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"Teknik rekonstruksi double bundle ACL (DBACL) atau single bundle ACL (SBACL) adalah cara operasi untuk memperbaiki putusnya anterior cruciate ligament (ACL), namun teknik rekonstruksi terbaik masih menjadi perdebatan. Tes Lachman, tes Pivot, dan rolimeter memberikan gambaran stabilitas anterior dan rotasi sendi lutut sedangkan biomarker cartilage oligomeric matrix protein cairan sinovium lutut (sfCOMP) dan MRI T2-map dapat menggambarkan integritas kartilago sendi. Tujuan penelitian ini adalah menganalisis stabilitas sendi dan integritas kartilago untuk mengetahui teknik rekonstruksi ACL yang terbaik, DBACL atau SBACL.Dilakukan uji klinis acak tersamar tunggal pada pasien Rumah Sakit Pusat Angkatan Darat Gatot Soebroto Jakarta yang menjalani operasi rekonstruksi ACL pada Januari 2019– Januari 2022. Pada kedua kelompok dilakukan tes Lachman, tes pivot, dan rolimeter, serta penilaian sfCOMP dan p MRI T2-map. Uji statistik beda dua kelompok dilakukan setelah uji normalitas pada karakteristik subjek penelitian, luaran stabilitas dan integritas sendi pada saat sebelum operasi, setelah tiga dan enam bulan operasi. Seluruh data diuji normalitas sebarannya dengan menggunakan uji Shapiro-Wilk atau Kolmogorov-Smirnov. Analisis bivariat dilakukan dengan uji T tidak berpasangan atau Mann-Whitney, analisis data kategorik menggunakan uji Chi square, analisis berpasangan dengan menggunakan Friedman dan tes Wilcoxon. Uji korelasi menggunakan Spearman. Batas kemaknaan yang dianggap bermakna adalah p < 0,05.Dari 43 pasien yang dianalisis, sebanyak 22 pasien masuk kelompok SBACL dan 21 pasien kelompok DBACL. Tidak terdapat perbedaan bermakna pada tes Lachman (p = 0,849, p = 0,126, dan p = 0,466), tes pivot (p = 0,877, p = 0,678, p = 0,904), rolimeter (p = 0,395, p = 0,566, p = 0,455), sfCOMP (p = 0,375, p = 0,990, p = 0,409), MRI T2-map (p = 0,846, p = 0,106, p >0,999), dan MRI T2-map semikuantitatif (p = 0,970, p = 0,643, p = 0,190) pada kedua kelompok sebelum operasi serta setelah tiga bulan dan enam bulan operasi. Rerata pemeriksan stabilitas sendi setiap kelompok mengalami perbaikan dari sebelum operasi, setelah tiga bulan dan enam bulan operasi (p < 0,05). Kelompok SBACL dan DBACL tidak memiliki perbedaan bermakna pada nilai sfCOMP (SBACL, p = 0,58; DBACL, p = 0,084), MRI T2-map (SBACL, p = 0,055; DBACL, p = 0,717) dan MRI T2-map semikuantitatif (SBACL, p = 0,05; DBACL, p = 0,06) saat setelah tiga bulan dan enam bulan operasi. Biomarker sfCOMP menurun setelah tiga bulan dan tidak menunjukkan perbaikan setelah enam bulan pada kedua kelompok. Pemeriksaan rolimeter tidak memiliki perbedaan bermakna dengan penanda integritas kartilago sfCOMP dan MRI T2-map. Disimpulkan rekonstruksi DBACL memberikan luaran klinis, biokimia, dan radiologis setara dengan SBACL ditinjau dari tes Lachman, tes pivot, rolimeter, serta pengukuran sfCOMP dan penilaian MRI T2-map. Tidak ada perbedaan bermakna antara stabilitas sendi dengan kadar sfCOMP dan MRI T2-map, setelah operasi rekonstruksi SBACL dan DBACL.

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The double bundle ACL (DBACL) or single bundle ACL (SBACL) reconstruction technique is a surgical technique to repair the ruptured anterior cruciate ligament (ACL). Examination of the Lachman test, Pivot test, and rolimeter represent the anterior and rotational stability of the knee joint. In addition, the biomarker cartilage oligomeric matrix protein in synovial fluid of the knee (sfCOMP) and MRI T2-map can be used to provide an overview of joint cartilage integrity. Therefore, the best ACL reconstruction technique, DBACL or SBACL, can be identified by analyzing changes in joint stability and cartilage integrity.

A single-blind randomized clinical trial was conducted to determine whether DBACL reconstruction surgery is superior to SBACL reconstruction in terms of subclinical measurements of joint stability and cartilage integrity. Lachman test, pivot test, and rolimeter, as well as the sfCOMP measurement and the MRI T2-map assessment, were evaluated on both groups. In addition, normality tests on the characteristics of the study subjects on each outcome of joint stability and joint integrity were conducted, followed by paired and unpaired statistical tests of both groups.

Of the 43 patients analyzed, 22 were allocated to the SBACL group and 21 to the DBACL group. No significant difference was found on the Lachman test (p = 0.849, p = 0.126, and p = 0.466), pivot test (p = 0.877, p = 0.678, p = 0.904), and rolimeter (p = 0.395, p = 0.566, p = 0.455), as well as sfCOMP (p = 0.375, p = 0.990, p = 0.409), MRI T2-map (p = 0.846, p = 0.106, p > 0.999), and MRI T2-map semiquantitative (p = 0.970, p = 0.643, p = 0.190) in both groups before surgery, after three months and after six months postoperative. The mean value of the joint stability examination for each group improved from before surgery, after three months, and after six months postoperative (p < 0.05). The SBACL and DBACL groups had no significant difference in sfCOMP (SBACL, p = 0.58; DBACL, p = 0.084), MRI T2-map (SBACL, p = 0.055; DBACL, p = 0.717) and MRI T2-map semiquantitative (SBACL, p = 0.05; DBACL, p = 0.06) at three months and six months. The sfCOMP biomarker showed a decrease in values after three months and did not show further improvement after six months in both groups. Rolimeter examination did not significantly correlate with the cartilage integrity marker sfCOMP and MRI T2-map. DBACL reconstruction provides results that are equivalent to SBACL in terms of Lachman tests, pivot tests, and rolimeters, as well as sfCOMP measurements and MRI T2-map assessments. No significant relationship between joint stability and sfCOMP levels and MRI T2-map, both after SBACL and DBACL reconstructive surgery."

"This book reviews current knowledge on the diagnosis and treatment (surgical and non-surgical) of cartilage defects at the knee joint. In the discussion of diagnosis, the focus is primarily on imaging findings, particularly those obtained with MRI. The remainder of the book is devoted to the full range of current conservative and surgical treatments, with attention to both treatment indications and results as reported in the recent literature. In reviewing non-surgical treatment, oral and intra-articular medical management is evaluated and rehabilitation and physical therapy are also considered. The three main types of surgical technique, microfracture surgery and similar procedures, mosaicplasty and related techniques, and autologous chondrocyte transplantation, are then extensively discussed in a series of highly informative chapters. "

"Pendahuluan: Penurunan kekuatan otot quadriceps femoris dan otot hamstring merupakan komplikasi yang terjadi pada pasien post rekonstruksi Anterior Cruciate Ligament ACL jika rehabilitasi tidak dijalankan dengan tepat. Modalitas latihan di darat dan di air merupakan salah satu program rehabilitasi yang bermanfaat untuk meningkatkan kekuatan otot quadriceps femoris dan hamtring. Penelitian ini bertujuan untuk mengetahui efektifitas modalitas latihan di darat dan di air terhadap peningkatan kekuatan otot quadriceps dan hamstring pada pasien rehabilitasi post rekonstruksi ACL phase 3. Metode: Penelitian ini menggunakan quasi-experimental design dengan pendekatan pre-post test design pada 38 responden n kontrol= n perlakukan= 19. Latihan diberikan selama 60 menit dalam 12 kali pertemuan. Hasil: Terdapat perbedaan yang bermakna rerata kekuatan otot quadriceps femoris dan hamstring di darat p=0.000 dan p=0.000; alpha=0.05 ; di air p=0.000 dan p=0.000; alpa=0.05. Tidak ada perbedaan yang bermakna rerata kekuatan otot quadriceps femoris dan hamstring setelah diberikan latihan phase 3di darat dan di air p=0.146 dan p=0.231; alpha=0.05.

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Introduction Desreased strength of the quadriceps and hamstring muscles becomes a complication that occurs in post reconstruction patients Anterior Cruciate Ligament ACL if rehabilitation is not ecexuted properly. Modalities of exercise on land and in water is one of the programs that is beneficial for improving the muscle strength of quads and hamstring. This study aims to determine the effectiveness of training modalities on land and in water to increase the strength of quadriceps femoris and hamstring muscles in post reconstruction rehabilitation patients ACL phase 3. Method This study used quasi experimental design with pre post test design approach on 38 respondents n control n treatment 19. Exercises are given for 60 menutes in 12 meetings. Results There was asignificat difference mean of quadriceps femoris and hamstring muscle strength on land p 0.000 and p 0.000 alpha 0.05 in water p 0.000 and p 0.000 alpha 0.05. There was no significant difference in mean quadriceps femoris and hamstring muscle strength after phase 3 exercises on land and in water p 0.146 and p 0.231 alpha 0.05."

"[ABSTRAKLatar belakang : Cedera ligamentum krusiatum anterior merupakan salah satu cedera olahraga yang sering terjadi. Penanganan dengan operasi rekonstruksi diharapkan dapat membantu pasien untuk kembali melakukan aktivitas fisik seperti semula. Tujuan: Mengetahui aktivitas fisik dan kemampuan fungsional pasien 12-24 bulan pasca operasi rekonstruksi ligamentum krusiatum anterior akibat cedera olahraga, serta faktor-faktor yang mempengaruhinya. Metode: Dikumpulkan 11 subyek dari daftar rumah sakit tempat praktek dokter spesialis bedah ortopedi anggota IHKS dan IOSSMA. Data demografik dan kondisi fungsional subyektif lutut dikumpulkan menggunakan kuesioner IKDC, data aktivitas fisik menggunakan kuesioner aktivitas fisik Tegner, dan data kondisi fungsional obyektif lutut menggunakan tes lompat satu kaki. Hasil: Sebagian besar subyek memiliki indeks massa tubuh di atas normal dan kebiasaan merokok. Seluruh cedera ligamentum krusiatum anterior yang dialami terjadi akibat suatu mekanisme cedera non-kontak dengan biomekanisme yang khas, yaitu: permukaan plantar kaki menempel di lantai dan berada di posisi menjauhi pusat massa tubuh, sendi lutut berada dalam keadaan hampir ekstensi dan valgus, serta batang tubuh bergeser ke lateral. Namun, sebagian besar subyek tidak menjalani program rehabilitasi sebelum operasi rekonstruksi. Hampir seluruh subyek memiliki tingkat aktivitas fisik lebih rendah dibandingkan dengan tingkat aktivitas fisiknya sebelum cedera, dan alasan utamanya adalah karena adanya rasa takut untuk kembali ke aktivitas fisiknya seperti semula. Sebagian besar subyek memiliki kondisi fungsional sendi lutut yang buruk, baik secara subyektif maupun obyektif, dan didapatkan kecenderungan adanya hubungan antara hal tersebut dengan beberapa faktor, yaitu jarak waktu antara terjadinya cedera dengan dilakukannya operasi rekonstruksi, serta pemberian program rehabilitasi sebelum maupun sesudah operasi rekonstruksi. Kesimpulan: Pasien 12-24 bulan pasca operasi rekonstruksi ligamentum krusiatum anterior akibat cedera olahraga memiliki tingkat aktivitas fisik dan kemampuan fungsional yang rendah. Dan terdapat kecenderungan bahwa hal tersebut dipengaruhi oleh jarak waktu antara terjadinya cedera dengan dilakukannya operasi rekonstruksi, serta pemberian program rehabilitasi sebelum dan sesudah operasi rekonstruksi yang dijalani.

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ABSTRACTBackground: Anterior cruciate ligament (ACL) injury is one of the common sports injuries and one of the management strategy is by doing reconstruction surgery. It is hoped that the patient can get back to previous physical activity level after the surgery. Objective: To know the physical activity level and functional ability of patients 12-24 months post anterior cruciate ligament reconstruction surgery due to sports injury and their related factors. Methods: Eleven subjects were selected from hospitals where orthopedic surgeons of IHKS and IOSSMA having their practice. The followings data were collected: demographic and subjective functional knee evaluation using IKDC questionnaire, physical activity level using Tegner activity scale, and objective functional knee evaluation using single leg hop test. Results: Most of the subjects had high body mass index and smoking habit. All the anterior cruciate ligament injuries happened due to a non-contact mechanism with a classic biomechanics: plantar surface of the foot planted on the ground and positioned away from the center of mass of the body, valgus and almost fully extended knee, and lateral trunk motion. Unfortunately, most of the subjects did not have pre-surgical rehabilitation program. Almost all the subjects had a lower physical activity level compare to the one before injury, and the main reason was afraid to do their previous physical activity. Most of the subjects also had bad subjective and objective functional knee condition, and there was a possibility that it was affected by the time interval duration between the injury and reconstruction surgery, and the rehabilitation program given pre- and post-reconstruction surgery. Conclusion: The patients 12-24 months post ACL reconstruction surgery due to sports injury had low physical activity level and functional ability. There was a propensity that this condition was affected by the time interval duration between the injury and reconstruction surgery, and the rehabilitation program given pre- and post-ACL reconstruction surgery., Background: Anterior cruciate ligament (ACL) injury is one of the common sports injuries and one of the management strategy is by doing reconstructionsurgery. It is hoped that the patient can get back to previous physical activity levelafter the surgery.Objective: To know the physical activity level and functional ability of patients12-24 months post anterior cruciate ligament reconstruction surgery due to sportsinjury and their related factors.Methods: Eleven subjects were selected from hospitals where orthopedicsurgeons of IHKS and IOSSMA having their practice. The followings data werecollected: demographic and subjective functional knee evaluation using IKDCquestionnaire, physical activity level using Tegner activity scale, and objectivefunctional knee evaluation using single leg hop test.Results: Most of the subjects had high body mass index and smoking habit. Allthe anterior cruciate ligament injuries happened due to a non-contact mechanismwith a classic biomechanics: plantar surface of the foot planted on the ground andpositioned away from the center of mass of the body, valgus and almost fullyextended knee, and lateral trunk motion. Unfortunately, most of the subjects didnot have pre-surgical rehabilitation program. Almost all the subjects had a lowerphysical activity level compare to the one before injury, and the main reason wasafraid to do their previous physical activity. Most of the subjects also had badsubjective and objective functional knee condition, and there was a possibility thatit was affected by the time interval duration between the injury and reconstructionsurgery, and the rehabilitation program given pre- and post-reconstructionsurgery.Conclusion: The patients 12-24 months post ACL reconstruction surgery due tosports injury had low physical activity level and functional ability. There was apropensity that this condition was affected by the time interval duration betweenthe injury and reconstruction surgery, and the rehabilitation program given pre- and post-ACL reconstruction surgery.]"

"Anterior knee pain (AKP) sering disamakan dengan nyeri patellofemoral, merupakan keluhan yang sering dirasakan dari individu yang aktif secara fisik. Pada militer kejadian AKP sering tidak terlaporkan sehingga diperlukan instrumen evaluasi luaran klinis khususnya pada populasi militer. Anterior knee pain scale (AKPS) atau Skor Kujala, dalam Bahasa Indonesia merupakan instrumen yang sudah terbukti sahih dan andal mengevaluasi keterbatasan fungsional pada pasien umum dengan diagnosis patellofemoral pain syndrome. Tesis ini bertujuan untuk menguji kesahihan dan keandalan kuesioner AKPS versi Bahasa Indonesia pada prajurit militer khususnya Kostrad dengan nyeri lutut anterior. Metode penelitian adalah studi potong lintang dengan jumlah subjek 34 orang yang sesuai kriteria inklusi dan eksklusi. Subjek kemudian dilakukan inform consent, pemeriksaan fisik, pengisian kuesioner, dan dilakukan test-retest kuesioner pada hari ke tiga sejak pengisian pertama. Hasil penelitian didapatkan koefisien korelasi antara 0,423-0,779, dan Cronbach’s alpha keseluruhan adalah 0,806. Nilai ICC 0,993 dengan tingkat kepercayaan 95%. Hasil analisis menunjukkan nilai korelasi dan konsistensi internal diatas nilai minimal yang berarti sahih dan andal dengan tingkat signifikansi p<0.05. Kesimpulannya, AKPS versi Bahasa Indonesia terbukti sahih dan andal digunakan sebagai alat ukur keterbatasan fungsional penderita nyeri lutut anterior pada prajurit militer.

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Anterior knee pain (AKP) is often referred to as patellofemoral pain and is often felt in physically active individuals. The incidence of AKP often goes unreported in the military, so clinical outcome evaluation instruments are needed, especially in the military population. Anterior knee pain scale (AKPS) or Kujala Score in the Indonesian version, is an instrument that has been proven valid and reliable to evaluate functional limitations in patients with a diagnosis of patellofemoral pain syndrome. This study aims to test the validity and reliability of the Indonesian version of the AKPS questionnaire on military soldiers, especially Kostrad with anterior knee pain. Study design is cross sectional with the total of subject are 34 that met the inclusion and exclusion criteria. Subjects were then given informed consent, physical examination, filling out the questionnaire, and a test-retest was conducted for filling out the questionnaire on the third day after the first filling. The results showed that the correlation coefficient was between 0.423-0.779, and the overall Cronbach's alpha was 0.806. The ICC value is 0.993 with a 95% confidence level. The results of the analysis show that the correlation and internal consistency values are above the minimum value, which means they are valid and reliable with a significance level of p<0.05. In conclusion, the Indonesian version of the AKPS proved valid and reliable to measure functional limitations in patients with anterior knee pain in military soldiers."

"Latar BelakangLama mengemudi lebih dari 8 jam per hari, serta berbagai faktor pekerjaan lain, seperti posisi kerja dapat menimbulkan nyeri lutut akul pada pengemudi taksi. Pada taimn 2000, di Taipei telah di lakukan penelitian kesehatan untuk pengemudi taksi, di dapatkan prevalensi nyert lutut pada yang mengemudi lebih dari I 0 jam sebesar 22%,Mctode penclitianDesain peneiitian ini adalah potong lintang. Pemilihan subyek dilakukan secara consecutive pada pekerja yang datang ke pool saat studi dilakukan. Terpilih 300 sampel dari populasi beijumlah 1349 orang. Variabel dependen adalah nyeri lutut akut, dan variabel independen adalah umur, pendidikan, status gizi, kebiasaanolah raga, riwayat berhenti berolah raga, pekerjaan tambahan, lama rnengemudi, masa kerja, siklus kerja, proporsi macet, pencapaian target penghasiian, shift kerja, besar sudut fleksi lutut sewaktu menglnjak pedal. Pengumpulan data· dHakukan dengan pengisian kuisloner,logsheet dan body map, perneriksaan fisik, pengukuran kedua sudut lutut.HasilDari 300 responden, didapatkan 95 orang (31,7%) mengalami nyeri lutut akut, diantaranya 14,7% nyeri lutut kanan saja, 27,37% nyeri lutut kiri saja dan 57,89% nyeri lutut kanan dan kiri. Pada analisis bivariat tidak ditemukan adanya hubungan bennakna dari 13 variabel tcrsebut dengan terjadinya nyeri lutut Ada 5 dari 13 variabel, yang diikutsertakan dalam analisis multivariat dan tidak didapatkan faktor dominan terjadinya nyeri lutut akut. Tetapi dari analisis antara besar sudut lutut kiri dengan nyeri lulut akut pada sendi lutut kiri, didapatkan hubungan yang bermakna (OR= 1,904 CI 1,028-3,530).

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BackqroundDriving for more than 8 hours and other work factors, such as awkward position can cause acute knee pain among taxi drivers. A research conducted in Taipei (2000) found the prevalence of knee pain among drivers that drove more than 10 hours per day was 22%.Research method:This study used a cross sectional design. Subjects were selected consecutively among drivers that arrived in the pooL A sample of 300 drivers were selected from 1349. The dependent variable was acute knee pain, and independent variables were age, education, nutritional status, exercise habits, history of quitting exercising, extra work, period of driving working period, duty cycle, proportion of traffic jam, achievement of target, working shifts, knee flexion angle. Data collection was conducted using questionnaire. log sheet and body map, physical examination, and measurement of both the knee angles .ResultOf the 300 respondents, 95 people (3l.7%) experienced acute knee pain, 14.7% of had only right knee pain, 27.37% left knee pain only and 57.89"/o right and left knee pain. Bivariate analysis did not reveal any significant relationship of 13 variables with the occurrence of knee pain. There are five of the 13 variables, which is included in multivariate analysis and no dominant factors of acute knee pain were found. But on the analysis of angle of the left knee with acute knee pain in the left knee joint, a significant relationship (OR 1.904 Cl 1.028 to 3.530)."

"Latar Belakang: Gangguan sendi temporomandibula memiliki etiologi yang kompleks dan multifaktorial, salah satunya adalah stres. Pada masa pandemi COVID-19 stres mahasiswa meningkat karena adanya perubahan sistem pembelajaran dari tatap muka menjadi daring. Penelitian mengenai hubungan stres mahasiswa selama pembelajaran daring dengan gangguan sendi temporomandibula belum pernah dikaji sebelumnya.Tujuan: Mengetahui hubungan antara stres mahasiswa selama pembelajaran daring dengan gangguan sendi temporomandibula, mengetahui hubungan gangguan sendi temporomandibula dengan jenis kelamin selama pembelajaran daring, dan mengetahui hubungan antara gangguan sendi temporomandibula dengan durasi, dan frekuensi pembelajaran daring.Metode: Desain penelitian ini adalah penelitian potong lintang yang dilakukan pada 351 mahasiswa Universitas Indonesia. Partisipan penelitian diberikan dua buah kuesioner, yaitu Perceived Stress Scale (PSS) versi bahasa Indonesia untuk mengukur stres dan Temporomandibular Disorders Diagnostic Index (TMD-DI) untuk mengukur gangguan sendi temporomandibula.Hasil Penelitian: Uji Mann-Whitney menunjukkan terdapat hubungan antara stres mahasiswa selama pembelajaran daring dengan gangguan sendi temporomandibula (p<0.05). Uji Chi-square menunjukkan tidak terdapat hubungan antara gangguan sendi temporomandibula dengan jenis kelamin selama pembelajaran daring (p>0.05). Uji Chi-square menunjukkan bahwa tidak terdapat hubungan antara gangguan sendi temporomandibula dengan durasi dan frekuensi pembelajaran daring (p>0.05).Kesimpulan: Terdapat hubungan antara stres mahasiswa selama pembelajaran daring dengan gangguan sendi temporomandibula.

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Background: Temporomandibular disorders has complex and multifactorial etiology, particularly stress. During pandemic COVID-19 student stress has increased by changes in learning system from face-to-face into e-learning. The study to analyze the relationship between student stress during e-learning and temporomandibular disorders never been conducted.

Objectives: This study aimed to assess the relationship of student stress during e-learning and temporomandibular disorders, analyze the relationship between temporomandibular disorders and gender during e-learning, and analyze the relationship between temporomandibular disorders with duration and frequency of e-learning.

Methods: The number of 351 students of Universitas Indonesia participated in this cross- sectional study. Each participant is given two questionnaires. Perceived Stress Scale (PSS) Indonesian version to assess stress and TMD-DI to assess temporomandibular disorders.

Result: The Mann-Whitney test showed there was a relationship between student stress during e-learning learning and temporomandibular disorders (p<0.05). Chi- square test showed there was no relationship between temporomandibular disorders and gender during e-learning (p>0.05). Chi-square test showed there was no relationship between temporomandibular disorders with duration and frequency of e-learning (p> 0.05).

Conclusions: There was a relationship between student stress during e-learning and temporomandibular disorders."

"ABSTRAKOperasi Total knee replacement (TKR) adalah prosedur pilihan pada penanganan osteoartritis berat. Terdapat dua jenis prostesis yang umum digunakan, yaitu cruciate retaining (CR) dan cruciate substituting (CS). Belum ada kesepakatan ahli mengenai mana prostesis yang lebih baik. Penelitian ini bertujuan untuk membandingkan luaran fungsional pasien yang menjalani TKR menggunakan dua jenis prostesis tersebut. Penelitian ini merupakan uji klinis acak tersamar ganda. Pasien dengan osteoartritis berat dibagi 2 kelompok dan dinilai luaran fungsional 3 bulan dan 6 bulan pasca-TKR. Hasilnya sudut fleksi lutut kelompok CS lebih baik 13,1 derajat setelah 3 bulan dan 12,9 derajat setelah 6 bulan. Penilaian subjektif menggunakan skor IKDC tidak terdapat perbedaan bermakna antara kedua kelompok.

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ABSTRACTTotal knee replacement (TKR) is a procedure of choice in the management of severe osteoarthritis. Currently two types of prosthesis are widely used, cruciate retaining (CR) and cruciate substituting (CS). Experts has not yet reached agreement regarding which one is better. This study aims to compare functional outcome between the two types of prosthesis. This study was a randomized double-blind clinical trial. Patients with severe osteoarthritis were divided into two groups, and evaluated in 3 and 6 months after operation. Result of this study were that flexion angle of CS group was 13,1 degrees better in 3 months and 12,9 degrees in 6 months. Subjective evaluation using IKDC score did not show significant differences between two groups."

"Pendahuluan: Cedera ACL merupakan penyakit dengan impact besar pada pasien usia produktif. Pada penelitian ini, fokus utama adalah pilihan graft. Autograft quadriceps merupakan pilihan yang rasional untuk masyarakat Asia dimana diameter serta panjang tendon hamstring lebih kecil. Kami bermaksud melakukan perbandingan luaran klinis antara autograft quadriceps dan hamstring pada kasus rekonstruksi ACL per artroskopik.Metode: Desain penelitian adalah kohort prospektif. Tiga puluh pasien diikutsertakan dalam studi ini yang dibagi menjadi dua grup (quadriceps dan hamstring). Pengambilan data berlangsung selama 1 tahun (Februari 2016-2017) di RSPAD Gatot Subroto dan RS Cipto Mangunkusumo, Jakarta. Instrumen yang digunakan adalah rolimeter dan 3 buah kuesioner (IKDC, Tegner-Lysholm, dan KOOS). Evaluasi dilakukan secara repeated time measurements.Hasil: Rerata rolimeter kelompok quadriceps 3,12 ± 0,94 dan kelompok hamstring 3,87 ± 0,61 (p=0,015). Parameter side to side difference didapatkan lebih baik pada kelompok quadriceps (0,34 ± 0,70) dibandingkan hamstring (0,84 ± 0,60) dengan p=0,04. Pada skor IKDC, didapatkan data 1 bulan (p=0,002; rentang 95%IK [8,81-31,79]) dan 3 bulan (p=0,004; 95%IK [4,85-20,39]) paska operasi yang baik. Skoring Tegner-Lysholm bermakna pada kedua data (numerik dan kategorik). Pada data numerik (1 bulan paska operasi), didapatkan nilai p=0,004 yang sinkron dengan data kategorik (p=0,050). Untuk skoring KOOS, didapatkan hasil bermakna pada 3 dan 6 bulan paska operasi pada sub-item nyeri (p=0,034) serta symptoms (p=0,001).Diskusi: Luaran klinis pada kelompok quadriceps lebih baik dibandingkan hamstring, baik secara parameter obyektif maupun subyektif.

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Introduction: ACL rupture has a high impact in productive-age population. In this research, the main focus is the graft choice. Quadriceps is a rational choice for Asian population in which the diameter and length of the hamstring tendon is small. In this research, we evaluate the clinical outcome between quadriceps and hamstring autografts in arthroscopic-assisted ACL reconstruction. Methods: Research design was prospective cohort. Total sample was 30 patients divided into 2 groups (quadriceps and hamstring). Sampling was taken between February 2016-2017 (1 year) in Army Hospital Gatot Subroto and Cipto Mangunkusumo Hospital, Jakarta. Instruments used in this study are the rolimeter and questionnaires (IKDC, Tegner-Lysholm, dan KOOS). Data assessment was carried out in repeated time measurements.Results: Mean difference of quadriceps (3,12 ± 0,94) and hamstring (3,87 ± 0,61) is statistically different (p=0,015). Side to side difference shows better result in quadriceps (0,34 ± 0,70) compared to hamstring (0,84 ± 0,60) with p=0,04. IKDC scores in 1 month (p=0,002; CI95% [8,81-31,79]) and 3 months (p=0,004; CI95% [4,85-20,39]) post operative is better in quadriceps group. In Tegner-Lysholm assessment (1 month post operative), the numbers were consistent between numeric data (p=0,004) and categoric data (p=0,050) in quadriceps group. There was an improvement during 3 and 6 months post operative KOOS sub-item scales; pain (p=0,034) and symptoms (p=0,001). Discussion: The functional outcome of quadriceps group was better than hamstring group, based on objective and subjective parameters."