesis is made by means of X-ray examination. Evaluation of total hip replacement requires a very good quality radiographs. According to the philosophy of optimizing, diagnostic radiology should strive to provide the highest diagnostic value at the lowest dose of radiation. The aim of the study was to analyze how different elements of the prosthesis affect the Exposure Index (EXI) and the dose expressed as a Dose Area Product (DAP). 108 radiographs were analyzed for titanium femoral stem with cobalt-chrome head, ceramic cup in a metal bowl and the whole prosthesis – by changing the anode voltage in the range of 70-93 kV and three different variants using the anti-scattered grid (without grid, f (o) = 115, f (o) = 180). EXI value measured​respectively to the entire prosthesis, ceramic cup in a metal bowl and titanium femoral decreases along with the use of grid with a larger angle of lead strips (f (o) = 180). Type of material applied in individual elements of prosthesis affect the value of the DAP. DAP increases when prosthesis is exposed at a distance of 115 cm FFD and anti-scattered gird f (o) = 180 is used, instead of f (o) = 115.
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